Balance tele-rehabilitation with wearable technology for older adults with Parkinson disease

抽象的。在老年人平衡和活动能力逐渐下降期间最大限度地发挥独立功能 患有慢性疾病的成年人，如帕金森病（PD），是康复的一个独特挑战。 平衡训练以减少跌倒风险是老年人康复的一个重要特征，特别是那些患有PD的人。 然而，最近的COVID-19大流行暴露了安全和有效地 在人们的家中提供平衡康复服务。事实上，在大多数情况下， 由于远程康复无法远程评估平衡技能、锻炼 任务表现，或将平衡技能转移到日常生活中。我们假设，使用客观的措施， 远程平衡评估将改善结果，远程康复是可行的， 艺术，循证平衡康复。 在80名PD患者中，我们将使用最先进的可穿戴传感器来客观测量家中的平衡 在日常生活中被动监测。在目标I中，我们将确定虚拟的工具化平衡评估 使用可穿戴传感器可以预测我们的黄金标准，临床现场平衡评估， （迷你最佳）。在目标II中，我们将确定以平衡为重点的远程康复的可行性和有效性。 为此目的，将受试者随机分为两组：无监督的家庭锻炼（标准治疗）或2） 物理治疗师监督的平衡远程康复在第三个目标中，我们将探讨远程通信后的改进， 康复转移到日常生活活动能力，用7天被动监测测量。该项目将 确定使用基于可穿戴传感器的平衡和步态测量的可行性和有效性， PD患者平衡的虚拟评估。此外，我们将探讨远程康复如何改善 平衡，如果改善转化为日常流动性。该项目的成果将有助于制定一项 更有效的家庭平衡和康复评估和治疗，可用于任何老年人 有平衡障碍的成年人。

Abstract. Maximizing independent function during the progressive decline of balance and mobility in older adults with chronic diseases, such as Parkinson's disease (PD), is a unique challenge for rehabilitation. Balance training to reduce fall risk is a critical feature of rehabilitation for older adults, especially those with PD. However, the recent COVID-19 pandemic has uncovered serious weaknesses in safely and effectively delivering balance rehabilitation in people's homes. In fact, balance rehabilitation, for the most part, has been deferred during the pandemic due to inability of tele-rehabilitation to remotely assess balance skills, exercise task performance, or transfer of balance skills into daily life. We hypothesize that using objective measures for balance assessment remotely will improve outcomes and that telerehabilitation is feasible using state-of-the- art, evidence-based balance rehabilitation. In 80 people with PD, we will use state-of-the-art wearable sensors to objectively measure balance in the home and in daily life passive monitoring. In Aim I, we will determine if a virtual, instrumented balance assessment using wearable sensors can predict performance on our gold standard, clinical in-person balance assessment (Mini-BESTest). In Aim II, we will determine the feasibility and efficacy of a balance-focused tele-rehabilitation. For this Aim people will be randomized into either unsupervised home exercises (standard of care) or 2) physical therapist-supervised, balance tele-rehabilitation. In Aim III, we will explore if improvements after tele- rehabilitation transfer to daily life mobility, measured with 7 days of passive monitoring. This project will determine the feasibility and efficacy of using wearable sensor-based measures of balance and gait to improve virtual assessment of balance in people with PD. Moreover, we will explore how tele-rehabilitation improves balance and if the improvement translates to daily mobility. This outcome of this project will help develop a more effective home-based balance and rehabilitation assessment and treatment that can be used in any older adults with balance impairments.