Arm Motor Rehabilitation, Entertainment and Cognition System for the Elderly

老年人手臂运动康复、娱乐及认知系统

• 批准号: 8455491
• 负责人: Grigore C BURDEA
• 金额: $ 70.81万
• 依托单位: BRIGHT CLOUD INTERNATIONAL CORPORATION
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-30 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8455491
• 关键词: Accounting; Acute; Adult; Age; Alzheimer' s Disease; Arthritis; Articular Range of Motion; Auditory; Blinded; Caring; Childhood; Chronic; Clinical; Clinical Research; Cognition; Cognitive; Cognitive deficits; Communication; Comorbidity; Computer software; Control Groups; Coupled; Custom; Data; Data Analyses; Data Collection; Data Storage and Retrieval; Databases; Delayed Memory; Depressed mood; Devices; Elderly; Elements; Evaluation; Force of Gravity; Forearm; Friction; Friends; Funding; Goals; Health; Health Care Costs; Health care facility; Height; International; Intervention; Libraries; Lifting; Location; Maintenance; Maintenance Therapy; Manuals; Medical; Memory; Mental Depression; Methods; Monitor; Morale; Motivation; Motor; Neurosciences; New Jersey; Occupational Therapy; Outcome; Participant; Patients; Performance; Phase; Play; Population; Post-Traumatic Stress Disorders; Problem Solving; Quality of life; Randomized; Randomized Controlled Trials; Rehabilitation therapy; Relative (related person); Reporting; Rewards; Robot; Robotics; Running; Sampling; Secure; Short-Term Memory; Shoulder; Site; Skilled Nursing Facilities; Small Business Innovation Research Grant; Stroke; Surface; Survivors; System; Technology; Testing; Therapeutic; Time; Training; Traumatic Brain Injury; United States; United States National Institutes of Health; Upper Extremity; Variant; Wireless Technology; Work; acute stroke; age group; age related; arm; base; chronic pain; cognitive training; computerized; cost; design; digital; executive function; experience; functional gain; grasp; healthy volunteer; improved; motor deficit; novel; patient population; phase 2 study; point of care; post stroke; programs; psychologic; public health relevance; self esteem; success; therapy duration; usability; virtual; virtual reality; web-accessible

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.

描述（由申请人提供）：假设对熟练护理设施（SNF）中的老年中风幸存者居民使用机器人康复床结合虚拟现实游戏将：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、注意力、解决问题的能力）； 3) 提供情绪提升并维持它。这实现了一种综合的、单点护理的安全康复方法。该项目的目标是 1 开发一种新型单手和双手训练装置，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，该计划在临床上有效且对老年中风幸存者和其他患者群体有吸引力。具体目标 1) 开发 BrightArm Duo 系统，用于改善 SNF 居民慢性中风后的手臂/肩部运动范围、肩部力量、耐力、抓握力量、双手功能和 ADL 独立性、短期记忆、注意力、执行功能并减少抑郁； 2) 通过对中风幸存者进行为期 12 个月的多中心、纵向、随机对照研究，评估新的康复和维持治疗系统。方法 1）通过设计和构建新的跟踪工作表面和计算机化前臂支撑来构建 BrightArm Duo 系统； 2) 开发定制康复游戏，融合单手和双手运动和认知训练元素，并自动适应每位患者。这些游戏应结合起来引发 >350 次重复/会话； 3) 开发一个安全的可通过网络访问的数据库模块，用于游戏数据存储和分析以及与其他 SNF 中的居民对战的能力。数据将在游戏过程中实时透明采样并上传至BCI临床服务器； 4) 可用性研究 健康的老年人，发现技术问题； 5) 对居住在新泽西州两个 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）和实验组（N=32）。对照组将继续现有的健康维护计划。实验组将采用现有的维护计划，加上额外的 8 周初始强化训练，然后定期进行“加强”康复课程。所有科目都会有多重评估 由对身体和认知/情感功能不知情的临床医生进行。两个设施的现有维护计划将记录在所有研究参与者的管理中。实验组将评估 BrightArm Duo 疗法的有效性并获得 ADL 的独立性。 NIH 相关性 一种新的设备和治疗/维护方法，用于单臂/双手康复和单点护理中的认知/情感治疗。该方法可以扩展到其他患有急性、亚急性和慢性、成人和儿童运动和认知共病的患者群体。 公共卫生相关性： 公共卫生相关性： 在美国，每年与中风相关的费用接近 500 亿美元。该产品可同时改善和维持手臂单手和双手功能，增强手臂力量，提高专注力和记忆力，并提高士气，对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）有益。该产品促进单点护理治疗，降低医疗保健成本。