Interactive Telehealth and Auto-Biofeedback Sensor System for Individuals Who Use a Wheelchair

适用于轮椅使用者的交互式远程医疗和自动生物反馈传感器系统

• 批准号: 9345724
• 负责人: Joseph T Gwin
• 金额: $ 75万
• 依托单位: BIOSENSICS, LLC
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-10 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9345724
• 关键词: Acceleration; Accelerometer; Achievement; Algorithms; Biofeedback; Biomedical Technology; Cardiovascular system; Caregivers; Caring; Cellular Phone; Chronic; Clinic; Clinical Trials; Clinical effectiveness; Community Participation; Comorbidity; Complication; Control Groups; Dangerousness; Data; Decubitus ulcer; Detection; Devices; Diabetes Mellitus; Education; Electronic Mail; Electronics; Engineering; Esthetics; Feedback; Goals; Health; Health Insurance Portability and Accountability Act; Home environment; Incidence; Individual; Internet; Intervention; Life; Link; Manual wheelchair; Manuscripts; Measurement; Measures; Medical Records; Methods; Modification; Monitor; Morbidity - disease rate; Movement; Obesity; Osteoporosis; Participant; Patient Care; Patient risk; Patients; Pattern; Performance; Phase; Physical activity; Provider; Publications; Quality of life; Randomized Clinical Trials; Recommendation; Recruitment Activity; Rehabilitation Centers; Research Infrastructure; Role; Scientist; Secondary Prevention; Secure; Self Management; Self-Help Devices; Skin; Small Business Innovation Research Grant; Spinal cord injury; System; Technology; Testing; Thinness; Tissues; United States; Wheelchairs; Wireless Technology; Work; base; cost; cost efficient; depressive symptoms; disability; group intervention; healing; high risk; improved; innovation; innovative technologies; instrument; mortality; novel; post intervention; pressure; prevent; prototype; satisfaction; secondary analysis; sensor; technology development; telehealth; telehealth systems; tool; wearable technology; web site

PROJECT ABSTRACT / SUMMARY Inactivity in individuals with chronic disabilities who use a wheelchair results in significant and costly secondary complications, such as pressure ulcers, obesity, diabetes, osteoporosis, and cardiovascular comorbidities. We propose to develop an interactive telehealth monitoring and biofeedback system to promote physical activity and pressure relief maneuver performance among wheelchair users. In this project we focus on patients with spinal cord injury (SCI) who are at particularly high risk for developing pressure ulcers from sitting too long (31% annual incidence, 85% lifetime incidence). However, the proposed technology is broadly applicable to wheelchair-based telehealth. The proposed technology - which attaches to any wheelchair without modification - has three core components: 1) an activity monitoring system (i.e., detection of wheel-pushes), 2) a pressure relief monitoring system, and 3) reminders and feedback regarding the achievement of pressure relief and physical activity goals. Biofeedback will be delivered locally (to the user) via a smartphone app and remotely (to the clinician) via a secure internet interface. The enabling technologies are innovative sensor systems to monitor wheelchair specific activity patterns but the significant value comes from integrating these novel measurements within a biofeedback system that encourages wheelchair users to actively avoid secondary complications of inactivity and allows care providers to identify at risk patients and intervene efficiently. Existing technologies do not compare with the proposed solution. Products exist to monitor wheelchair seat pressure but these products are costly, cumbersome, and not designed for home use. Products exist to monitor wheelchair specific physical activity but these devices cannot distinguish passive from active wheelchair movement. No existing technology combines these measures with biofeedback and telehealth functionality. The team we have assembled for this collaborative project includes engineers, clinicians, and scientists from BioSensics (a privately held biomedical technology development company) and Rancho Los Amigos National Rehabilitation Center (one of the largest comprehensive rehabilitation centers in the United States). During Phase I of this project we developed and validated a prototype version of wheelchair sensor and smartphone app (Dowling et. al., Wireless Health, 2015; Dowling et. al., Assistive Technologies, In Press). During Phase II we will improve the seat sensor hardware and develop the remote monitoring and telehealth aspects of the proposed system including 1) a secure HIPAA compliant website so patients, caregivers, and clinicians can remotely view activity and pressure relief data, 2) an automated method for pushing alerts to clinicians and caregivers (via SMS or e-mail) if pressure relief or activity goals are not met, and 3) a simple interface so clinicians and caregivers can send telehealth reminders to the wheelchair user’s smartphone app.

项目摘要/摘要 使用轮椅的慢性残疾人缺乏运动会导致严重且代价高昂的继发性 并发症，如压疮、肥胖、糖尿病、骨质疏松症和心血管并发症。我们 建议开发交互式远程健康监测和生物反馈系统，以促进身体健康 轮椅使用者的活动及减压动作表现。在这个项目中，我们主要关注 脊髓损伤(SCI)患者因久坐导致压疮的风险特别高 时间太长(年发病率为31%，终身发病率为85%)。然而，提议的技术是广泛的 适用于基于轮椅的远程保健。 这项拟议的技术--无需修改就可以安装在任何轮椅上--有三个核心 组件：1)活动监测系统(即，车轮推动检测)，2)压力释放监测 系统，以及3)关于实现减压和体力活动的提醒和反馈 目标。生物反馈将通过智能手机应用程序在本地(传递给用户)和远程传递(传递给临床医生) 通过安全的互联网接口。使之成为可能的技术是监测轮椅的创新传感器系统。 特定的活动模式，但重要的价值来自于将这些新的度量集成到 生物反馈系统，鼓励轮椅使用者积极避免不活动的继发性并发症 并允许护理提供者识别有风险的患者并有效地进行干预。现有的技术不能 与建议的解决方案进行比较。存在监测轮椅座椅压力的产品，但这些产品 价格昂贵、笨重，而且不是为家庭使用而设计的。存在用于监控轮椅特定物理状态的产品 活动，但这些设备不能区分被动和主动轮椅运动。没有现有的技术 将这些措施与生物反馈和远程医疗功能相结合。 我们为这个协作项目组建的团队包括工程师、临床医生和来自 BioSensics(一家私营生物医学技术开发公司)和兰乔·洛斯·阿米戈斯国家牧场 康复中心(美国最大的综合康复中心之一)。在.期间 在这个项目的第一阶段，我们开发并验证了轮椅传感器的原型版本，并 智能手机应用程序(Dowling et.等人，无线健康，2015年；道林等人。《辅助技术》杂志 按下)。在第二阶段，我们将改进座椅传感器硬件，开发远程监控和 所提议的系统的远程医疗方面包括1)符合HIPAA的安全网站， 护理人员和临床医生可以远程查看活动和压力缓解数据，2)自动化方法 如果压力缓解或活动目标未达到，则向临床医生和护理人员推送警报(通过短信或电子邮件)， 以及3)简单的界面，以便临床医生和护理人员可以向轮椅使用者发送远程健康提醒 智能手机应用程序。