Beacon Sensors and Telerehabilitation to Assess and Improve use of Devices for visual functioning (BeST-AID)

项目摘要或摘要 放大设备在阅读和日常任务中的成功应用取决于它们的 视力低下(LV)者可正确使用。与交通、地理和/或合作有关的障碍 疾病往往限制了LV患者参加几次办公室培训课程的能力，这是低视力的一部分 康复(LVR)，通过放大设备优化视觉功能。实时是一个很有前途的解决方案 提供远程康复的视频会议，包括由LVR提供商远程提供的LVR服务- 办公室给家里的病人。LV的远程康复治疗似乎是可行的，并为患者和 LVR供应商，但还没有关于改善患者视觉功能的潜力的公开结果。 LVR的另一个关键问题是需要一个有效的系统来持续评估患者的功能 在家。理想情况下，这将包括一种非侵入性的、有效的方法来评估放大镜设备 遗弃发生，以便可以启动及时的远程康复会话。小巧的蓝牙低能耗 连接在放大镜手柄上的信标传感器可以收集关于分钟到分钟的实时数据 环境变化，这可能是LV患者在家使用放大镜的一个指标。 具体地说，我们建议评估远程康复通过以下方式增强视觉功能的潜力 提供远程提供的使用放大设备的LVR培训。在一次办公室培训课程之后 对于新的放大设备(S)，我们的目标是确定在视觉功能方面是否有额外的收益 将受试者随机分为远程康复或额外的办公室内左肺复苏术(主动对照)。这将提供估计 视功能改变的效应大小措施，以计划未来更大规模的随机对照试验。 参与者将在连续两个阶段之前和之后接受评估：(1)单次LVR后一个月 培训课程，然后(2)在三个月内通过远程康复最多三次LVR课程 在参与者的家中或在办公室进行LVR。我们将确定哪些患者的特征和/或放大 设备最有可能从远程康复中受益，这将在未来的第三阶段临床试验中成为目标。我们会 还要确定来自蓝牙信标传感器的数据是否为手持放大镜设备的有效指示器 LV患者在家中使用。我们将向在AIM 1注册的受试者部署Estimote贴纸信标传感器 在同一研究期间。我们预计信标传感器的测量结果将显著增加 当放置在LV患者手持的放大装置的部分时的温度和/或运动 进行日常活动。信标传感器数据将决定在放大时评估是否可行 使用设备，如果远程康复或办公室内LVR后放大镜使用的频率发生变化。 这项工作将评估和改进为LVR实施这些技术的程序，以便 制定未来的随机对照试验方案。我们设想远程康复和信标传感器 可通过以更高效和及时的方式提供后续LVR服务来改善LV患者的预后。

Project Summary or Abstract The successful application of magnification devices for reading and daily tasks is predicated on their correct use by individuals with low vision (LV). Barriers related to transportation, geography, and/or co- morbidities often limit LV patients’ ability to attend several in-office training sessions as part of low vision rehabilitation (LVR) to optimize visual function with magnification devices. A promising solution is real-time videoconferencing to provide telerehabilitation, involving remotely delivered LVR services by a LVR provider in- office to a patient at home. Telerehabilitation for LV appears to be feasible and acceptable by both patients and LVR providers, yet there are no published outcomes on the potential to improve patients’ visual functioning. Another key issue in LVR is the need for an effective system to continually assess how patients are functioning at home. Ideally this would involve a non-invasive, efficient method to assess when magnifier device abandonment occurs, so that a timely telerehabilitation session can be initiated. Small Bluetooth low energy beacon sensors attached to the handles of magnifiers can collect real-time data regarding minute-to-minute environmental changes, which might serve as an indicator of magnifier use by LV patients at home. Specifically, we propose to assess the potential for telerehabilitation to enhance visual function by providing remotely-delivered LVR training to use magnification devices. Following one in-office training session for new magnification device(s), we aim to determine if there is additional gain in visual functioning by randomizing subjects to telerehabilitation or additional in-office LVR (active control). This will provide estimates of effect size for changes in visual function measures to plan a future larger-scale randomized controlled trial. Participants will be assessed before and after two consecutive periods: (1) one month after a single LVR training session, followed by (2) up to three LVR sessions over a three month period either via telerehabilitation in the participants’ homes or LVR in-office. We will determine which patient characteristics and/or magnification devices are most likely to benefit from telerehabilitation, to be targeted in a future, phase III clinical trial. We will also determine whether data from Bluetooth beacon sensors are valid indicators of hand-held magnifier device usage by LV patients at home. We will deploy Estimote Sticker beacon sensors to subjects enrolled in Aim 1 during the same study period. We anticipate that beacon sensors will measure significantly increased temperature and/or motion when placed on the part of the magnification device held by LV patients while performing daily activities. Beacon sensor data will determine if it is feasible to assess when magnification devices are used, and if the frequency of magnifier use changes following telerehabilitation or in-office LVR. This work will evaluate and refine the procedures for implementing these technologies for LVR, in order to develop future randomized controlled trial protocols. We envision that telerehabilitation and beacon sensors could improve LV patient outcomes by providing follow-up LVR services in a more efficient and timely manner.