FitMi AD: a safe and motivating computer-guided exercise system for individuals with MCI or mild dementia due to Alzheimer's disease

阿尔茨海默病（AD）影响美国超过500万老年人。AD与加速 身体功能恶化，导致更高的福尔斯风险，活动能力下降， 生活，失去独立。AD或轻度认知障碍患者的运动干预 (MCI)已经显示出对整体健康、身体功能和独立性的改善。 不幸的是，由于安全问题和身体不适，这些人很难维持日常锻炼。 需要监督和指导。为了满足这一需求，我们开发了一个运动指导应用程序， 触摸屏Flint平板电脑，连接到传感器，低姿态的固定周期（Cyberspace）。我们评估 该系统在促进MCI或轻度痴呆患者家庭锻炼中的可行性， 第一阶段SBIR。运动指导应用程序和整体方法收到了积极的反馈。但 Cyber硬件有许多关键问题，使其无法成为一个可行的家庭锻炼选择 对于该人群（例如，它会造成潜在的绊倒危险，并且对某些用户没有吸引力）。到 为了解决这些局限性，我们建议在第二阶段整合第三阶段开发的指导运动应用程序， 我与我们现有的FitMi系统，这是一个无线，传感器在家庭锻炼设备最初 为中风患者开发的。我们将这个新系统称为FitMi AD。现有的FitMi 硬件包括一个专利，多用途无线输入设备（“冰球”）和一个可穿戴无线 测量运动和压缩力输入装置（“夹子”）。因此，我们认为， 适当的，临床知情的设计改进，FitMi AD将促进个人的家庭锻炼 轻度认知障碍或AD所致轻度痴呆。具体地说，除了结合调度，跟踪， 在第一阶段开发和验证的目标设定功能中，FitMi AD将包括一个新的 《锻炼：国家老龄化研究所（NIA）的指南》（Exercise：A Guide from the National Institute on Aging）FitMi AD还将使用真实的- 时间数据从蓝牙心率监测器自动调整运动强度，以实现 有益的运动水平。第二阶段项目的具体目标是：目标1）执行结构化 与临床专家和患有MCI或轻度痴呆的AD患者及其护理人员的访谈 优化FitMi AD的设计（n=25）;目的2）开发具有迭代功能的FitMi AD运动软件 专家和用户反馈;目标3）确定家庭运动训练的安全性和有效性 在AD所致MCI或轻度痴呆患者中进行的随机对照试验中， （n=30）。我们的假设是，在家中使用FitMi AD锻炼的参与者将显着表现出 身体功能的改善比对照组更大。如果成功，FitMi AD将是一个安全的， 有效的，商业上可行的家庭锻炼工具，用于MCI或轻度痴呆症患者， AD，从而改善他们的生活质量，减轻照顾者的负担。

Alzheimer’s disease (AD) affects over 5 million older adults in the US. AD is associated with accelerated deterioration in physical function, resulting in a higher risks of falls, decline in mobility, reduced quality of life, and loss of independence. Exercise interventions for individuals with AD or mild cognitive impairment (MCI) have shown promising improvements to overall health, physical function, and independence. Unfortunately, routine exercise is difficult to maintain for these individuals due to safety concerns and the need for supervision and guidance. To address this need, we developed an exercise guidance app for our touchscreen Flint Tablet that connects to a sensorized, low-profile stationary cycle (Cycli). We evaluated the feasibility of this system in promoting home exercise in individuals with MCI or mild dementia in a Phase I SBIR. The exercise guidance app and overall approach received positive feedback. However, the Cycli hardware had a number of critical issues that prevent it from being a viable home exercise option for this population (e.g. it created a potential tripping hazard and was not engaging for some users). To address these limitations, we propose in Phase II to integrate the guided exercise app developed in Phase I with our existing FitMi system, which is a wireless, sensorized at-home exercise device originally developed for individuals with stroke. We refer to this new system here as FitMi AD. The existing FitMi hardware includes a patented, multipurpose wireless input device (a “Puck”) and a wearable wireless input device (a “Clip”) that measure both movement and compression force. Thus, we believe that with appropriate, clinically informed design improvements, FitMi AD will facilitate home exercise in individuals with MCI or mild dementia due to AD. Specifically, in addition to incorporating the scheduling, tracking, and goal-setting features developed and validated in Phase I, FitMi AD will include a new library of exercises from Exercise: A Guide from the National Institute on Aging (NIA). FitMi AD will also use real- time data from a Bluetooth heart rate monitor to automatically adjust the exercise intensity to achieve a beneficial level of exertion. Our specific aims for this Phase II project are to: Aim 1) Perform structured interviews with clinical experts and individuals with MCI or mild dementia due to AD and their caregivers to optimize the design of FitMi AD (n=25); Aim 2) Develop the FitMi AD exercise software with iterative expert and user feedback; Aim 3) Determine the safety and effectiveness of home-based exercise training with FitMi AD in a randomized controlled trial with individuals with MCI or mild dementia due to AD (n=30). Our hypothesis is that participants who exercise at home with FitMi AD will show significantly greater improvements in physical function than the control group. If successful, FitMi AD will be a safe, effective, and commercially viable home exercise tool for individuals with MCI or mild dementia due to AD, thus improving their quality of life and reducing the burden on caregivers.