Subject-specific vibrotactile feedback for improving balance in older adults

描述（由申请人提供）：衰老有助于姿势控制的变化，老年人比年轻人更不稳定，更容易跌倒。许多经历跌倒的老年人通常有损害平衡的感觉缺陷，如前庭功能障碍。因此，开发能够提供有关平衡的额外感觉信息的平衡假体对于有跌倒风险的老年人具有明显的临床重要性。福尔斯。感觉替代平衡假体旨在增加可用于平衡的感觉信息，以补偿失去或减少的自然感觉功能。振动-触觉反馈已经被证明在减少响应于站立时的平衡扰动的低频身体摇摆（低于约0.5Hz）方面是有效的。然而，当前的装置倾向于引起高频身体摇摆的不期望的增加，这与提高稳定性的目的是相反的，特别是在老年人中，老年人更容易福尔斯，并且在较高频率下已经比年轻人摇摆得更多。此外，与针对用户进行微调的其他感觉假体（诸如助听器）不同，当前的振动触觉平衡假体主要采用"一刀切"的方法，因为它们针对所有受试者使用相同的设置（即，参数值）。我们的分析表明，这种方法有助于增加高频身体摇摆，并且需要针对特定对象的设计来提高更宽频率范围内的稳定性，特别是在高频下不增加摇摆。在这项研究中，我们的目标是实施，使用工程系统识别方法，并测试一种新的特定于对象的振动触觉反馈（VTF）设计，将减少老年人的高频姿势摇摆，以响应平衡扰动，而站着。减少老年人的高频摇摆将使他们的摇摆看起来更像年轻人的自然摇摆，并应减少与高频摇摆有关的跌倒风险。拟议的研究是必要的第一步，以评估开发用户定制的VTF假体的可行性，以实现特定的减少身体摇摆和增加老年人站立时的稳定性。在这项研究中获得的知识应该是有用的，推进使用VTF更复杂的姿势控制任务。 公共卫生相关性：福尔斯是老年人受伤的主要原因，每年造成数十亿美元的医疗费用，并对人的健康和生活质量产生不利影响。导致福尔斯跌倒的一个因素是感觉功能的下降。感觉替代装置，例如关于身体位置和运动的振动触觉反馈，作为平衡假体最近已经变得令人感兴趣。这项研究解决的问题是，这些设备是否可以被设计为引起身体摇摆的频率选择性变化，以减少老年人的高频摇摆，这与跌倒风险有关。

DESCRIPTION (provided by applicant): Aging contributes to changes in postural control, and older adults are less stable and more prone to falls than young adults. Many older people who experience a fall often have sensory deficits that impair balance, such as vestibular dysfunction. Accordingly, the development of a balance prosthesis that can provide additional sensory information about balance has clear clinical importance for older persons at risk for falls. Sensory substitution balance prostheses aim to augment sensory information available for balance in order to compensate for lost or diminished natural sensory function. Vibro-tactile feedback has been shown to be effective at reducing low frequency body sway (below about 0.5 Hz) in response to balance perturbations while standing. However, current devices tend to cause an undesirable increase in high frequency body sway, which is arguably counter to the aim of improving stability, especially in older adults, who are more prone to falls, and already sway more than young adults at higher frequencies. In addition, unlike other sensory prostheses such as hearing aids, which are fine-tuned to the user, current vibro-tactile balance prostheses largely employ a "one size fits all" approach, in that they use the same settings (i.e. parameter values) for all subjects. Our analysis has shown that this approach contributes to increased high frequency body sway, and that a subject-specific design is required to improve stability over a broader range of frequencies and, especially, to not increase sway at high frequencies. In this research, we aim to implement, using engineering system identification methods, and test a novel subject-specific vibrotactile feedback (VTF) design that will reduce high frequency postural sway of older adults in response to balance perturbations while standing. Reducing high frequency sway in older adults will cause their sway to look more like the natural sway of young adults, and should reduce fall risk, which has been associated with high frequency sway. The proposed research is a necessary first step to assess the feasibility of developing a user-customized VTF prosthesis, to achieve specific reductions in body sway and increased stability in older adults while standing. The knowledge to be gained in this study should be useful for advancing the use of VTF for more complex postural control tasks. PUBLIC HEALTH RELEVANCE: Falls are a major source of injury among older adults, resulting in billions of dollars in annual medical costs and adversely affecting a person's health and quality of life. One factor contributing to falls is declines in sensory function. Sensory substitution devices, such as vibrotactile feedback about body position and motion, have become of recent interest as a balance prosthesis. This research addresses the question of whether these devices can be designed to cause frequency-selective changes in body sway, in order to reduce the high frequency sway of older persons, which has been associated with fall risk.