Boost: A pragmatic inpatient rehabilitation strategy for improving musculoskeletal arm recovery after stroke
Boost:一种实用的住院康复策略,可改善中风后手臂肌肉骨骼的恢复
基本信息
- 批准号:10325263
- 负责人:
- 金额:$ 86.88万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-09-21 至 2023-08-31
- 项目状态:已结题
- 来源:
- 关键词:Analysis of CovarianceBiomechanicsChronicClinicalCognitiveControl GroupsDevicesEducational process of instructingElbowExerciseFeedbackHealthcareHomeHourImpairmentIn SituIndividualInpatientsLegLifeLiving StandardsManual wheelchairModelingMotorMovementMuscleMusculoskeletalNervous System TraumaOutcome MeasurePainPamphletsParticipantPathway interactionsPatientsPatternPhaseProductionPublic HealthRandomizedRandomized Controlled TrialsRecoveryRehabilitation therapyResearchRestRoboticsSafetySelf CareSensoryShoulderSmall Business Innovation Research GrantSocietiesSterile coveringsStrokeSupervisionSystemTechniquesTechnologyTestingTimeUpper ExtremityWheelchair propulsionWheelchairsarmarm paresisbaseclinical efficacyclinical practicecommercializationconventional therapydaily functioningdesigndisabilityexperimental studyfollow-upimprovedinnovationmanufacturabilitymotor deficitmotor impairmentmotor recoverymovement practicenovelpost strokeprimary outcomeprototyperehabilitation strategyroutine practicespasticitystroke recoverysuccesssynergismtooluser centered design
项目摘要
One in six people will have a stroke; over half will incur chronic upper extremity (UE) impairment. While
intensive rehabilitation reduces impairment, most individuals do not perform enough movement practice
early after stroke when plasticity is heightened. Our hypothesis is that there is a threshold level of UE
motor drive needed to provoke true UE recovery, yet individuals do not routinely exceed this threshold
during inpatient rehabilitation. To solve this, Flint Rehab and UC Irvine propose to test a novel, pragmatic
rehabilitation strategy for enabling individuals with even severe arm impairment to increase UE motor
drive early after stroke. We will leverage a ubiquitous piece of technology–the manual wheelchair–based
on two key observations. The first is a pivotal study by Feys et al. that had 100 inpatients with subacute
stroke rock themselves in rocking chairs by repetitively reaching forward with their impaired arm 500-
1000 times per day; these patients had significantly greater increases in UE Fugl-Meyer (FM) score of 17
points at a five-year follow up compared to control. This is a remarkable effect, yet this therapy remains
unimplemented in routine clinical practice. A second observation: 70% of stroke inpatients (and nearly all
with more severe impairments) spend several hours each day sitting passively in manual wheelchairs,
often with their paretic arm strapped into an arm trough. Further, when they move in their wheelchair,
they are pushed, or taught to use their “good” arm and leg. Our core idea is to use a novel, moveable
wheelchair armrest called Boost to enable inpatients to perform the repetitive arm therapy validated by
Feys while seated in their wheelchair. Boost quickly clicks into a wheelchair frame just like a conventional
wheelchair armrest and incorporates an innovative linear mechanism that enables UE activation in two
modes: 1) with the chair remaining stationary, or 2) with the user contributing to propelling their
wheelchair with their impaired arm. This latter mode transforms the "good arm + good leg" compensatory
wheelchair propulsion technique into “good arm + good leg + impaired arm” propulsion. We hypothesize
that use of Boost during inpatient therapy will enable individuals with stroke to achieve the threshold
level of UE motor drive required to provoke UE recovery in routine practice, significantly improving
recovery compared to conventional treatment. We have already pilot tested a functional prototype of
Boost with positive results. Thus, for this Direct-to-Phase II SBIR our aims are to: Aim 1) Develop a
commercial-ready model of Boost with clinical and end-user feedback; Aim 2) Perform a randomized
controlled trial of Boost with inpatients with subacute stroke (N=58). At project end, we will have
validated the clinical feasibility and efficacy of Boost and optimized it for production and mass distribution.
If our plan is successful, we will have demonstrated that wheelchair-based “rocking therapy” can help
patients routinely achieve the threshold level of sensory motor drive needed to provoke true UE recovery.
六分之一的人会中风;超过一半的人会导致慢性上肢(UE)损伤。而当
强化康复减少损伤,多数个人动作练习不足
卒中后早期,可塑性增强。我们的假设是UE存在一个阈值水平
汽车驱动需要刺激真正的UE恢复,但个人通常不会超过这一门槛
在住院康复期间。为了解决这个问题,弗林特康复中心和加州大学欧文分校提议测试一种新颖、务实的
使严重手臂损伤患者能够增加UE运动的康复策略
中风后要早点开车。我们将利用一项无处不在的技术-手动轮椅
基于两个关键的观察。第一个是Feys等人的一项关键研究。有100名亚急性疾病住院患者
用受损的手臂反复向前伸手,在摇椅上摇晃自己-500-
每天1000次;这些患者的UE Fugl-Meyer(FM)评分增加幅度明显更大,为17
与对照组相比,进行了五年的随访。这是一个显著的效果,但这种疗法仍然
未在常规临床实践中实施。第二个观察:70%的中风住院患者(几乎所有
有更严重的损伤)每天花几个小时被动地坐在手动轮椅上,
通常他们偏瘫的手臂被绑在手臂槽里。此外,当他们坐在轮椅上移动时,
他们被推搡,或被教导如何使用他们“好”的胳膊和腿。我们的核心理念是用一种新颖的、可移动的
轮椅扶手称为Boost,使住院患者能够进行重复的手臂治疗
坐在轮椅上的飞人。Boost快速进入轮椅框架,就像传统的
轮椅扶手,并结合了创新的直线机构,使UE激活在两个
模式:1)椅子保持静止,或2)使用者推动其
手臂受伤的轮椅。这后一种模式转化为“好臂+好腿”的补偿方式
轮椅推进技术转变为“好臂+好腿+残臂”推进。我们假设
在住院治疗期间使用Boost将使中风患者能够达到阈值
在常规练习中要求UE电机驱动水平以促使UE恢复,显著提高
与常规治疗相比,恢复情况更好。我们已经对功能原型进行了初步测试
以积极的结果推动。因此,对于这个直接到第二阶段的SBIR,我们的目标是:目标1)开发
具有临床和最终用户反馈的商业就绪型Boost模型;目标2)执行随机
58例亚急性卒中住院患者的Boost对照试验。在项目结束时,我们将拥有
验证了Boost的临床可行性和有效性,并对其进行了生产和批量分配的优化。
如果我们的计划成功,我们将证明基于轮椅的“摇摆疗法”可以起到帮助作用。
患者通常达到促使UE真正恢复所需的感觉运动驱动的阈值水平。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Daniel Zondervan其他文献
Daniel Zondervan的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Daniel Zondervan', 18)}}的其他基金
IndieTrainer: Enabling Children with Cerebral Palsy to Receive Gamified Power Mobility Training in their Own Manual Wheelchairs
IndieTrainer:让脑瘫儿童在自己的手动轮椅上接受游戏化的力量移动训练
- 批准号:
10430265 - 财政年份:2021
- 资助金额:
$ 86.88万 - 项目类别:
IndieTrainer: Enabling Children with Cerebral Palsy to Receive Gamified Power Mobility Training in their Own Manual Wheelchairs
IndieTrainer:让脑瘫儿童在自己的手动轮椅上接受游戏化的力量移动训练
- 批准号:
10251511 - 财政年份:2021
- 资助金额:
$ 86.88万 - 项目类别:
Boost: A pragmatic inpatient rehabilitation strategy for improving musculoskeletal arm recovery after stroke
Boost:一种实用的住院康复策略,可改善中风后手臂肌肉骨骼的恢复
- 批准号:
10490452 - 财政年份:2021
- 资助金额:
$ 86.88万 - 项目类别:
FitMi AD: a safe and motivating computer-guided exercise system for individuals with MCI or mild dementia due to Alzheimer's disease
FitMi AD:一种安全、激励性的计算机引导锻炼系统,适用于患有 MCI 或因阿尔茨海默氏病导致的轻度痴呆症的患者
- 批准号:
10324211 - 财政年份:2019
- 资助金额:
$ 86.88万 - 项目类别:
FitMi Plus: Smart Functional Modules for Practicing Activities of Daily Living after Stroke
FitMi Plus:用于中风后日常生活活动练习的智能功能模块
- 批准号:
10055788 - 财政年份:2019
- 资助金额:
$ 86.88万 - 项目类别:
FitMi Plus: Smart Functional Modules for Practicing Activities of Daily Living after Stroke
FitMi Plus:用于中风后日常生活活动练习的智能功能模块
- 批准号:
9977336 - 财政年份:2019
- 资助金额:
$ 86.88万 - 项目类别:
FitMi AD: a safe and motivating computer-guided exercise system for individuals with MCI or mild dementia due to Alzheimer's disease
FitMi AD:一种安全、激励性的计算机引导运动系统,适用于患有 MCI 或因阿尔茨海默氏病导致的轻度痴呆症的患者
- 批准号:
10474575 - 财政年份:2019
- 资助金额:
$ 86.88万 - 项目类别:
Lever Actuated Rehabilitation of the Arm using Wheelchair Propulsion and Computer Gaming
使用轮椅推进和电脑游戏进行杠杆驱动的手臂康复
- 批准号:
9143148 - 财政年份:2015
- 资助金额:
$ 86.88万 - 项目类别:
相似海外基金
CAREER: Evolutionary biomechanics and functional morphology of salamander locomotion
职业:蝾螈运动的进化生物力学和功能形态
- 批准号:
2340080 - 财政年份:2024
- 资助金额:
$ 86.88万 - 项目类别:
Continuing Grant
Cruising the whale superhighway: The evolution, biomechanics, and ecological drivers of migration in cetaceans
巡航鲸鱼高速公路:鲸目动物迁徙的进化、生物力学和生态驱动因素
- 批准号:
NE/Y000757/1 - 财政年份:2024
- 资助金额:
$ 86.88万 - 项目类别:
Research Grant
2024 Summer Biomechanics, Bioengineering, and Biotransport Conference; Lake Geneva, Wisconsin; 11-14 June 2024
2024年夏季生物力学、生物工程和生物运输会议;
- 批准号:
2413182 - 财政年份:2024
- 资助金额:
$ 86.88万 - 项目类别:
Standard Grant
Predictive Biomechanics for Modelling Gait Stability and Falls Prediction
用于步态稳定性和跌倒预测建模的预测生物力学
- 批准号:
DP240101449 - 财政年份:2024
- 资助金额:
$ 86.88万 - 项目类别:
Discovery Projects
CAREER: Characterization of Vocal Fold Vascular Lesions Biomechanics using Computational Modeling
职业:使用计算模型表征声带血管病变生物力学
- 批准号:
2338676 - 财政年份:2024
- 资助金额:
$ 86.88万 - 项目类别:
Standard Grant
NSF Convergence Accelerator, Track M: TANDEM: Tensegrity-based Assistive aND rehabilitation Exosuits to complement human bioMechanics
NSF 融合加速器,轨道 M:TANDEM:基于张拉整体的辅助和康复外装,以补充人体生物力学
- 批准号:
2344385 - 财政年份:2024
- 资助金额:
$ 86.88万 - 项目类别:
Standard Grant
Doctoral Dissertation Research: The three-dimensional biomechanics of the grasping big toe among higher primates
博士论文研究:高等灵长类抓握大脚趾的三维生物力学
- 批准号:
2341368 - 财政年份:2024
- 资助金额:
$ 86.88万 - 项目类别:
Standard Grant
Material testing machine for biomechanics
生物力学材料试验机
- 批准号:
520201861 - 财政年份:2023
- 资助金额:
$ 86.88万 - 项目类别:
Major Research Instrumentation
Stem cell/niche biomechanics in intestinal health and disease
肠道健康和疾病中的干细胞/利基生物力学
- 批准号:
2885708 - 财政年份:2023
- 资助金额:
$ 86.88万 - 项目类别:
Studentship
Determining the impact of lifestyle-related biomechanics on muscle in the ageing human arm
确定与生活方式相关的生物力学对衰老人类手臂肌肉的影响
- 批准号:
2899554 - 财政年份:2023
- 资助金额:
$ 86.88万 - 项目类别:
Studentship