PRAISE (Pressure Relief Assessment Information System): A Paradigm-shifting Mobile Health Platform for Pressure Relief Adherence in Manual Wheelchair Users
openNIBIB - National Institute of Biomedical Imaging and Bioengineering
TITLE: PRAISE (Pressure Relief Assessment Information System): A Paradigm-shifting Mobile Health
Platform for Pressure Relief Adherence in Manual Wheelchair Users
PROJECT SUMMARY:
The proposed project aims to create a pressure relief assessment information system (PRAISE) to enhance the
adherence of manual wheelchair users to Clinical Practice Guidelines (CPGs) designed to prevent pressure
ulcers. The motivation of this research stems from two core challenges. First, pressure ulcers pose a serious
threat to manual wheelchair users with spinal cord injuries, frequently leading to painful complications, infections,
and even premature death. To reduce pressure ulcer risks, CPGs recommend that wheelchair users perform
pressure relief activities (i.e., vertical pushups, lateral, and forward leans) every 15 to 30 minutes. However,
research reveals that wheelchair users may not adhere to CPGs in everyday life. Second, no universally adopted
tools currently exist to monitor CPG adherence, nor is the understanding of factors leading to non-adherence.
As a result, the prevalence of pressure ulcers among wheelchair users with spinal cord injuries remains high.
Built upon the International Classification of Functioning, Disability and Health (ICF) model, PRAISE will shift
from the conventional singular focus on adherence to a holistic approach, which will cohesively integrate a user's
health, personal, and environmental factors through its multidimensional design. First, PRAISE will enable users
to create profiles, including demographics, wheelchair usage patterns, and medical records related to pressure
ulcers. Second, this foundational data will be augmented by a spectrum of sensor data (i.e., accelerometer, heart
rate, GPS, and battery life) from a smartwatch, critical for ecological momentary assessments (EMAs). Third,
our novel distributed algorithm can accurately detect pressure relief activities without relying on frequent, costly
internet connections. It achieves this through lightweight processing on mobile devices to capture patterns
intrinsic to pressure relief activities, hence transmitting only relevant data segments to the server for fine-grained
recognition. Fourth, grounded in the ICF framework, PRAISE will dynamically integrate user-specific health,
personal, and environmental factors to deliver context-aware feedback and personalized guidance. Through
reinforcement learning, PRAISE will continuously evolve its guidance by learning from user responses and
behavior, ensuring that interventions remain effective and tailored to individual needs over time.
In collaboration with a diverse advisory team, PRAISE's development will prioritize robust security, user-
friendliness, advanced analytics, and customizable assessment modules. Once the advisory team completes
the initial validation, a feasibility and acceptability assessment will be conducted by involving 15 manual
wheelchair users for two weeks. To gain a deeper understanding of user experiences, we will employ multifaceted
approaches to gather and analyze user feedback. As PRAISE strives to make pressure ulcer prevention more
accessible and personalized for wheelchair users, it will help reduce health disparities, particularly for those who
may not have easy access to traditional healthcare resources. Therefore, PRAISE will revolutionize care for the
manual wheelchair users to achieve patient-centric, evidence-based interventions.
Up to $381K
health research