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80万新发或复发病例。神经肌肉损伤是一种常见的后果，但通过适当的治疗是有可能恢复的。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，尽管越来越多的人相信，中风后几个月甚至几年的治疗收益是可能的。此外，患者通常更喜欢门诊护理，在家中提供物理治疗也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，并将疼痛、肿胀、痉挛和(肩膀)半脱位等并发症降至最低。该项目？S的产品回应了美国医疗体系的其他趋势，包括合格护理人员供应的减少，循证医学的发展，以及增加自我护理的经济需求。我们虚拟教练技术的最终目标是以显著较低的成本利用稀缺的以人为基础的护理和基于计算机的解决方案。在这项拟议的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触角伸向患者。基于计算机的指导中的一个重大挑战是设计以预定方式影响人类行为的算法。很难预测人们会对命令、指示、提示和奖励作何反应。有些人会很好地回应一句有教养的“好样的孩子！”而其他人的反应更好的是教官？S：那？S还不够好！此外，不仅在人与人之间，而且在特定的个人内部，每天都是可变的。为了成为可行、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回应。对我们目标的追求，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。第二个挑战是设计锻炼软件，考虑神经肌肉障碍患者的不同呈现方式。这些患者具有不同程度的运动控制、认知能力和与其损伤相关的共病。当然，运动套餐并没有考虑到它们的局限性。我们的翻译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，通过促进长期康复的运动来指导他们。

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.