SCH: Context-aware Freezing of Gait mitigation in real-world setting

SCH：现实环境中的上下文感知步态冻结冻结

• 批准号: 10533377
• 负责人: Leslie J Cloud
• 金额: $ 32.36万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10533377
• 关键词: Awareness; Freezing; Gait; Instruction

This project seeks to reduce the burden of freezing of gait (FoG), which is suffered by over 50% of people living with Parkinson’s disease (PD). FoG is a common, devastating manifestation of PD for which there is no cure or adequate medical or surgical treatment. FoG has been defined as a “brief, episodic absence or marked reduction of forward progression of the feet, despite the intention to walk”. It is widely known that FoG episodes are frequently triggered by various environmental and psychological factors. The most commonly recognized triggers include start hesitation (freezing upon gait initiation), walking through tight quarters, turn hesitation (freezing when changing directions), approaching a visual target, dual tasking, and stressful, time sensitive situations such as entering an elevator before the doors close. Each individual with PD is unique with regard to how sensitive they are to these various triggers, underscoring the need for customized therapeutic approaches. A promising option for treating FoG is the use of tactile stimulation, however, no technology to date can provide customized therapy that adapts to the individual’s needs with regard to the specific triggering scenarios. In this proposed project, the Virginia Commonwealth University and William & Mary teams will work together to develop novel technology that deploys context-specific vibration stimuli tailored to the individual’s needs, with the goal of preventing or mitigating FoG. In Task 1, we will design and develop a wearable system for automatic FoG detection and vibration delivery using existing technology (Ultigesture UG motion sensors, PDVibe3, and a smartphone). The device will be able to detect FoG immediately upon occurrence. In Task 2, we will determine the optimum dose of vibration frequency and amplitude for the five most common environmental and psychological triggers for FoG in a controlled environment (in the clinical lab). In Task 3, we will integrate a global positioning mechanism into the wearable system so that the device can recognize environmental triggers of FoG. We will program the optimal parameters of vibration determined in Task 2 (for each of the five triggers) to deploy in response to corresponding environmental and psychological triggers and will test it in a real-world setting (a public place). Upon completion of this project we will have created and tested a closed-loop system that will deliver customized vibration therapy to people with PD at the precise moment it is needed to prevent or mitigate FoG episodes. This project aligns directly with the NINDS mission to reduce the burden of neurological diseases such as PD.

该项目旨在减轻冻结步态 (FoG) 的负担，超过 50% 的帕金森病 (PD) 患者都患有这种疾病。 FoG 是 PD 的一种常见的、破坏性的表现，无法治愈或没有足够的药物或手术治疗。 FoG被定义为“尽管有行走的意图，但脚部的向前推进却短暂、间歇性消失或显着减少”。众所周知，FoG 发作经常由各种环境和心理因素引发。最常见的触发因素包括开始犹豫（步态开始时僵住）、穿过狭窄的空间、转弯犹豫（改变方向时僵住）、接近视觉目标、双重任务以及压力大、时间敏感的情况，例如 就像在门关闭之前进入电梯一样。每个帕金森病患者对这些不同触发因素的敏感程度都是独一无二的，这凸显了定制治疗方法的必要性。治疗 FoG 的一个有前途的选择是使用触觉刺激，然而，迄今为止，还没有任何技术可以提供适应个人对特定触发场景的需求的定制治疗。在这个拟议项目中，弗吉尼亚联邦大学和 William & Mary 团队将共同开发新技术，根据个人需求部署特定环境的振动刺激，目标是预防或减轻 FoG。在任务1中，我们将设计和开发用于自动FoG的可穿戴系统 使用现有技术（Ultigesture UG 运动传感器、PDVibe3 和智能手机）进行检测和振动传递。该设备将能够在发生 FoG 后立即检测到。在任务 2 中，我们将在受控环境（临床实验室）中确定 FoG 的五种最常见环境和心理触发因素的振动频率和振幅的最佳剂量。在任务3中，我们将把全球定位机制集成到可穿戴系统中，以便设备能够识别FoG的环境触发因素。 我们将对任务 2 中确定的最佳振动参数（针对五个触发因素中的每一个）进行编程，以响应相应的环境和心理触发因素进行部署，并将在现实环境（公共场所）中对其进行测试。该项目完成后，我们将创建并测试一个闭环系统，该系统将在需要预防或减轻 FoG 发作的精确时刻为 PD 患者提供定制的振动治疗。该项目与 NINDS 的使命直接一致，即减轻帕金森病等神经系统疾病的负担。