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）：已经证明了力量和平衡训练以防止身体衰落和老年人下降。大多数秋季预防研究的重点是利用合格的个人的监督小组或家庭运动干预措施。由于功能或认知能力下降，提供护理的责任或运输困难，因此在社区范围内实施这些干预措施受到限制。个人的高昂成本和缺乏小组练习设施的成本同样有问题。一种有希望且具有成本效益的方法来剪裁强度在社区环境中，在社区环境中为老年人进行平衡练习是通过互联网提供培训。但是，尚未开发基于互动的基于网络的家庭锻炼技术，包括虚拟监督培训。 Biosensics LLC（马萨诸塞州剑桥）和亚利桑那大学（跨学科的预先运动表现（ICAMP）和亚利桑那州衰老中心）之间的合作转变SBIR项目的目的是开发低成本，易于使用，易于使用的，交互式网络的互动性，基于家庭的培训，以改善移动性和降低老年人的流动性和降低老年人的风险。提出的系统将基于现有的非相互作用的基于Web的培训程序，使用虚拟屏幕上的培训师开发。新的Interactive Web应用程序将包括模仿其用户动作的屏幕“用户化身”。这将通过开发一个含有运动学传感器的仪器套管来实现。根据传感器信号，将使用人体的简化生物力学模型实时估算身体段运动学（例如，脚部位置，踝角和臀部角度）。运动学数据将驱动屏幕上的用户化身，该化身将为用户提供有关其锻炼性能的实时反馈。将包括基于游戏的功能，以奖励正确执行的练习，并激励用户根据其最初的运动性能实现单独设定的锻炼目标。为了确保用户友好性，将根据既定的老年人使用媒体使用指南制定应用程序。在两项临床研究中，我们将评估新系统提供的运动过程中下肢运动学估计值的准确性。在第二项临床研究（一项随机对照试验）中，我们将评估所提出的技术在改善移动性，步态，平衡，生活质量和跌倒风险的有效性与无监督的家庭火车相比。几项经过验证的结果指标将用于评估功能性能的与培训相关的变化，以及用户可接受的新技术可接受性/可用性。本研究的一个独特元素是，锻炼依从性和运动精度都将被客观评估。一项更大的临床研究，以进一步评估所提出的技术在该项目的第二阶段中，计划在老年人中提高移动性和降低的效果。此外，将在第二阶段进行其他硬件和软件开发，以使该系统适用于目标人群的商业化。提出的技术可能会通过降低跌倒和改善功能，生活质量和独立性的风险，对美国医疗保健系统产生重要影响。该方法解决了衰老的人口降低和多种疾病过程的关键问题。此外，本研究中评估和完善的方法将用于未来的基于Web的应用程序，该应用程序旨在在各种疾病过程中进行运动训练，以影响流动性和平衡，例如中风，糖尿病和痴呆症。