Pants With A Higher Purpose
Smart-e-Pants look like a simple pair of cycling shorts. Talk to Vivian Mushahwar, however, and you’ll learn that a life-changing circuitry of wires lies beneath the shiny spandex.
A U of A research team led by Mushahwar, professor of physical medicine and rehabilitation and of neuroscience, developed the undergarment to help prevent pressure ulcers, commonly known as bedsores. A serious health complication for people who are confined to a bed due to illness or have reduced mobility or sensation, they are estimated to cost the Canadian health-care system more than $3.5 billion a year.
You can hear Mushahwar speak Sept. 28 during Alumni Weekend at the Saturday Scholar Series.
How do Smart-e-Pants work?
The idea is to use electrical stimulation in very brief bursts at low amplitudes to get the muscles we sit on or lie on to contract. The device causes muscle contractions every 10 minutes or so. We have found from our experiments that this method seems to be effective in preventing pressure ulcers. So that’s hugely exciting.
What is a pressure ulcer or bedsore?
It’s a major breakdown of soft tissue. Any place where the muscle and fat are trapped between bone — for example, the bones we sit on or the bones we lie down on — and an external surface, the soft tissue just breaks down. People in a coma, or in hospital for long periods, or those who cannot move on their own are highly susceptible to this tissue breakdown. It’s a recognized medical problem with no solution, and none of the current interventions have been effective. So we sat back and thought, “Well, this is staring us in the face, so it’s time to do something about it.
What causes them?
We can sit in front of our computers for hours without developing pressure ulcers. The reason is that we continually adjust our posture subconsciously. We fidget. If you watch people, they do that every six to nine minutes. These subconscious adjustments in posture redistribute pressure in the tissue around the bones and increase oxygenation. This helps keep the tissue healthy and prevents it from breaking down. That’s something that people with neural injuries or some diseases are unable to do. So our team decided we needed to restore their ability to adjust their posture subconsciously, or fidget. And that’s how Smart-e-Pants were born.
Without Smart-e-Pants, how do you prevent bedsores?
One of the methods is having nursing staff turn the patients every two hours or so. This schedule of two hours goes back to the 1850s, when Florence Nightingale was taking care of the wounded. It took her nurses two hours to go from patient number 1 back to patient number 1, and that policy was adopted and hasn’t really changed. It’s driven more by economics than whether it’s effective. And it’s not effective — people continue to develop pressure ulcers, because you need to be adjusting your posture continually, not every two hours. In two hours, the damage is done. There’s another critical thing about Smart-e-Pants that other methods don’t have: the active muscle contraction. Our muscle tissue is designed to contract; it needs those contractions to restore its mechanical properties. If you’re turning someone, you’re not getting their muscles to contract.
How did you get involved in neuroscience?
I got my PhD in bioengineering at the University of Utah after doing a BSc in electrical engineering at Brigham Young University. I loved electrical engineering but I missed the human, biological component. I had this dream that I could use my electrical engineering skills to help people with spinal cord injuries. I started working with the nervous system during my PhD training — which is like a dream to an electrical engineer because the nervous system is the most complicated circuit out there — and I was just hooked. It allowed me to put what I do into a health context by trying to help people regain function after dramatic injuries to the brain and spinal cord. I also started looking at the secondary complications associated with disability or the loss of mobility or sensation, such as pressure ulcers. Pressure ulcers are a very prominent problem that has just never gone away. There’s documentation about their incidence rates in the ’40s and ’50s, and the rates haven’t changed since then, despite improvements in clinical care and health technology.