A Wearable Haptic Feedback System for Home-based Gait Training for Older Adults

项目摘要 美国的老年人口正在迅速增长。独立生活是最重要的 成功衰老的核心，独立行动能力是独立功能的关键。许多 社区居住的老年人可以独立行走，表现出轻到中度的异常 步态模式，如果继续不治疗将导致摔倒的风险，害怕摔倒，失去灵活性， 以及其他健康问题。随着年龄的增长，步态的许多早期变化反映了 运动控制受损。这些运动控制缺陷并不能通过针对性的干预得到改善 肌肉和心肺系统。干预措施侧重于培训 为了产生更稳定和有效的步态，需要感知运动系统。《知识》 差距在于(1)强化知觉运动系统的训练结构和(2)合并 这种训练不引人注意地融入了用户的日常步行锻炼中，因为神经运动技能可以 通过定期训练提高了水平。为了弥补这些差距，一种首创的可穿戴触觉反馈 已经创建了一个使用触觉反馈和基于无线智能手机的系统 技术能够实现独立和重复的运动学习驱动的步态训练。目标是 这一提议的目的是检验这样一个假设，即生物力学驱动的触觉反馈，目标是 通过运动学习练习和人类对潜在生物力学变量的缺陷 适应，可以显著提高神经控制的运动通过修改 老年人的关键步态参数。触觉反馈旨在增加大腿峰部伸展 从而提高步长和步态速度作为两个关键步态参数。 这项建议的两个目标是为了实现上述目标。在目标1中，我们 将测试两种基于误差反馈和正强化的算法，提供 触觉反馈，增加大腿伸展。这一目标决定了哪种方法能更好地唤起人们的记忆 用户在培训阶段的回应。目标2将重点放在保持步态 通过与开发的系统和两个算法的长期实践进行改进 在以后反馈不再存在的日期。这项工作将提供可翻译的研究 涉及工程学、神经科学和心理学等多个学科的机会， 以及运动学习和物理疗法，有可能影响许多人的生活 个人。由于这项研究的目标是用户的认知，以影响他们的身体能力 通过运动学习训练，以及提高认知能力的机动性的好处 对于老年人来说，它可以提供机会来解决老年人的认知衰退问题。

Project Summary The population of older adults in the U.S. is growing very rapidly. Living independence is at the core of successful aging, and independent mobility is critical to independent functioning. Many community-dwelling older adults, who can walk independently, exhibit mild to moderate abnormal gait patterns that if remaining untreated will lead to a risk of falls, fear of falling, loss of mobility, and other health issues. Many of the early changes in gait seen with aging are a reflection of impaired motor control. These motor control deficits are not ameliorated by interventions targeting the muscular and cardiopulmonary systems. Interventions that focus on training the perceptuomotor system are needed to generate a more stable and efficient gait. The knowledge gaps lie in (1) the structure of the training to enhance the perceptuomotor system, and (2) merging the training unobtrusively into users’ daily walking exercise because neuromotor skills can be improved by regular training. To address these gaps, a first-of-its-kind wearable tactile feedback system has been created that uses tactile feedback coupled with wireless smartphone-based technology to enable independent and repeated motor learning-driven gait training. The objective of this proposal is to test the hypothesis that biomechanics-driven tactile feedback, which targets deficits in the underlying biomechanical variables via motor learning exercises and human adaptation, can significantly improve the neural control of movement through modification of the key gait parameters in older adults. The tactile feedback aims to increase the thigh peak extension and, thereby, improve stride length and gait speed as two key gait parameters. The two aims of this proposal are geared towards achieving the mentioned objective. In Aim 1, we will test two algorithms based on error feedback and positive reinforcement methods to provide tactile feedback to increase the thigh extension. This aim determines which methods evoke better responses from users during the training phase. Aim 2 will focus on the retention of gait improvements through longer-term practicing with the developed system and the two algorithms at a later date when the feedback is no longer present. This work will provide translatable research opportunities involving multiple disciplines such as engineering, neuroscience, and psychology, as well as motor learning physical therapy with the potential to impact the lives of many individuals. Since this research targets users' cognition to effect change their physical capabilities through motor learning training, and the benefits of improving mobility for cognitive capabilities in older adults, it can open up opportunities to address cognitive declines in older adults.