Assessment of movement in the elderly during sleep with reference to pressure sore prevention
This thesis describes the assessment of movement in the elderly with reference to pressure prevention. Chapter 1 provides an introduction to the problem of pressure sores, and outlines the importance of age and immobility in their causation. Chapter 2 contains a review of the literature pertaining to the aetiology and epidemiology of pressure sores. A study conducted by the author at McGill University, into the pathophysiology of pressure sores - using the pig as an experimental model, is described. Chapter 3 discusses the previous published work on movement during sleep. Typical patterns of movement during sleep, and principles and techniques used to monitor overnight mobility are described. Chapter 4 describes an investigation into the relationship between body - support surface interface pressure and overnight mobility. Previously established monitoring systems were utilised. A high degree of correlation between the two variables was established. Chapter 5 deals with the desig n and development of a mobility monitoring system for routine use in the clinical environment. The system consists of three elements, force transducers, processing instrumentation - the output of which is representative of the size of move by the patient, and an F.M. analogue tape recorder - used to transfer the mobility data between the hospital and the laboratory. Chapter 6 contains a review of present methods of assessment of patients with reference to their risk of developing sores, selection of elderly subjects, an outline of the experimental protocol utilised and techniques of analysing the data. Chapter 7 contains the results of the experimental investigation into overnight mobility of elderly patients in hospital, with associated discussion. These results indicate the feasibility of developing simple, reliable parameters to characterise body movements during sleep in a clinical environment and that there are clinical factors associated with consistently low mobility. Chapter 8 provides a summary of this thesis. Relevant appendices and bibliography are included at the end of the thesis.