A Music-Based Rehabilitation Device for Training and Assessing Hand Function

描述（由申请人提供）：手部损伤是一种常见的疾病，在美国和世界各地都是导致残疾的主要原因。仅以中风为例，据估计，每年70万中风幸存者中有80%需要手部治疗。密集的康复训练可减少长期手部损伤。不幸的是，在受伤后2周，人们通常必须在没有专业帮助的情况下在家中进行手部治疗。个人很少遵守家庭治疗的书面家庭计划。为了解决这个问题，我们开发了一种价格合理（制造成本低于100美元）的仪表手套，用户需要练习抓握动作来玩一个定制的电脑游戏，该游戏的灵感来自游戏史上第三大最受欢迎的电子游戏《吉他英雄》。在一项针对9名中风患者的初步研究中，我们发现MusicGlove准确地测量了临床手部损伤水平，激励人们在40分钟的训练中进行1400多次握力动作练习，并在临床上显著改善了手部功能。当被问及他们在家完成这种治疗的可能性有多大时，他们给了满分10分的满分10分。为了将MusicGlove推向商业化，这个第一阶段项目的目标是：1)开发一个适合家庭康复的MusicGlove原型（1-3个月）。我们将修改我们的临床原型，以承受数月的紧张家庭使用而不会损坏，拥有一个直观，易于使用的游戏界面，适合那些对计算机经验最少的用户，并自动量化和记录用户的运动和使用习惯。2)对原型进行可用性研究，并根据用户反馈完善设计（2-3个月）。这些反馈将从中风后手部受损的个体及其临床护理人员那里获得。3)进行家庭使用设备的试点研究，比较其性能与传统的家庭自我监督治疗（4-6个月）。我们将招募10名慢性中风患者在家中使用该设备2个月；一个由10人组成的对照组将接受一个由小册子指定的标准家庭手部练习计划。我们假设，戴音乐手套锻炼的人会a)比对照组更多地锻炼他们的手；b)与对照组相比，他们的Box & Block评分显著提高（6个Block）。该项目将产生一个可工作和测试的原型，我们可以将其推向生产，并生成必要的用户体验数据，以继续改进产品，并在第二期进行更大规模的功效试验。

DESCRIPTION (provided by applicant): Hand impairment is a common condition that contributes substantially to disability in the U.S. and around the world. In the case of stroke alone, it is estimated that 80% of the 700,000 individuals who survive a stroke each year require hand therapy. Intensive rehabilitation exercise reduces long-term hand impairment. Unfortunately, as soon as 2 weeks after the onset of an injury, people often must perform hand therapy at home without professional assistance. Individuals rarely comply with written home programs for home therapy. To address this problem, we have developed an affordable (< $100 manufacturing cost) instrumented glove that requires the user to practice functional gripping movements to play a custom computer game inspired by the third most popular video game in gaming history, Guitar Hero. In a pilot study with 9 individuals with a stroke, we found that the MusicGlove accurately measures clinical hand impairment level, inspires people to make over 1400 practice grip movements in 40 minute training sessions, and induces clinically significant improvements in hand function. When asked how likely they would be to complete this therapy at home, they rated it a perfect 10 out 10. To move MusicGlove toward commercialization, the objectives of this Phase 1 project are to: 1) Develop a prototype of the MusicGlove suitable for at-home rehabilitation (months 1-3). We will modify our clinical prototype to withstand months of intense home use without breaking, to have an intuitive, easy-to-use game interface that is suitable for users who have minimal experience with computers, and to automatically quantify and log the user's movement and use habits. 2) Perform a usability study of this prototype and refine the design based on user feedback (months 2-3). This feedback will be obtained from individuals with hand impairment after stroke and their clinical caregivers. 3) Conduct a pilot study of at-home use of the device, comparing its performance to conventional at-home self-supervised therapy (months 4-6). We will recruit 10 individuals with a chronic stroke to use the device at home for 2 months; a control group of 10 individuals will receive a program of standard home hand exercises specified by a booklet. We hypothesize that the individuals who exercise with the MusicGlove will a) exercise their hand more than the control group; and b) improve their Box & Block score by a clinically significant amount (6 blocks), compared to the control group. This project will result in a working and tested prototype that we can push to production and generate the user experience data necessary to continue to improve the product and to move to a larger efficacy trial to be proposed in Phase II. PUBLIC HEALTH RELEVANCE: This research is relevant to public health because it will increase the accessibility and lower the costs of rehabilitation therapy for the upper extremity. This will provide a pathway to a better life for millions of U.S citizens suffering from motor impairment after stroke and other neurologic injuries. Not only does rehabilitation therapy reduce the likelihood of devastating complications, it also improves functional ability, increasing the standard of living of individuals with impairment and reducing the burden on society caused by disability.