Option 1: Small-Business ERC Collaborative Opportunity for the Virtual Coach for Home-Based Therapy

美国成年人口中中风发生率为2.9%，每年有近80万例新发或复发病例。神经肌肉损伤是一种常见的后果，尽管通过适当的治疗可以恢复。尽管大多数医疗保健计划都包括中风后的治疗，但保险报销上限通常将其限制在几周内，尽管越来越多的证据表明，中风后数月甚至数年的治疗可能会有所收获。再加上患者通常更喜欢门诊外的治疗，在家庭环境中进行物理治疗是一个令人信服的案例。该项目将产生的新产品将增加有意义的运动的剂量，以促进康复并最大限度地减少合并症，如疼痛、肿胀、痉挛和（肩膀）半脱位。这个项目吗?s的产出回应了美国医疗保健系统的其他趋势，包括合格护理提供者的供应减少，循证医学的发展以及对自我保健的经济需求增加。我们的虚拟教练技术的最终目标是以低得多的成本利用稀缺的人工护理和基于计算机的解决方案。本研究所发展的自我调整目标设定能力，将使专业治疗师能够延伸到病人身上。以计算机为基础的教练面临的一个重大挑战是，设计出能够以有意的方式影响人类行为的算法。很难预测人们对命令、指示、提示和奖励的反应。有些人对“好孩子”的教养反应良好，而另一些人对教官的教养反应更好。s”呢?这还不够好！”此外，这种可变性不仅存在于人与人之间，而且存在于特定个体的日常生活中。为了成为一个可用的、普遍的解决方案，虚拟教练需要对他们所服务的人的心理做出反应。追求我们的目标，特别是探索性研究目标，在激励人们坚持锻炼方案的背景下解决了这一挑战。第二个挑战是设计运动软件，考虑到神经肌肉损伤患者的异质表现。这些患者有不同程度的运动控制、认知能力和与他们的损伤相关的合并症。现成的运动包没有说明它们的局限性。我们的转化研究目标是通过利用对受损患者的研究和已经开发的软件架构来指导他们通过促进长期康复的运动来克服这一挑战。

Stroke occurs in 2.9% of the US adult population and there are nearly 800,000 new or recurringcases annually. Neuromuscular impairment is a common consequence, though one from which recoveryis possible with appropriate therapy. Though most healthcare plans cover post-stroke therapy,insurance reimbursement caps typically limit it to a few weeks, despite a growing body ofevidence that therapeutic gains are possible months and even years after a stroke. Addingthe fact that patients generally prefer out-of-clinic care, there is a compelling case fordelivery of physical therapy in the home setting. The new product that will result from thisproject will increase dosing of meaningful exercises that promote recovery and minimize co-morbiditiessuch as pain, swelling, spasticity and (shoulder) subluxation.This project?s outputs respond to other trends in the US healthcare system, including thedwindling supply of qualified care providers, the movement toward evidence based medicineand the economic requirement for increased self-care. The ultimate goal of our Virtual Coachtechnology is to leverage scarce human-based care with computer based solutions at substantiallylower cost. The self-adjusting goal-setting capability developed in the proposed researchwill enable professional therapists to extend their reach to patients.One significant challenge in computer-based coaching is devising algorithms that affect humanbehavior in an intended way. It is difficult to predict how people will react to commands,instructions, prompts and rewards. Some respond well to a nurturing "atta boy!" while othersrespond better to a drill sergeant?s "that?s not good enough!" Moreover, not only is therevariability among people, but also within a particular individual from day-to-day. To be aviable, pervasive solution, Virtual Coaches will need to be responsive to the psychologyof the people they serve. Pursuit of our objectives, especially the exploratory research objective,addresses this challenge in the context of motivating people to adhere to an exercise regimen.A second challenge is designing exercise software factoring in the heterogeneous presentationof individuals with neuromuscular impairments. Such patients have varying levels of motorcontrol, cognitive ability and co-morbidities associated with their impairments. Off theshelf exercise packages do not account for their limitations. Our translational research objectiveis to overcome this challenge by leveraging research conducted on impaired patients and analready developed software architecture for coaching them through movements that promote longterm recovery.