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A Virtually Supervised Web-Based Home Exercise Technology for Older Adults

针对老年人的虚拟监督的基于网络的家庭锻炼技术

基本信息

批准号：
8726275
负责人：
Joseph T Gwin
金额：
$ 19.79万
依托单位：
BIOSENSICS, LLC
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-01 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8726275
关键词：
Address Adherence Adult Age Aging Algorithms Ankle Arizona Balance training Binding Biomechanics Caregivers Clinical Research Communities Computer software Data Dementia Development Diabetes Mellitus Disease E-learning Effectiveness Elderly Elements Engineering Ensure Equilibrium Exercise Fall prevention Feedback Future Gait Goals Guidelines Health Healthcare Systems Hip region structure Home environment Human body Impaired cognition Instruction Interdisciplinary Study Internet Intervention Lower Extremity Mails Measures Methodology Methods Metric Modality Modeling Monitor Motion Motor Movement Neoprene Online Systems Outcome Measure Participant Performance Phase Population Positioning Attribute Process Qualifying Quality of life Randomized Controlled Trials Recruitment Activity Regimen Research Research Personnel Rewards Sample Size Signal Transduction Small Business Innovation Research Grant Solutions Stroke System Target Populations Techniques Technology Text Time Training Training Programs Transportation Universities Vendor Wireless Technology aging population base caregiving commercialization community setting compare effectiveness cost cost effective design evidence base fall risk falls foot functional decline high risk improved improved functioning improved mobility instrument kinematics new technology novel post intervention prevent programs prototype public health relevance rural area sensor signal processing software development strength training time use usability virtual virtual reality web site

项目摘要

DESCRIPTION (provided by applicant): Strength and balance training has been demonstrated to prevent physical decline and falls in older adults. The majority of fall prevention studies have focused on supervised group or home-based exercise interventions utilizing qualified personal. The implementation of these interventions on a community-wide level is limited due to home-bound status because of functional or cognitive decline, care-giving responsibilities, or transportation difficulties. High costs for personal, and lack of group exercie facilities are likewise problematic. A promising and cost-effective approach for tailoring strength and balance exercise to older adults in a community setting is to provide training via the internet. However, interactive web-based home exercise technologies, including virtually supervised training, have not yet been developed. The objective of this collaborative SHIFT SBIR project between BioSensics LLC (Cambridge, MA) and the University of Arizona (Interdisciplinary Consortium on Advance Motion Performance (iCAMP) and Arizona Center on Aging) is to develop a low cost, easy-to-use, interactive web application for home-based strength and balance training to improve mobility and reduce fall risk in older adults. The proposed system will be developed based on an existing non-interactive prototype web-based training program using a virtual on- screen trainer. The new interactive web application will include an on-screen 'user avatar' that mimics its users movements. This will be accomplished by developing an instrumented overshoe containing kinematic sensors. Based on the sensor signals, body segment kinematics (e.g., foot position, ankle angle, and hip angle) will be estimated in real-time using a simplified biomechanical model of the human body. The kinematic data will drive the on-screen user avatar, which will provide real-time feedback to the user regarding their exercise performance. Game-based features will be included for rewarding correctly performed exercises and motivating the user to achieve individually set exercise goals based on his/her initial motor performance. To ensure user-friendliness, the application will be developed based on established guidelines for media use in older adults. In the first of two clinical studies we will evaluate the accuracy of the estimates of lower extremity kinematics during exercise provided by the new system. In the second clinical study (a randomized controlled trial) we will evaluate the effectiveness of the proposed technology for improving mobility, gait, balance, quality of life, and risk of falling compared to unsupervised home trainin. Several validated outcome measures will be used to assess training-related changes in functional performance, as well as user perceived acceptability/usability of the new technology. A unique element of the present study is that both exercise adherence and exercise accuracy will be objectively assessed. A larger clinical study to further assess the benefits of the proposed technology for improving mobility and reducing falls in older adults is planned for Phase II of this project. In addition, in Phase II additional hardware and software development will be performed to make the system suitable for commercialization to the target population. The proposed technology could have an important effect on the US health care system by reducing the risk of falling and improving function, quality-of-life, and independence among older adults. This methodology addresses key issues for an aging population with high risk of falling and multiple disease processes. Moreover, the methods evaluated and refined in this study will be used in future web-based applications focused on exercise training in various disease processes that effect mobility and balance, such as stroke, diabetes, and dementia.

描述（由申请人提供）：力量和平衡训练已被证明可以预防老年人的身体衰退和福尔斯。大多数预防跌倒研究集中在利用合格的个人进行监督的团体或基于家庭的锻炼干预。由于功能或认知能力下降、照顾责任或交通困难，这些干预措施在全社区一级的实施受到限制。个人费用高，缺乏团体锻炼设施也是同样的问题。一种有前途且具有成本效益的剪裁强度方法在社区环境中为老年人提供平衡和锻炼是通过互联网提供培训。然而，包括虚拟监督训练在内的基于网络的交互式家庭锻炼技术尚未开发。BioSensics LLC（马萨诸塞州剑桥）和亚利桑那大学（高级运动性能跨学科联盟（iCAMP）和亚利桑那州老龄化中心）之间的这一合作性CIBIR项目的目标是开发一种低成本、易于使用的交互式网络应用程序，用于基于家庭的力量和平衡训练，以提高老年人的流动性并降低跌倒风险。拟议的系统将开发一个现有的非交互式原型基于网络的培训计划，使用虚拟屏幕上的教练。新的交互式网络应用程序将包括一个屏幕上的“用户化身”，模仿其用户的动作。这将通过开发一种包含运动传感器的仪器化套鞋来实现。基于传感器信号，身体部分运动学（例如，脚位置、踝角和髋角）将使用人体的简化生物力学模型来实时估计。运动学数据将驱动屏幕上的用户化身，其将向用户提供关于他们的锻炼表现的实时反馈。将包括基于游戏的功能，用于奖励正确执行的练习，并激励用户根据他/她的初始运动表现实现单独设定的练习目标。为确保方便用户，将根据老年人媒体使用的既定准则开发该应用程序。在两项临床研究的第一项中，我们将评估新系统提供的运动期间下肢运动学估计的准确性。在第二项临床研究（随机对照试验）中，我们将评估与无人监督的家庭训练相比，拟议技术在改善移动性、步态、平衡、生活质量和跌倒风险方面的有效性。将使用几个经确认的结局指标来评估功能性能的培训相关变化，以及用户对新技术的可接受性/可用性的感知。本研究的一个独特之处在于，运动坚持性和运动准确性都将得到客观评估。计划在本项目的第二阶段进行一项更大规模的临床研究，以进一步评估拟议技术在改善老年人活动性和减少福尔斯跌倒方面的益处。此外，在第II阶段，将进行额外的硬件和软件开发，以使系统适用于目标人群的商业化。这项技术可能会对美国医疗保健系统产生重要影响，降低老年人跌倒的风险，改善老年人的功能、生活质量和独立性。这种方法解决了具有高跌倒风险和多种疾病过程的老龄化人口的关键问题。此外，本研究中评估和改进的方法将用于未来基于网络的应用程序，重点是影响移动性和平衡性的各种疾病过程中的运动训练，如中风，糖尿病和痴呆症。