Quantifying and Reducing Motor Compensation After Stroke in Ambient Settings

 描述(申请人提供)：该项目将开发一种轻便、不显眼的可穿戴传感器系统，能够在家庭环境中监控个人的运动，并提供运动质量的实时反馈。该系统将帮助临床医生监测家庭环境中功能能力的变化，并将帮助患有神经运动DefiCITS的患者在自我护理中发挥更积极的作用。这样的系统对于确定中风后个人是否使用代偿性运动特别有用。补偿是指使用新的肢体和策略来完成以前与中风患肢一起执行的任务。这种补偿被认为是不适应的，可能会导致进一步的伤害和生活质量下降。在没有临床观察者的情况下(例如，在家里)，代偿策略可能会演变并被fi。因此，本项目的目标是(1)开发一种在家庭环境中使用可穿戴传感器来量化此类补偿的技术，以及(2)评估两种基于生物反馈的干预措施的相对效果fi，旨在减少家庭补偿策略的使用。这些干预措施为参与者提供关于其运动质量的反馈，但在交付方式上有所不同--一种提供关于个人身体的内部定向反馈，另一种提供关于个人环境的外部定向反馈。如果成功，这个项目可能会使美国700万慢性中风患者中的许多人受益。fi我们的方法将利用前瞻性实验设计和组间人类受试者研究。我们预计，这两种基于生物反馈的干预措施都将使参与者受益，但内部定向反馈将显著减少补偿的使用。在这个项目中开发和验证的方法最终可能对其他患有慢性运动性心脏病(fidefiCits)的人有利。

 DESCRIPTION (provided by applicant): This project will develop a lightweight, unobtrusive system of wearable sensors capable of monitoring an individual's motion in the home setting, and providing real-time feedback of motion quality. This system will help clinicians monitor changes in functional ability in home settings, and will help patients with neuro-motor deficits t take a more active role in self-care. Such a system is particularly useful for determining if individuals are using compensatory motions after stroke. Compensation describes the use of new limbs and strategies to accomplish tasks previously performed with the stroke affected limb. Such compensation is thought to be maladaptive and may lead to further injury and depressed quality of life. Compensatory strategies likely evolve and are affirmed in the absence of a clinical observer (e.g., at home). Thus, this project aims to (1) develop a technique for quantifying such compensation in the home setting using wearable sensors and (2) evaluate the relative efficacy of two biofeedback-based interventions designed to reduce the use of compensatory strategies at home. These interventions provide the participant with feedback regarding their movement quality, but differ in the style of delivery - one provides internally directed feedback regarding the person's body, and the other provides externally directed feedback regarding the person's environment. If successful, this project may benefit many of the seven million people living with chronic stroke in the United States. Our methodology will utilize a prospective experimental design, and a between-groups human subjects study. We anticipate that both biofeedback based interventions will benefit the participant, but that the internally directed feedback will significantly reduce the use of compensation. The methodology developed and validated in this project may eventually benefit other individuals living with chronic motor deficits.