Arm Motor Rehabilitation, Entertainment and Cognition System for the Elderly

描述(由申请人提供)：假设使用机器人康复床结合虚拟现实游戏，老年中风幸存者居民在熟练的护理设施(SNF)将：1)改善和维持上肢单手和双手功能、伸展能力、力量和ADL独立性；2)改善和维持认知(记忆力、专注力、解决问题)；以及3)提供情绪振奋并保持其。这实施了一种综合的、单点护理的安全康复方法。该项目的目标是1)开发一种新型的单手和双手训练设备，比康复机器人更便宜、更安全；2)基于虚拟现实的适应性和综合性维护计划，临床上有效，并吸引老年中风幸存者和其他患者群体。具体目标1)开发BrightArm Duo系统，以改善SNF居民慢性中风后的手臂/肩部活动范围、肩部力量、耐力、握力、双手功能和ADL独立性、短期记忆、注意力、执行功能和减少抑郁；2)通过对中风幸存者进行为期12个月的多点纵向随机对照研究，评估用于康复和维持治疗的新系统。方法1)通过设计和构建新的跟踪工作面和计算机化的前臂支撑来构建BrightArm Duo系统；2)开发包含单手和双手运动和认知训练元素的定制康复游戏，并自动适应每个患者。游戏应该结合在一起，以诱导&gt；350重复/会话；3)开发一个安全的网络可访问的数据库模块，用于游戏数据存储和分析，并能够与其他SNF的居民进行游戏。数据将在游戏过程中实时透明采样并上传到BCI临床服务器；4)可用性研究 健康的老年成年人，以发现技术问题；5)对新泽西州两个SNF的老年中风幸存者进行的纵向、多地点随机对照研究。受试者将被随机分为对照组(N=16)和试验组(N=32)。对照组将继续执行现有的健康维护计划。试验组将有现有的维护计划和额外的8周的初始强化训练，然后定期的“助推器”康复会议。所有科目都将有多项评估 身体和认知/情绪功能的盲目临床医生。这两个设施的现有维护计划将在行政管理中记录给所有研究参与者。试验组将评估BrightArm Duo疗法的有效性，并在ADLS中获得独立性。NIH相关性一种新的设备和治疗/维护方法，用于单手/双手手康复和单点护理中的认知/情绪治疗。该方法可以推广到其他运动和认知并存的患者群体，包括急性、亚急性和慢性、成人和儿科。 公共卫生相关性：公共卫生相关性：在美国，每年与中风相关的成本接近500亿美元。该产品同时改善和维持手臂的单手和双手功能，增加手臂力量，改善注意力和记忆力，并提振士气，使老年中风幸存者和其他患者群体(创伤性脑损伤、创伤后应激障碍、慢性疼痛、阿尔茨海默病、儿科)受益。该产品促进了降低医疗保健成本的单点护理疗法。

DESCRIPTION (provided by applicant): It is hypothesized that the use robotic rehabilitation tables coupled with virtual reality games with elderly stroke survivors residents in skilled nursin facilities (SNFs) will: 1) improve and maintain upper extremity uni-manual and bimanual function, reach, strength and ADL independence; 2) improve and maintain cognition (memory, focus, problem solving); and 3) provide emotive uplifting and maintain it. This implements an integrative, single-point-of-care safe rehabilitation approach. The objectives of the project are 1 to develop a novel uni-manual and bimanual training device that is cheaper and safer than rehabilitation robots; 2) a virtual reality-based adaptable and integrative maintenance program that is clinically effective and engaging for elderly stroke survivors and other patient population. SPECIFIC AIMS 1) to develop the BrightArm Duo system for improving arm/shoulder motion range, shoulder strength, endurance, grasp strength, bimanual function and ADL independence, short-term memory, focusing, executive function and reduce depression in SNF residents chronic post-stroke; 2) to evaluate the new system for rehabilitation and maintenance therapy through a multi-site, longitudinal, randomized controlled study of stroke survivors over a 12 month period. METHODS 1) Construct the BrightArm Duo system by designing and building a new tracking work surface and computerized forearm supports; 2) Develop custom rehabilitation games that incorporate uni- and bimanual motor and cognitive training elements and automatically adapt to each patient. The games should combine to induce >350 repetitions/session; 3) Develop a secure web-accessible database module for game data storage and analysis and ability to play against residents in other SNFs. Data will be sampled transparently in real time during play and uploaded to BCI clinical server; 4) Usability study with healthy elderly adults, to uncover technical problems; 5) Longitudinal, multi-site randomized controlled study with elderly stroke survivors that are residents at two SNFs in New Jersey. Subjects will be randomized into a control group (N=16) and an experimental group (N=32). The control group will continue with existing health maintenance programs. The experimental group will have existing maintenance program plus an additional 8 week initial intensive training, followed by periodic "booster" rehabilitation sessions. All subjects will have multiple evaluations by blinded clinicians for physical and cognitive/emotive function. Existing maintenance programs at the two facilities will be documented in administration to all study participants. The experimental group will rate the BrightArm Duo therapy usefulness and gained independence in ADLs. NIH RELEVANCE A new device and therapeutic/maintenance method for uni/bimanual arm rehabilitation and cognition/emotive therapy in a single-point-of-care. The approach can be extended to other patient populations with motor and cognitive co-morbidities acute, sub-acute and chronic, adult and paediatric. PUBLIC HEALTH RELEVANCE: Public Health Relevance: Costs associated with stroke are close to 50 billion a year in the United States. A product the simultaneously improves and maintains arm uni-manual and bimanual function, increases arm strength, improves ability to focus and memory, and lifts morale benefits elderly stroke survivors and other patient populations (traumatic brain injury, post-traumatic stress disorder, chronic pain, Alzheimer's Disease, pediatric). The product facilitates a single-point-of-care therapy that reduces health care costs.