{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T06:16:17Z","timestamp":1793686577006,"version":"4.5.1"},"reference-count":47,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hallisey Family","award":["202309PJT-508073-BME-ADHD-249077"],"award-info":[{"award-number":["202309PJT-508073-BME-ADHD-249077"]}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["202309PJT-508073-BME-ADHD-249077"],"award-info":[{"award-number":["202309PJT-508073-BME-ADHD-249077"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>A key best practice to prevent and treat pressure injuries (PIs) is to ensure at-risk individuals are repositioned regularly. Our team designed a non-contact position detection system that predicts an individual\u2019s position in bed using data from load cells under the bed legs. The system was originally designed to predict the individual\u2019s position as left-side lying, right-side lying, or supine. Our previous work suggested that a higher precision for detecting position (classifying more than three positions) may be needed to determine whether key bony prominences on the pelvis at high risk of PIs have been off-loaded. The objective of this study was to determine the impact of categorizing participant position with higher precision using the system prediction F1 score. Data from 18 participants was collected from four load cells placed under the bed legs and a pelvis-mounted inertial measurement unit while the participants assumed 21 positions. The data was used to train classifiers to predict the participants\u2019 transverse pelvic angle using three different position bin sizes (45\u00b0, ~30\u00b0, and 15\u00b0). A leave-one-participant-out cross validation approach was used to evaluate classifier performance for each bin size. Results indicated that our prediction F1 score dropped as the position category precision was increased.<\/jats:p>","DOI":"10.3390\/s24196483","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T07:39:52Z","timestamp":1728459592000},"page":"6483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Detecting Patient Position Using Bed-Reaction Forces for Pressure Injury Prevention and Management"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9864-1396","authenticated-orcid":false,"given":"Nikola","family":"Pupic","sequence":"first","affiliation":[{"name":"KITE Research Institute, Toronto Rehabilitation Institute\u2014University Health Network, Toronto, ON M5G 2A2, Canada"},{"name":"Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5202-3736","authenticated-orcid":false,"given":"Sharon","family":"Gabison","sequence":"additional","affiliation":[{"name":"KITE Research Institute, Toronto Rehabilitation Institute\u2014University Health Network, Toronto, ON M5G 2A2, Canada"},{"name":"Department of Physical Therapy, University of Toronto, Toronto, ON M5G 1V7, Canada"},{"name":"Rehabilitation Sciences Institute, University of Toronto, Toronto, ON M5G 1V7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Evans","sequence":"additional","affiliation":[{"name":"KITE Research Institute, Toronto Rehabilitation Institute\u2014University Health Network, Toronto, ON M5G 2A2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4821-7650","authenticated-orcid":false,"given":"Geoff","family":"Fernie","sequence":"additional","affiliation":[{"name":"KITE Research Institute, Toronto Rehabilitation Institute\u2014University Health Network, Toronto, ON M5G 2A2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Dolatabadi","sequence":"additional","affiliation":[{"name":"Vector Institute, Toronto, ON M5G 1M1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2675-0195","authenticated-orcid":false,"given":"Tilak","family":"Dutta","sequence":"additional","affiliation":[{"name":"KITE Research Institute, Toronto Rehabilitation Institute\u2014University Health Network, Toronto, ON M5G 2A2, Canada"},{"name":"Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada"},{"name":"Rehabilitation Sciences Institute, University of Toronto, Toronto, ON M5G 1V7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1097\/WON.0000000000000281","article-title":"Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System","volume":"43","author":"Edsberg","year":"2016","journal-title":"J. Wound Ostomy Cont. Nurs."},{"key":"ref_2","first-page":"39","article-title":"Pressure Ulcers: Updated Guidelines for Treatment and Prevention","volume":"48","author":"Perez","year":"1993","journal-title":"Geriatrics"},{"key":"ref_3","first-page":"7","article-title":"The Future of Pressure Ulcer Prevention Is Here: Detecting and Targeting Inflammation Early","volume":"19","author":"Gefen","year":"2018","journal-title":"EWMA J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/iwj.13316","article-title":"How Patient Migration in Bed Affects the Sacral Soft Tissue Loading and Thereby the Risk for a Hospital-Acquired Pressure Injury","volume":"17","author":"Lustig","year":"2020","journal-title":"Int. Wound J."},{"key":"ref_5","first-page":"58","article-title":"What Is New in Our Understanding of Pressure Injuries: The Inextricable Association between Sustained Tissue Deformations and Pain and the Role of the Support Surface","volume":"28","author":"Gefen","year":"2020","journal-title":"Wound Pract. Res."},{"key":"ref_6","first-page":"34","article-title":"Pressure Map Technology for Pressure Ulcer Patients: Can We Handle the Truth?","volume":"25","author":"Pompeo","year":"2013","journal-title":"Wounds Compend. Clin. Res. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/S0965-206X(02)80031-6","article-title":"Pressure Relief Behaviour and the Prevention of Pressure Ulcers in Wheelchair Users in the Community","volume":"12","author":"Stockton","year":"2014","journal-title":"J. Tissue Viability"},{"key":"ref_8","unstructured":"Ontario, H.Q. (2017). Pressure Injuries. Care for Patients in All Settings. Qual. Stand., 51."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1001\/archinte.161.12.1549","article-title":"Quality of Care for Hospitalized Medicare Patients at Risk for Pressure Ulcers","volume":"161","author":"Lyder","year":"2001","journal-title":"Arch. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2588","DOI":"10.1097\/00003246-200211000-00031","article-title":"Body Positioning of Intensive Care Patients: Clinical Practice versus Standards","volume":"30","author":"Krishnagopalan","year":"2002","journal-title":"Crit. Care Med."},{"key":"ref_11","first-page":"4780","article-title":"A Novel System to Tackle Hospital Acquired Pressure Ulcers","volume":"Volume 2016-Octob","author":"Renganathan","year":"2016","journal-title":"Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society"},{"key":"ref_12","unstructured":"Takashini, M., Black, J., Dealey, C., and Gefen, A. (2010). Pressure in Context. In International review: Pressure ulcer precention: Pressure, shear, friction and microclimate in context. A consensus document. Wounds Int."},{"key":"ref_13","first-page":"1393","article-title":"Pressure Ulver Prevention-Evaluation of Awarness in Families of Patients at Risk","volume":"62","author":"Skalska","year":"2005","journal-title":"Prz. Lek."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1080\/10376178.2017.1364973","article-title":"Health Service Provision and the Use of Pressure-Redistributing Devices: Mixed Methods Study of Community Dwelling Individuals with Pressure Injuries","volume":"53","author":"Jackson","year":"2017","journal-title":"Contemp. Nurse"},{"key":"ref_15","first-page":"253","article-title":"Identifying Gaps, Barriers, and Solutions in Implementing Pressure Ulcer Prevention Programs","volume":"37","author":"Jankowski","year":"2011","journal-title":"Jt. Comm. J. Qual. Patient Saf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/iwj.13071","article-title":"The National Cost of Hospital-Acquired Pressure Injuries in the United States","volume":"16","author":"Padula","year":"2019","journal-title":"Int. Wound J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/iwj.12603","article-title":"Health Economic Burden That Different Wound Types Impose on the UK\u2019s National Health Service","volume":"14","author":"Guest","year":"2017","journal-title":"Int. Wound J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1093\/ageing\/afh086","article-title":"The Cost of Pressure Ulcers in the UK","volume":"33","author":"Bennett","year":"2004","journal-title":"Age Ageing"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e021769","DOI":"10.1136\/bmjopen-2018-021769","article-title":"Cohort Study Evaluating Pressure Ulcer Management in Clinical Practice in the UK Following Initial Presentation in the Community: Costs and Outcomes","volume":"8","author":"Guest","year":"2018","journal-title":"BMJ Open"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"261","DOI":"10.12968\/jowc.2012.21.6.261","article-title":"The Cost of Pressure Ulcers in the United Kingdom","volume":"21","author":"Dealey","year":"2012","journal-title":"J. Wound Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1097\/01.ASW.0000399650.81995.6c","article-title":"Beds: Practical Pressure Management for Surfaces\/Mattresses","volume":"24","author":"Norton","year":"2011","journal-title":"Adv. Skin Wound Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1111\/j.1742-481X.2012.01002.x","article-title":"The Average Cost of Pressure Ulcer Management in a Community Dwelling Spinal Cord Injury Population","volume":"10","author":"Chan","year":"2013","journal-title":"Int. Wound J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/WON.0000000000000320","article-title":"Pressure Injury in a Community Population: A Descriptive Study","volume":"44","author":"Corbett","year":"2017","journal-title":"J. Wound. Ostomy Cont. Nurs."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1111\/j.1532-5415.2012.04106.x","article-title":"Hospital-Acquired Pressure Ulcers: Results from the National Medicare Patient Safety Monitoring System Study","volume":"60","author":"Lyder","year":"2012","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1111\/jgs.13475","article-title":"Under Pressure: Financial Effect of the Hospital-Acquired Conditions Initiative-a Statewide Analysis of Pressure Ulcer Development and Payment","volume":"63","author":"Meddings","year":"2015","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/j.1524-475X.2008.00373.x","article-title":"Prevalence of Pressure Ulcers on Hospital Admission among Nursing Home Residents Transferred to the Hospital","volume":"16","author":"Keelaghan","year":"2008","journal-title":"Wound Repair Regen."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1002\/nop2.50","article-title":"Characteristics of Patients Who Are Admitted with or Acquire Pressure Ulcers in a District General Hospital; a 3 Year Retrospective Analysis","volume":"3","author":"Worsley","year":"2016","journal-title":"Nurs. Open"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41591-018-0300-7","article-title":"High-Performance Medicine: The Convergence of Human and Artificial Intelligence","volume":"25","author":"Topol","year":"2019","journal-title":"Nat. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1136\/svn-2017-000101","article-title":"Artificial Intelligence in Healthcare: Past, Present and Future","volume":"2","author":"Jiang","year":"2017","journal-title":"Stroke Vasc. Neurol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3390\/applbiosci3010002","article-title":"The Integration of Artificial Intelligence into Clinical Practice","volume":"3","author":"Karalis","year":"2024","journal-title":"Appl. Biosci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"101690","DOI":"10.1016\/j.xcrp.2023.101690","article-title":"FlexiPulse: A Machine-Learning-Enabled Flexible Pulse Sensor for Cardiovascular Disease Diagnostics","volume":"4","author":"Ma","year":"2023","journal-title":"Cell Rep. Phys. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ijnurstu.2018.09.003","article-title":"Predictors of Superficial and Severe Hospital-Acquired Pressure Injuries: A Cross-Sectional Study Using the International Pressure Ulcer PrevalenceTM Survey","volume":"89","author":"Kayser","year":"2019","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1093\/clinids\/14.3.647","article-title":"Bacteremia in a Long-Term-Care Facility: A Five-Year Prospective Study of 163 Consecutive Episodes","volume":"14","author":"Muder","year":"1992","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Jiang, Z., Lee, Y.S., Wang, Y., John, H., Fang, L., and Tang, Y. (2024). Advancements in Flexible Sensors for Monitoring Body Movements during Sleep: A Review. Sensors, 24.","DOI":"10.3390\/s24165091"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Xiao, A., Zheng, T., Xiao, H., and Huang, R. (2022). The Relationship between Sleeping Position and Sleep Quality: A Flexible Sensor-Based Study. Sensors, 22.","DOI":"10.3390\/s22166220"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Li, Y., Zhang, P., Wang, S., Su, T., Zhang, K., Huang, L., and Wu, S. (2024). Sleep State Monitoring System Based on Flexible Pressure Sensor Arrays for Evaluating Sleep Quality. IEEE Sens. J., 1.","DOI":"10.1109\/JSEN.2024.3452940"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jtv.2018.12.001","article-title":"Detection and Classification Methodology for Movements in the Bed That Supports Continuous Pressure Injury Risk Assessment and Repositioning Compliance","volume":"28","author":"Duvall","year":"2019","journal-title":"J. Tissue Viability"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Adami, A.M., Adami, A.G., Hayes, T.L., and Beattie, Z.T. (2013, January 9\u201312). A System for Assessment of Limb Movements in Sleep. Proceedings of the 2013 IEEE 15th International Conference on e-Health Networking, Applications and Services (Healthcom 2013), Lisbon, Portugal.","DOI":"10.1109\/HealthCom.2013.6720712"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Alaziz, M., Jia, Z., Liu, J., Howard, R., Chen, Y., and Zhang, Y. (2016, January 27\u201329). Motion Scale: A Body Motion Monitoring System Using Bed-Mounted Wireless Load Cells. Proceedings of the 2016 IEEE First International Conference on Connected Health: Applications, Systems and Engineering Technologies (CHASE), Washington, DC, USA.","DOI":"10.1109\/CHASE.2016.13"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Alaziz, M., Jia, Z., Howard, R., Lin, X., and Zhang, Y. (2017, January 17\u201319). MotionTree: A Tree-Based In-Bed Body Motion Classification System Using Load-Cells. Proceedings of the 2017 IEEE\/ACM International Conference on Connected Health: Applications, Systems and Engineering Technologies (CHASE), Philadelphia, PA, USA.","DOI":"10.1109\/CHASE.2017.71"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1145\/3372023","article-title":"In-Bed Body Motion Detection and Classification System","volume":"16","author":"Alaziz","year":"2020","journal-title":"ACM Trans. Sens. Netw."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1089\/wound.2018.0934","article-title":"Pressure Ulcer Monitoring Platform\u2014A Prospective, Human Subject Clinical Study to Validate Patient Repositioning Monitoring Device to Prevent Pressure Ulcers","volume":"9","author":"Minteer","year":"2020","journal-title":"Adv. Wound Care"},{"key":"ref_43","first-page":"205566832091216","article-title":"Toward Mitigating Pressure Injuries: Detecting Patient Orientation from Vertical Bed Reaction Forces","volume":"7","author":"Wong","year":"2020","journal-title":"J. Rehabil. Assist. Technol. Eng."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Gabison, S., Pupic, N., Evans, G., Dolatabadi, E., and Dutta, T. (2022). Measuring Repositioning in Home Care for Pressure Injury Prevention and Management. Sensors, 22.","DOI":"10.1101\/2022.03.18.22272369"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Pupic, N., Gabison, S., Evans, G., Fernie, G., Dolatabadi, E., and Dutta, T. (2022). Detecting Patient Position Using Bed-Reaction Forces and Monitoring Skin-Bed Interface Forces for Pressure Injury Prevention and Management. medRxiv.","DOI":"10.1101\/2022.03.15.22272323"},{"key":"ref_46","unstructured":"Beattie, Z.T., Hagen, C.C., and Hayes, T.L. (September, January 30). Classification of Lying Position Using Load Cells under the Bed. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Boston, MA, USA."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1038\/s41591-018-0335-9","article-title":"Evaluation and Accurate Diagnoses of Pediatric Diseases Using Artificial Intelligence","volume":"25","author":"Liang","year":"2019","journal-title":"Nat. Med."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/19\/6483\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:09:37Z","timestamp":1760112577000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/19\/6483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,9]]},"references-count":47,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["s24196483"],"URL":"https:\/\/doi.org\/10.3390\/s24196483","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,9]]}}}