ZeroG TRIP: Training Responses in Postural Rehabilitation

项目摘要 这个项目的目标是显著提高我们对不平衡的理解和治疗 老年人和神经损伤患者在受到外部干扰后的反应 滑倒滑倒或绊倒我们的实验室研究表明，通过练习平衡反应可以改善 老年人和帕金森氏病(PD)患者。然而，这些实验室研究尚未得到 转化为临床实践，因为目前还没有安全可靠的培训和 量化平衡反应，特别是在地面行走时。零重力步态与平衡训练 由Aretech，LLC(弗吉尼亚州阿什伯恩)开发并现已商业化的系统允许具有步态和 平衡障碍对安全行走的影响--同时承受体重和摔倒 保护。目前的系统不允许患者练习从意外的外部环境中恢复 用于平衡训练的扰动也不包含用于量化的必要工具 平衡反应。 在第一阶段SBIR中，我们将通过开发ZeroG系统的 可在站立时传递的可调节大小和方向的受控平衡扰动 以及在地面上行走。零重力平衡扰动序列的框架，称为TRIP(列车 姿势康复的反应)，将基于我们实验室过去一年的科学发现 十年。我们将开发训练姿势阶跃反应所需的特定扰动特性 对于因帕金森病而导致平衡障碍的人，请与理疗师就可用性和安全性密切合作。 最后，通过问卷调查确定ZeroG Trip系统的可行性和临床实用性 来自患者和治疗师的反馈。 这项SBIR的第二阶段将侧重于ZeroG Trip系统的其他技术开发以及随后的 该设备的临床测试。具体地说，我们计划开发和测试姿势踏步的创新指标 与Aretech、LLC和ZeroG Trip合作，使用身体佩戴的传感器回应ZeroG Trip APDM公司。我们还将利用APDM传感器来跟踪患者在整个步态周期中的运动 这样我们就可以自动触发跳闸扰动，而不必手动触发 微扰。最后，我们将改进触摸屏电脑和无线平板电脑上的用户界面， 使控制对用户直观，同时提供足够的灵活性来控制扰动序列。 第二阶段的临床测试将集中于比较平衡反应和平衡的改善。 帕金森病患者TRIP训练后的信心与零体重支持步行的比较。 ZeroG Trip系统将使理疗师能够安全和系统地评估和治疗 平衡反应不足，这是导致跌倒、残疾和生活质量下降的主要原因。

Project Summary The goal of this project is to significantly enhance our understanding and treatment of inadequate balance responses in the elderly and in patients with neurological impairments following external perturbations such as a slip or trip. Our laboratory studies have shown that balance responses can be improved with practice in the elderly and in patients with Parkinson's disease (PD). However, these laboratory studies have not been translated into clinical practice because there is currently no safe and reliable technology for training and quantifying balance responses, particularly during overground walking. The ZeroG gait and balance training system developed and now commercialized by Aretech, LLC (Ashburn, VA) allows individuals with gait and balance disorders to safety practice walking overground with concurrent body-weight support and fall protection. The current system does not allow patients to practice recovering from unexpected external perturbation for balance training nor does the system contain the necessary instrumentation for quantifying balance responses. In this Phase I SBIR, we will significantly enhance the capabilities of the ZeroG system by developing controlled balance perturbations of adjustable magnitude and direction that can be delivered during standing and overground walking. The framework for the ZeroG balance perturbation sequences, called TRIP (Train Responses in Postural Rehabilitation), will be based upon the scientific findings of our laboratory over the last decade. We will develop the specific perturbation characteristics needed to train postural stepping responses in people with balance deficits due to PD and work closely with physical therapists on usability and safety. Finally, we will determine the feasibility and clinical usability of the ZeroG TRIP system through questionnaire feedback from patients and therapists. Phase II of this SBIR will focus on additional technical development of the ZeroG TRIP system and subsequent clinical testing of the device. Specifically, we plan to develop and test innovative metrics of postural stepping responses for ZeroG TRIP using the body-worn sensors with the partnership between Aretech, LLC and APDM, Inc. We will also utilize the APDM sensors to track the patient's movements throughout the gait cycle so that we can automatically trigger the TRIP perturbation rather than having to manually trigger the perturbation. Finally, we will refine the user interfaces on both the touch screen computer and wireless tablet, making the controls intuitive for the user yet providing sufficient flexibility to control the perturbation sequences. The clinical testing during Phase II will focus on comparing improvements in balance responses and balance confidence after training with TRIP compared to ZeroG body-weight support walking in people with PD. The ZeroG TRIP system will enable physical therapists to safely and systematically assess and treat inadequate balance responses, which are a major contributor to falls, disability, and declining quality of life.