Personalized modeling for real-time pressure ulcer prevention in sitting posture. Issue 1 (February 2018)

• Record Type: Journal Article
• Authors: Luboz, Vincent; Bailet, Mathieu; Boichon Grivot, Christelle; Rochette, Michel; Diot, Bruno; Bucki, Marek; Payan, Yohan
• Is Part Of: Journal of tissue viability. Volume 27:Issue 1(2018)
• Page Start: 54
• Page End: 58
• Publication Date: 2018-02
• Subjects: Biomechanical modeling -- Reduced order model -- Pressure ulcer prevention; Wounds and injuries -- Periodicals; Ulcers -- Periodicals; Bedsores -- Periodicals; Bedsores; Ulcers; Wounds and injuries; Electronic journals; Periodicals; 617.1406
• DOI: 10.1016/j.jtv.2017.06.002
• Languages: English
• ISSNs: 0965-206X

Abstract

Abstract: Ischial pressure ulcer is an important risk for every paraplegic person and a major public health issue. Pressure ulcers appear following excessive compression of buttock's soft tissues by bony structures, and particularly in ischial and sacral bones. Current prevention techniques are mainly based on daily skin inspection to spot red patches or injuries. Nevertheless, most pressure ulcers occur internally and are difficult to detect early. Estimating internal strains within soft tissues could help to evaluate the risk of pressure ulcer. A subject-specific biomechanical model could be used to assess internal strains from measured skin surface pressures. However, a realistic 3D non-linear Finite Element buttock model, with different layers of tissue materials for skin, fat and muscles, requires somewhere between minutes and hours to compute, therefore forbidding its use in a real-time daily prevention context. In this article, we propose to optimize these computations by using a reduced order modeling technique (ROM) based on proper orthogonal decompositions of the pressure and strain fields coupled with a machine learning method. ROM allows strains to be evaluated inside the model interactively (i.e. in less than a second) for any pressure field measured below the buttocks. In our case, with only 19 modes of variation of pressure patterns, an error divergence of one percent is observed compared to the full scale simulation for evaluating the strain field. This reduced model could therefore be the first step towards interactive pressure ulcer prevention in a daily set-up. Highlights: A reduced order model of a Finite Element buttocks model is proposed. It is based on a training set of pressure measurements and simulations. It relies on a proper orthogonal decompositions coupled with a machine learning method. It allows optimizing the computation to reach quasi real time interactions. The reduced model could be integrated in a daily pressure ulcer prevention set up.