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: 10732863
• 负责人: Leslie J Cloud
• 金额: $ 6.82万
• 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/10732863
• 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.

该项目旨在减轻步态冻结（FoG）的负担，超过50%的帕金森病（PD）患者患有这种疾病。FoG是PD的一种常见的破坏性表现，无法治愈或进行适当的药物或手术治疗。FoG被定义为“尽管有行走的意图，但短暂的、间歇性的缺失或足部向前运动的明显减少”。众所周知，FoG事件经常由各种环境和心理因素触发。最常见的触发因素包括启动犹豫（步态启动时的冻结），通过狭窄的空间行走，转弯犹豫（改变方向时的冻结），接近视觉目标，双重任务以及压力，时间敏感的情况，如 在电梯门关上之前进入电梯每个患有PD的个体在对这些不同触发因素的敏感性方面都是独特的，这强调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，迄今为止没有技术可以提供定制的治疗，以适应个人对特定触发场景的需求。在这个拟议中的项目中，弗吉尼亚联邦大学和William &玛丽团队将共同开发新技术，根据个人的需求部署特定于情境的振动刺激，以预防或减轻FoG。在任务1中，我们将设计和开发一个用于自动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后立即检测FoG。在任务2中，我们将确定在受控环境（临床实验室）中FoG五种最常见的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，我们将在可穿戴系统中集成全球定位机制，以便设备可以识别FoG的环境触发。 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，并将在真实世界的环境（公共场所）中进行测试。在这个项目完成后，我们将创建并测试一个闭环系统，该系统将在需要预防或缓解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，以减少PD等神经系统疾病的负担。