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Currently, there is a lack of adoption and evidence demonstrating the effectiveness of technologies aimed at preventing pressure injuries. This study presents and evaluates a new monitoring and feedback system to facilitate pressure relief activity performance in 22 manual wheelchair users with SCI. After a two-week baseline, participants received pressure injury education, set goals, and were instructed on how to use the system. Data were then collected using the system for 8\u2009months, and a technology acceptance model (TAM) questionnaire was used to assess usability, with 10 participants identified as Responders. Immediately following goal setting and system biofeedback activation, Responders showed a four-fold increase in pressure relief activity (4.48\u00b14.24 versus 23.37\u00b114.85\u2009s\/h, p\u2009=\u20090.004) but activity eventually declined to baseline levels by month 8 (4.26\u00b15.78\u2009s\/h). Recorded sitting time also dropped significantly (5.62\u00b13.30\u2009h\/day at Baseline versus 1.81\u00b12.08\u2009h\/day at months 6\u20138, p\u2009=\u20090.013). Thirty-six out of 40 questionnaire items scored above the acceptability threshold (&amp;gt;5\/7). The system demonstrated good acceptability and effectively promoted short-term increases in pressure relief activity. Its greatest value may be as a short-term training tool during rehabilitation or retraining. Future iterations of the system must address limitations associated with promoting long-term adherence.<\/jats:p>","DOI":"10.1115\/1.4071026","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T12:00:51Z","timestamp":1770206451000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":0,"title":["Development and Pilot Evaluation of a Sensor-Infused Monitoring and Training System to Prevent Pressure Injuries in Individuals With Spinal Cord Injury"],"prefix":"10.1115","volume":"9","author":[{"given":"Jack","family":"Janett","sequence":"first","affiliation":[{"name":"Pathokinesiology Laboratory, Rancho Los Amigos National Rehabilitation Center, 7601 Imperial Highway, Downey, CA 90242"},{"id":[{"id":"https:\/\/ror.org\/03t3q6164","id-type":"ROR","asserted-by":"publisher"}],"name":"Rancho Los Amigos National Rehabilitation Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Pineda","sequence":"additional","affiliation":[{"name":"Pathokinesiology Laboratory, Rancho Los Amigos National Rehabilitation Center, 7601 Imperial Highway, Downey, CA 90242"},{"id":[{"id":"https:\/\/ror.org\/03t3q6164","id-type":"ROR","asserted-by":"publisher"}],"name":"Rancho Los Amigos National Rehabilitation Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Macagno","sequence":"additional","affiliation":[{"name":"Sensoria Health, Inc. , 16150 NE 85th Street, Ste 222A, Redmond, WA 98052"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Vigano","sequence":"additional","affiliation":[{"name":"Sensoria Health, Inc. , 16150 NE 85th Street, Ste 222A, Redmond, WA 98052"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffery Wade","family":"Rankin","sequence":"additional","affiliation":[{"name":"Pathokinesiology Laboratory, Rancho Los Amigos National Rehabilitation Center, 7601 Imperial Highway, Downey, CA 90242"},{"id":[{"id":"https:\/\/ror.org\/04s7a0g31","id-type":"ROR","asserted-by":"publisher"}],"name":"Rancho Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"issue":"3","key":"2026022610500192700_bib1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/01.ASW.0000553109.70752.bf","article-title":"Pressure Ulcer Prevalence by Level of Paralysis in Patients With Spinal Cord Injury in Long-Term Care","volume":"32","year":"2019","journal-title":"Adv. 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