RAPD: Development of Domestic Virtual Robotic Environment

该奖项由2009年美国复苏和再投资法案（公法111-5）资助。0930927 Matsuoka每年约有70万美国人患有新发或复发性中风，其中约50万人幸运地存活下来。超过一半的中风发生在大脑控制运动的区域，使许多患者的运动功能受损[2]，这些功能通常位于身体的一侧和特定区域，如手臂或手。通过仔细的身体康复，受损的运动功能可以恢复部分或全部活动性，因为神经系统重新连接其神经回路，以在新的神经位置代表失去的功能。恢复的水平取决于卒中后康复护理的数量和质量[1，3]。一旦病情稳定，住院患者通常每天接受职业和物理治疗;门诊患者在恢复的前几个月每周访问康复诊所或接受治疗师家访几次[4]。研究表明，身体恢复持续超过中风后六个月[3]。不幸的是，长期护理的水平可能会因患者的保险计划、家庭将患者运送到康复护理的能力以及患者自身的动机水平而过早地降低。另一个限制最佳恢复的重要因素是“习得性不使用”[5，6，7]，即，当中风幸存者学会管理日常活动时，即使他们可以，也不使用以前瘫痪的肢体。我们的工作不仅可以帮助中风幸存者恢复身体活动能力，而且可以帮助他们克服社会，情感和动机障碍。我们的总体目标是开发一个家庭康复环境，即：（1）在居住地使用安全，（2）即使对于无动机的人也能参与，（3）为非现场治疗师和医生提供有用的界面，（4）能够克服或避免学习不使用问题。在建议的期限结束时，该环境将被放置在几个家庭中，在那里可以定性评估可用性和安全性（无需运行治疗程序）。这是一个为期三年的项目;在成功完成后，我们打算将该系统复制并分发到更多患者家中，以进行全面的治疗评估。拟议项目的智力价值在于：（1）设计一个安全和引人入胜的新型国内虚拟机器人环境所需的多学科工程贡献，以及（2）解决与场外治疗师和增强人的感知互动的有用生理/行为数据相关的科学问题？他们的动作没有意识到。随着这些问题的解决，我们将能够在自己的家中康复运动障碍患者，并扩大他们的活动范围，超出他们以前认为可能的范围。拟议工作的更广泛影响是：（1）减轻中风幸存者家庭的负担，并降低家庭和保险公司的护理成本，（2）扩大用于神经系统疾病、老年护理和额外残疾人群的家庭诊断、预防和锻炼范例的环境，（3）在中学阶段引入"？通过科学和工程学帮助人们。PI是一位在提供K-12外展服务方面有着良好记录的女性。

This award is funded under the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).0930927MatsuokaAbout 700,000 Americans suffer from new or recurrent strokes each year, with some 500,000 being fortunate enough to survive [1]. Over half of all strokes occur in areas of the brain that control movement, leaving many victims with impaired motor functions [2] that are most often localized in one side of the body and in one specific area, such as the arm or hand. With careful physical rehabilitation, damaged motor functions can recover partial or full mobility as the nervous system rewires its neural circuits to represent lost functions at new neural locations. The level of recovery depends on the amount and quality of post-stroke rehabilitative care [1,3]. Once their condition stabilizes, inpatients typically receive daily occupational and physical therapy; outpatients visit rehabilitation clinics or receive therapist home visits several times a week for the first few months of recovery [4]. Research shows that physical recovery continues beyond six months post-stroke [3]. Unfortunately, the level of longer term care can be prematurely curtailed by patients' insurance plans, families' ability to transport patients to rehabilitative care, and patients' own motivation levels. Another significant factor limiting optimal recovery is "learned non-use" [5,6,7], viz., when stroke survivors learn to manage daily activities without using the formerly paralyzed limb even if they can. Our work can play a critical role not only in helping stroke survivors regain physical mobility, but in helping them overcome the social, emotional and motivational barriers to doing so. Our overarching goal is to develop a domestic rehabilitative environment that is: (1) safe to use residentially, (2) engaging even for the unmotivated, (3) provides useful interface for off-site therapists and physicians, and (4) able to overcome or avoid learned non-use issues. Toward the end of the proposed period, this environment will be placed in several homes where usability and safety can be qualitatively assessed (without running the therapeutic program). This is a three-year project; after its successful completion, we intend to replicate and distribute the system to more patients' homes for complete therapeutic evaluation. The intellectual merits of the proposed project are in: (1) the multi-disciplinary engineering contribution needed to design a novel domestic virtual robotic environment that is safe and engaging, and (2) addressing scientific questions related to useful physiological/behavioral data for off-site therapists and perceptual interactions that augment people?s movements without their conscious awareness. With these problems solved, we will be able to rehabilitate patients with motor impairments in their own homes and extend their range of motion beyond what they had previously thought possible. The broader impacts of the proposed work are in: (1) reducing the burden on stroke survivors' families and lowering the cost of care to families and insurers, (2) extending the environment for use in domestic diagnosis, prevention, and exercise paradigms for neurological disorders, elder care, and additional disabled populations, and (3) recruiting more girls in the middle school into science and engineering by introducing the concept of ?helping people' through science and engineering. The PI is a woman with a strong track record in providing K-12 outreach.