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

中风发生在2.9%的美国成年人口中，每年有近800，000例新发或复发病例。神经肌肉损伤是一种常见的后果，虽然其中一个是康复是可能的适当的治疗。尽管大多数医疗保健计划涵盖中风后治疗，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可能会获得治疗效果。再加上患者通常更喜欢门诊外护理的事实，在家庭环境中提供物理治疗是一个令人信服的案例。这个项目的新产品将增加有意义的锻炼的剂量，促进恢复，减少并发症，如疼痛，肿胀，痉挛和（肩）半脱位。这个项目？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增加自我护理的经济需求。我们的虚拟教练技术的最终目标是充分利用稀缺的人性化护理与计算机为基础的解决方案，以大大降低成本。在这项研究中开发的自我调整目标设定能力将使专业治疗师能够将他们的范围扩大到患者。基于计算机的指导的一个重大挑战是设计出以预期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。一些人对一个有教养的“好男孩”反应很好！“而其他人对教官的反应更好？s“那个？这还不够好！“此外，不仅是人与人之间的可变性，而且在一个特定的个人从一天到一天。为了成为可行的、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，特别是探索性研究的目标，解决了这一挑战的背景下，激励人们坚持锻炼regime.A第二个挑战是设计运动软件factoring在异构presentationof个人与神经肌肉损伤。这些患者具有不同水平的运动控制、认知能力和与其损伤相关的共病。脱离自身的锻炼计划并不能说明它们的局限性。我们的转化研究目标是通过利用对受损患者进行的研究和已经开发的软件架构来克服这一挑战，以指导他们通过促进长期恢复的运动。

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.