Knee Biofeedback Rehabilitation Interface for Game-based Home Therapy (KneeBRIGHT)

项目摘要/摘要 意义：基于游戏的家庭治疗的膝关节生物反馈康复接口(“KneBRIGHT”) 将肌电(EMG)生物反馈与视频游戏疗法(VGT)相结合的系统提供膝关节 为骨关节炎(OA)患者提供一种引人入胜的有效工具，以便在家中进行康复练习。 KneBRIGHT旨在激励膝骨性关节炎患者定期进行肌肉强化锻炼 通过一种引人入胜的肌电驱动的视频游戏疗法。该系统结合了无线肌电电极， 通过提供自动指导的软件，方便患者在家庭环境中使用 循证、循序渐进的日常锻炼。重要的是，这些练习是在 有趣和引人入胜的游戏形式，以促进积极的体验，并鼓励继续坚持。 有待解决的问题：在美国，骨性关节炎是导致残疾的主要原因。康复服务通过 加强股四头肌是治疗膝骨性关节炎的一种成熟的治疗方法，但 由于缺乏关于最佳方案的指导，以及缺乏对锻炼计划的坚持，坚持锻炼计划的比例较低 在患者觉得乏味和乏味的重复例行公事中投入。 长期目标：通过有效和激励的康复练习改善膝骨性关节炎的结果。 第一阶段结果：在第一阶段的工作中，开发了一个原型KneBRIGHT系统，并在一个 实验室环境。对19名膝关节骨性关节炎患者进行的可行性测试表明，该方法具有统计学意义 膝关节运动中的肌肉激活、参与度水平和自愿运动持续时间的增加 与传统的肌电生物反馈系统进行的练习相比。 第二阶段假设：第二阶段计划将测试患者进行常规锻炼的假设 使用KneBRIGHT将：(1)与传统肌电相比，获得更好的肌肉力量增长 生物反馈方案；以及(2)与传统系统相比，表现出更高的依从性。 第二阶段综述：Barron Associates(视频游戏治疗领域的获奖创新者)已与 弗吉尼亚大学的这项SBIR第二阶段计划，以证明有效性和用户对 Knebright系统。第二阶段计划的具体目标是：(1)发展第二阶段 商业KneBRIGHT肌电模块；(2)开发第二阶段商业KneBRIGHT游戏软件 具有适应性的锻炼协议和扩展的游戏活动；(3)开发提供商仪表板，以支持 临床医生远程监控患者的表现；以及(4)执行肌肉力量的功效测试， 功能改善(通过膝关节骨关节炎结果评分)和依从性(与 传统系统)与膝骨性关节炎患者进行为期12周的临床试验。 影响：该系统将通过提高患者对 家庭锻炼，从而减轻疼痛症状，恢复膝骨性关节炎患者的身体功能。

PROJECT SUMMARY/ABSTRACT Significance: The Knee Biofeedback Rehabilitation Interface for Game-based Home Therapy (“KneeBRIGHT”) system combines electromyography (EMG) biofeedback with video game therapy (VGT) to provide knee osteoarthritis (OA) patients with an engaging, effective tool for conducting rehabilitation exercises at home. KneeBRIGHT aims to motivate patients with knee OA to conduct regular muscle strengthening exercise through an engaging, EMG-driven video game therapy. The system combines wireless EMG electrodes that are convenient for patients to use in a home setting with software that provides automated guidance through evidence-based, progressive exercise routines. Importantly, these exercises are presented to the patient in the form of fun and engaging games to promote a positive experience and encourage continued adherence. Problem to be Addressed: OA is the leading cause of disability in the United States. Rehabilitation through quadriceps strengthening is a well-established treatment for patients with OA of the knee, but patient adherence to exercise routines is low due to lack of guidance regarding optimal protocols and lack of engagement during the repetitive routines that patients find tedious and boring. Long-Term Goal: Improve knee OA outcomes through effective and motivating rehabilitation exercises. Phase I Results: During the Phase I effort, a prototype KneeBRIGHT system was developed and verified in a laboratory setting. The feasibility testing with 19 knee OA patients demonstrated statistically significant increases in muscle activation, engagement levels, and duration of voluntary exercise during the KneeBRIGHT exercises when compared with exercises conducted with a conventional EMG biofeedback system. Phase II Hypotheses: The Phase II program will test the hypotheses that patients performing exercise routines using KneeBRIGHT will: (1) achieve superior muscle strength gain compared to a conventional EMG biofeedback protocol; and (2) exhibit increased adherence compared to the conventional system. Phase II Summary: Barron Associates (award-winning innovators in video game therapy) has partnered with the University of Virginia for this SBIR Phase II program to demonstrate efficacy and user acceptance of the KneeBRIGHT system. The specific objectives of the Phase II program are to: (1) develop the Phase II commercial KneeBRIGHT EMG modules; (2) develop the Phase II commercial KneeBRIGHT game software with adaptive exercise protocols and expanded game activities; (3) develop a provider dashboard to enable clinicians to monitor patient performance remotely; and (4) perform efficacy testing of muscle strength, functional improvement (via Knee Osteoarthritis Outcome Score), and adherence (when compared to a conventional system) with knee OA patients in a 12-week clinical trial. Impact: The system will have a significant overall impact on public health by increasing patient adherence to home exercise and thereby reducing pain symptoms and restoring physical function to knee OA patients.