Areas of Research
The Sonenblum Clinical Research Group is dedicated to improving healthcare and increasing the health and function of people with disabilities through applied clinical research. Our work cuts across disciplines and welcomes people from all backgrounds as we bridge the gap between researchers, engineers and clinicians. Below, you will find descriptions of a few of our research projects. Please reach out for more information as we are always adding new projects!
Pressure Injury Risk Assessment
If you are a clinician, or a scientist who has spent time reading the literature, you probably have found yourself asking the question… “how did this person NOT break down?” The SCRG uses clinical research to answer that question, as well as the question of how we provide the best interventions based on this knowledge. To better understand individual risk, we have studied:
Blood flow
Adipose characteristics
Interface pressure
Big data analyses
In-seat movement patterns
We have devoted considerable attention to Biomechanical Risk, or the intrinsic characteristic of an individual’s soft tissues to deform in response to extrinsic applied forces. In other words, when you push on the butt (or other relevant body part), what does it do? Does it collapse like cottage cheese practically exposing the bone (e.g., High Biomechanical Risk) or does it remain in place, providing a nice layer of padding (Low Biomechanical Risk)? Our current effort is to better understand the role of adipose tissue, as there is some evidence that plays a bigger role in pressure ulcer development than we give it credit for. Keep an eye out to see if the data supports our hypothesis.
Our most recent adipose publication can be found here – An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History.
Early Detection of Pressure Injuries in Individuals with Diverse Skin Tones
Early detection of pressure injuries is crucial, beginning with identifying subtle skin changes that may indicate underlying damage. However, these signs can be challenging to spot, especially in individuals with darker skin tones. Nurses have reported difficulty recognizing early indicators in these patients, potentially leading to increased risk of prolonged hospital stays, infections, and in severe cases, premature death. To address this disparity, we're investigating the effectiveness and practical implementation of bedside technologies such as colorimeters, thermal cameras, and oximeters. These devices enable healthcare professionals to assess subcutaneous changes invisible to the naked eye, potentially reducing inequities in pressure injury prevention and care across all skin tones.
The use of mixed methods to explore the experiences of wheelchair users
In this work, we use quantitative data obtained by monitoring wheelchair use to augment qualitative research methods when trying to answer questions about experiences of wheelchair users. Most recently, we explored perceptions and life experiences of racially/ethnically diverse persons with SCI to identify the personal, cultural and contextual factors that may impact their engagement in daily activities.
How does this work? After a lot of behind the scenes preparation by the study team, we monitor objective activity data about study participants (e.g., time in wheelchair, bouts of mobility, vehicle trips, time out of the house). Then the quantitative team in the SCRG interprets the data and turns it into a story, creating a list of information and questions for the qualitative team that support the study’s research questions. The qualitative team works these details into their semi-structured interviews to create much richer data than either team could have produced alone. The output allows us to observe patterns of health outcomes, experience of discrimination, and wheelchair activity among a diverse population living with SCI. From here we can identify targeted interventions.
The role of repositioning and movement in pressure ulcer prevention
The SCRG has a research interest in measuring, analyzing, and interpreting how people move in their everyday lives. We also study the physiological impacts of these movements. Together, these efforts are designed to provide the needed evidence to answer some key questions:
Why can some people remain stationary for long periods of time, and not develop a pressure ulcer?
How do we tailor repositioning guidelines according to individual factors?
How much movement is good enough?
For examples of our work, read about in-seat movement in this article – Some people move it, move it… for pressure injury prevention, and the psychological impact of movement in this article – Effects of wheelchair cushions and pressure relief maneuvers on ischial interface pressure and blood flow in people with spinal cord injury.