A Novel Instrument to Address Freezing of Gait in Parkinson's Patients

一种解决帕金森病患者步态冻结的新型仪器

• 批准号: 10323757
• 负责人: Brian R Clark
• 金额: $ 30万
• 依托单位: BARRON ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10323757
• 关键词: Address; Admission activity; Adult; Age; Algorithms; American; Ankle; Auditory; Blinking; Bluetooth; Bradykinesia; Cessation of life; Chronic; Cities; Clinical; Clinical Research; Computer software; Cues; Custom; Data; Databases; Detection; Diagnosis; Evaluation; Event; Eyeglasses; Face; Feedback; Freedom; Freezing; Functional disorder; GTP-Binding Protein alpha Subunits, Gs; Gait; Goals; Hand; Head; Hospitalization; Incidence; Individual; Intelligence; Intention; Intervention; Jaw; Leg; Limb structure; Link; Manuals; Measurement; Motor; Movement Disorders; Music; Nature; Neurodegenerative Disorders; Nursing Homes; Operative Surgical Procedures; Outcome; Parkinson Disease; Patients; Periodicity; Pharmaceutical Preparations; Pharmacological Treatment; Phase; Population; Prevalence; Public Health; Quality of life; Research; Small Business Innovation Research Grant; Speech; Substantia nigra structure; Symptoms; System; Tactile; Technology; Thigh structure; Thinness; Time; Tremor; United States; Validation; Visual; Walking; Wireless Technology; Woman; Work; arm; commercialization; cost; design; disability; disabling symptom; dopaminergic neuron; experience; fall injury; foot; improved; individual patient; instrument; light weight; men; motor symptom; multimodality; novel; operation; parkin gene/protein; phase 1 study; phase 2 study; posture instability; prevent; prototype; response; sensor; social; symptomatology; usability

Project Summary/Abstract Introduction. Parkinson's Disease (PD) is a common neurodegenerative disorder that a ects 1 million Americans and 10 million individuals worldwide. The incidence of PD increases with age, and men are 50% more likely to have PD than women. The costs of PD are estimated to be $25 billion annually in the United States alone. One of the most debilitating and impactful symptoms of PD is Freezing of Gait (FOG). Problem to be Solved. FOG, de ned as an episodic absence or marked reduction of forward progression of the feet despite the intention to walk, is a common motor symptoms of PD. FOG is a \mysterious phenomenon" with a pathophysiology that is not fully understood. FOG decreases quality of life and activity level, and often leads to loss of independence and injurious falls. Although FOG is more common in the later stages of PD, it also occurs in 26% of early-stage patients. Surgical and pharmacological treatments are often ine ective in reducing FOG symptoms; however, alternate interventions can be more ecacious. External prompts, such as auditory, visual, or tactile cues, have been shown to help, but outcomes are generally mixed due to the individualized nature of FOG|various types of cues are more or less e ective depending on individuals and their present circumstances. The ParkinSense System. The proposed body-worn ParkinSense system is specially designed to help PD patients prevent FOG and resume ambulation when FOG occurs. The miniature, wireless ParkinSense instrument will be easily attachable to existing prescription or nonprescription eyeglasses, or can be worn as a low-pro le band under a cap or hat. Using sophisticated on-board six degrees-of-freedom inertial sensing and real-time processing algorithms, the ParkinSense system will automatically detect the onset of FOG and provide an individually calibrated and optimized combination of cues, including: auditory (including speech, music, or rhythmic beats), visual (transverse lines in the visual eld or blinking lights), and/or vibrotactile cues. In addition to the head-worn instrument, the ParkinSense system will include an optional limb-worn auxiliary unit. The head-worn unit will provide the main sensing and multimode cueing capabilities, and the auxiliary unit will enable supplemental sensing and cueing directly to a limb (e.g, a leg) if desired. The head-worn unit will communicate wirelessly with the limb-worn unit. The ParkinSense system will enable delivery of multiple types of cues in any combination. Cueing can be provided automatically in response to a FOG event, manually (controlled by the wearer), or continuously. Cue delivery can be optimized to provide maximum ecacy, unobtrusiveness, and comfort for individual users. Further, the ParkinSense system will have the capability to adapt its cues in real-time to match, for example, the functional step cadence of the wearer, thereby increasing ecacy.

项目总结/摘要 导论.帕金森氏病（Parkinson's Disease，PD）是一种常见的神经退行性疾病，在美国有100万人患有这种疾病 全球有1000万人。PD的发病率随着年龄的增长而增加，男性比男性多50%的可能性。 PD比女人多。仅在美国，PD的成本估计为每年250亿美元。 PD最具破坏性和影响力的症状之一是步态冻结（FOG）。 待解决的问题。FOG，定义为间歇性缺失或前向进展明显减少， 双脚不顾意图行走，是PD常见的运动症状。雾是一种“神秘的现象” 其病理生理机制尚不完全清楚FOG降低生活质量和活动水平，并且通常 导致失去独立性和受伤的福尔斯。尽管FOG在PD的后期更常见，但它 也发生在26%的早期患者中。 手术和药物治疗在减轻FOG症状方面通常是有效的;然而， 干预措施可以更加大胆。外部提示，如听觉，视觉或触觉提示，已显示 但由于FOG的个性化性质，结果通常是混合的|各种类型的线索， 或多或少有效取决于个人和他们目前的情况。 ParkinSense系统拟议的随身佩戴ParkinSense系统是专门为帮助PD患者而设计的 防止FOG并在FOG发生时恢复维护。微型无线ParkinSense仪器将 可以很容易地连接到现有的处方或非处方眼镜，或可以作为低prole带佩戴 在帽子或帽子下。使用先进的机载六自由度惯性传感和实时处理 算法，ParkinSense系统将自动检测FOG的发作，并提供单独的 校准和优化的线索组合，包括：听觉（包括语音、音乐或节奏节拍）， 视觉（视野中的横线或闪烁的灯）和/或振动触觉提示。 除了头戴式仪器外，ParkinSense系统还将包括一个可选的肢体佩戴辅助设备 单位头戴式装置将提供主要的传感和多模式提示能力，辅助装置 如果需要的话，将能够直接对肢体（例如腿）进行补充感测和提示。头戴式装置将 与肢体穿戴单元无线通信。ParkinSense系统将能够提供多种类型的 任何组合的线索。提示可以响应FOG事件自动提供，也可以手动（控制 由佩戴者）或连续地。提示传递可以被优化以提供最大的准确性、不显眼性， 以及个人用户的舒适性。此外，ParkinSense系统将有能力调整其提示， 实时地匹配例如穿戴者的功能性步伐节奏，从而提高准确性。