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Sprigle,
Stephen
Sprigle,
Stephen
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0000-0003-0462-0138
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ItemWheelchair in-seat monitoring design considerations(Georgia Institute of Technology, 2022-10) Sprigle, Stephen ; Sonenblum, Sharon Eve ; Deshpande, Yogesh ; Jordan, KathleenWheelchair in-seat activity trackers are developed to monitor and provide feedback about the pressure redistributing movements of wheelchair users, including weight shifts and other postural shifts that redistribute buttocks pressures. From a design perspective, in-seat activity trackers reflect myriad design decisions that impact performance, function, and usability. Many, if not all, of these decisions involve interconnections across system components, and can have significant impact on tracker operation and user-experience. Technology developers will have to manage many benefits and trade-offs that accompany design of each subsystem. Two documents were created based upon real-world use of in-seat trackers to briefly identify design criteria and constraints that should be considered.
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ItemAn Exploratory Analysis of The Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History - Supplementary Data(Georgia Institute of Technology, 2021) Sonenblum, Sharon Eve ; Measel, Megan ; Sprigle, Stephen ; Greenhalgh, John ; Cathcart, John McKayThe goals of this study were 1) to identify the relationship between adipose (subcutaneous and intramuscular) characteristics and pressure injury (PrI) history in wheelchair users, and 2) to identify subject characteristics, including Biomechanical Risk, that are related to adipose characteristics. Data in the supplement is associated with 43 full-time wheelchair users with and without a history of pelvic pressure injuries. Their buttocks were scanned in a seated posture in a FONAR UPRIGHT® MRI. Intramuscular adipose (the relative difference in intensity between adipose and gluteus maximus) and the subcutaneous adipose characteristics (the relative difference in intensity between subcutaneous adipose under and surrounding the ischium) were compared to pressure injury history and subject characteristics. Participants with a history of PrIs had different subcutaneous fat (subQF) characteristics than participants without a history of PrIs. Specifically, they had significantly darker adipose under the ischium than surrounding the ischium than participants without a history of PrIs. On the other hand, only when individuals with complete fat infiltration (n=7) were excluded, did individuals with PrI history have more fat infiltration than those without a PrI history. Presence of spasms and fewer years using a wheelchair were associated with leaner muscle. The results of the study suggest the hypothesis that changes in adipose tissue under the ischial tuberosity (presenting as darker SubQF) are associated with increased biomechanical risk for pressure injury. Further investigation of this hypothesis, as well as the role of intramuscular fat infiltration in PrI development may help our understanding of PrI aetiology. It may also lead to clinically-useful diagnostic techniques that can identify changes in adipose and biomechanical risk to inform early preventative interventions.
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ItemButtock tissue response to loading in men with SCI dataset(Georgia Institute of Technology, 2018-01-26) Sonenblum, Sharon Eve ; Sprigle, StephenObjective/Background: Despite the fact that most people with a spinal cord injury who use a wheelchair for mobility are considered at-risk for pressure ulcer (PrU) development, there still exists a spectrum of risk amongst this group. Efforts to differentiate risk level would benefit from clinical tools that can measure or predict the buttocks response to loading. Therefore, the goal of this study was to identify how tissue compliance and blood flow were impacted by clinically-measurable risk factors in young men with SCI. Methods: Blood flow at the ischial tuberosity was measured using laser Doppler flowmetry while the seated buttock was unloaded, and loaded at lower (40-60 mmHg) and high (>200 mmHg) loads. Tissue compliance of the buttock was measured using the Myotonometer while subject were lifted in a Guldmann Net. Results: Across 28 participants, blood flow was significantly reduced at high loads, while no consistent, significant changes were found at lower loads. At 40-60 mmHg, blood flow decreased in participants with a pressure ulcer history and lower BMI, but stayed the same or increased in most other participants. The buttock displaced an average of 9.3 mm (2.7 mm) at 4.2 N, which represented 82% (7%) of maximum displacement. BMI was related to the amount of buttock tissue displacement while smoking status explained some of the variation in the percent of max displacement. Conclusion: Wide variability in tissue compliance and blood flow responses across a relatively homogeneous population indicate that differences in biomechanical risk may provide an explanation for the spectrum of PrU risk among persons with SCI.
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ItemMobility Metrics for Manual Wheelchair Use in Everyday Life(Georgia Institute of Technology, 2010-06) Lopez, Ricardo A. ; Sonenblum, Sharon Eve ; Sprigle, StephenIn this study, a method for the robust detection of manual wheelchair movement with accelerometer-based data logging is used to obtain metrics of wheelchair mobility that complement mean- and total-distance-only based measurements. It is found that these metrics, that include distance, time and number of activity bouts, provide better understanding of everyday use of manual wheelchairs by shedding more light into how users operate their wheelchairs in their daily lives.
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ItemBlood Flow and Pressure Changes That Occur With Tilt-in-Space(Georgia Institute of Technology, 2010-06) Sonenblum, Sharon Eve ; Sprigle, StephenThe objective of this study was to evaluate the biomechanical responses to tilt in persons with SCI. Changes in blood flow and loading at the ischial tuberosities (ITs) across different amounts of tilt were measured with Laser Doppler flowmetry and interface pressure. Pressure reduction at the IT was not present at 15°, but did occur with tilts to 30° and greater. Unlike pressure, blood flow increased with all tilts from an upright position. Only 4 of 11 participants had a considerable increase (≥10%) in blood flow at 30° tilt, whereas 9 participants did during maximum tilt (i.e., 45°-60°). Based on the results of this study, tilting for pressure reliefs as far as the seating system permits is recommended to maximize the potential for significant blood flow increases and pressure relief. The use of interim small tilts is also supported, as they also provide some benefit.
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ItemA Data Processing Method to Measure the Use of Manual Wheelchairs(Georgia Institute of Technology, 2009) Sonenblum, Sharon Eve ; Caspall, Jayme ; Lopez, Ricardo ; Sprigle, Stephen
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ItemBlood Flow and Pressure Changes That Occur With Tilt-in-space(Georgia Institute of Technology, 2009) Sonenblum, Sharon Eve ; Sprigle, Stephen
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ItemUnderstanding Wheelchair Use Patterns: Tilt-in-Space(Georgia Institute of Technology, 2008-03) Sonenblum, Sharon Eve ; Sprigle, Stephen ; Harris, Frances ; Maurer, Chris
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ItemCharacterization of Power Wheelchair Use in the Home and Community(Georgia Institute of Technology, 2008) Sonenblum, Sharon Eve ; Sprigle, Stephen ; Harris, Frances ; Maurer, Christine L.Objective: To characterize the use of power wheelchairs and to determine if multiple measures of mobility and occupancy jointly provide a more comprehensive picture of wheelchair usage and daily activity in full-time power wheelchair users than daily distance alone. Design: Prospective observational study. Setting: Subjects’ everyday mobility was measured in their homes and communities for two weeks and prompted recall interviews were conducted by phone. Participants: A convenience sample of 25 non-ambulatory, full-time power wheelchair users. Interventions: Not applicable. Main Outcome Measures: Wheelchair usage was logged electronically and GPS / interview data were used to isolate chair use to home, indoors but not at home and outdoor environments. Distance wheeled, time spent wheeling, number of bouts, time spent in the wheelchair and the percent of time in the wheelchair spent wheeling were measured to describe wheelchair use. Results: The median wheelchair user spent 10.6 hours (5.0-16.6) in his/her wheelchair daily and wheeled 1.085 km (0.238-10.585) over 58 minutes (16-173) and 110 bouts (36-282). Wheelchair use varied across subjects, within subjects from day-to-day, and between environments. Mobility bouts outdoors were longer and faster than those wheeled indoors. In a regression analysis, distance wheeled explained only 33% of the variation in the number of bouts and 75% in the time spent wheeling. Conclusions: Power wheelchair use varies widely both within and between individuals. Measuring distance, time and number of bouts provides a clearer picture of mobility patterns than measuring distance alone, while occupancy helps to measure wheelchair function in daily activities.
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ItemImpact of Tilt-in-Space Power Wheelchairs on Health, Activity, and Participation(Georgia Institute of Technology, 2008) Harris, Frances ; Sonenblum, Sharon Eve ; Sprigle, Stephen ; Maurer, Christine L.This paper reports the results of a pre-post outcomes study on the impact of tilt-in-space power wheelchairs on the health, activity, and participation of 5 subjects. Using a methodology which combines traditional self-reports and activity monitoring technology, subjects who had previously used an upright power wheelchair were monitored at baseline and 3 months following receipt of a new tilt-in-space power wheelchair. Subjects visited similar numbers of destinations pre and post. However, wheelchair use metrics - including occupancy time, distance wheeled, and number of bouts - varied pre and post, without a consistent direction of change. Quality of life measured as self-perceived health status increased in all subjects. Although subject population is too small to generalize results, this study illustrates the complexity of participation measurement and the utility of this methodology to provide insights into the relationship between wheelchair use and activity and participation.