The Sonenblum Clinical Research Group (SCRG) 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!

The role of repositioning and movement in pressure ulcer prevention

iPhone screen displaying gauges. The gauges approximately 1/3 full and report the Weight Shifts and In-Seat Movement Scores.

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.

Pressure ulcer risk assessment and big data

3D rendering of a buttocks with heavily contoured peaks at the ischium.

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.

The use of mixed methods to explore the experiences of wheelchair users

Vertical bar graph with 4 bars, representing time spent at home, in a vehicle, occupancy and bouts. Time in vehicle does not overlap with time at home. Bouts and occupancy are during the day.

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.