Digital and Smart Technologies for Early Pressure Injury Detection and Prevention in Stroke and Mobility-Impaired Patients: A Scoping Review

Abstract

Background: Pressure injuries remain a major complication among stroke and other mobility-impaired populations. Digital and smart technologies are increasingly used to support early tissue-risk detection, monitoring, and prevention-related care processes. However, evidence remains dispersed across technology types, clinical functions, and care settings. Methods: This scoping review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidance. PubMed/MEDLINE, ScienceDirect, CINAHL Complete via EBSCOhost, IEEE Xplore, and Wiley Online Library were searched for English-language studies published from 1 January 2018 to 30 July 2025. Eligible studies involved digital or smart technologies used for early pressure injury detection, physiological risk monitoring, repositioning support, pressure redistribution, or prevention-related decision support in stroke or other mobility-impaired populations. Two reviewers screened records using Rayyan and charted study characteristics, technology functions, settings, and outcomes. Critical appraisal was not undertaken because the review aimed to map evidence rather than estimate effects. Results: Of 1063 identified records, 13 studies were included. Eight technology categories were mapped: subepidermal moisture scanners, pressure ulcer monitoring platform devices, comprehensive mobile assessment of pressure, artificial intelligence-enabled smartphone applications, artificial intelligence-powered smart decompression mattresses, Internet of Things-based smart bed systems, infrared thermography, and digital skin moisture monitoring. Subepidermal moisture scanners were the only technology represented by multiple studies (6/13); all other categories were represented by single studies. Reported outcomes mainly involved diagnostic support, repositioning adherence, feasibility, and workflow-related measures. Direct evidence on pressure injury incidence was limited and heterogeneous. Most studies were hospital-based, with very limited community or home-care evidence. Conclusion: Digital and smart technologies may support earlier recognition of pressure-related tissue changes and selected prevention-related care processes, particularly in hospitals. However, evidence remains heterogeneous and insufficient to support strong effectiveness claims across technology types. Implications: Future research should prioritize clear prevention outcomes, comparative and implementation studies, and community-based testing before considering meta-analysis.

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