Individualized Vestibular Rehabilitation for Elderly with Self-Management and Gaming Elements

具有自我管理和游戏元素的老年人个性化前庭康复

• 批准号: 10011222
• 负责人: Paulien Esther Roos
• 金额: $ 68.04万
• 依托单位: CFD RESEARCH CORPORATION
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10011222
• 关键词: Adherence; Adoption; Algorithms; Area; Clinic; Clinical; Collaborations; Data; Data Analyses; Databases; Development; Dizziness; Effectiveness; Elderly; Electronic Mail; Elements; Engineering; Ensure; Equilibrium; Equipment; Exercise; Eye; Fall prevention; Feedback; Florida; Focus Groups; Geography; Goals; Head; Health Personnel; Health Professional; Health care facility; Home Care Services; Home environment; Hospitals; Individual; Kansas; Literature; Machine Learning; Measures; Monitor; Motion; Older Population; Patient Monitoring; Patients; Performance; Phase; Physical Rehabilitation; Physical therapy; Play; Population; Provider; Quality of life; Questionnaires; Records; Rehabilitation therapy; Reporting; Research; Rewards; Safety; Scientist; Self Management; Software Design; Supervision; Tablets; Technology; Telephone; Testing; Time; Travel; Universities; Update; Visit; Work; base; clinical practice; clinically relevant; commercialization; compliance behavior; cost; design; exercise rehabilitation; experience; falls; gaze; handheld mobile device; human old age (65+); improved; interest; machine learning algorithm; machine learning method; mobile application; motion sensor; multidisciplinary; novel; novel strategies; patient engagement; physical therapist; programs; prototype; rehabilitation science; remote sensor; sensor; usability; visual tracking; web portal

Project Summary/Abstract: Vestibular rehabilitation has been proven to be effective in reducing dizziness and falls in older adults, but patient adherence is a major problem. Recent research shows that less than half of patients complete their rehabilitation. Some of the main reasons for this are the numerous visits that are required and accessibility. In particular for older individuals who experience dizziness and/or falls, it may be difficult to travel to attend rehabilitation sessions. Additionally, rehabilitation programs become expensive in terms of equipment and health professional’s time. Programs may also not be available to all who may benefit because of geographical limitations. Previous research has shown that remote monitoring and gaming elements have great potential to solve these issues, even in an older population. However, current solutions are generic and effectiveness can be inconsistent. The overall goal of this project is to develop a vestibular rehabilitation app to be used by older adults at home. The app will improve adherence through gaming, self-management, and remote monitoring. Patients will use low-cost sensors placed on their bodies (head and waist) to play the games on the app. This allows simultaneous monitoring of patient progress while performing the exercises. This data can be shared with a clinician via email or the cloud, allowing the patient to perform the rehabilitation at their home and the clinician to monitor how well the patients performed their exercises. The vestibular rehabilitation components are packaged in a phone and tablet app that is easy to navigate for older individuals and has a modular design that allows individualized rehabilitation. By improving patient engagement and enjoyment, rehabilitation adherence should be improved as well. Phase I demonstrated feasibility of this approach. In Phase II, games will be added to cover a full at-home rehabilitation session and improve usability of the app. In addition, machine learning algorithms will be developed to provide real-time feedback if exercises are performed incorrectly. This ensures patients will perform their exercises correctly when at home. As in Phase I, clinical collaborators will provide continued guidance and testing throughout development to ensure clinical relevance and promote adoption during commercialization. This project uses a novel approach in that it develops rehabilitation games specifically designed for vestibular rehabilitation through a mobile app tailored for an older population. Current gaming approaches for rehabilitation typically use existing or commercial games. The use of sensors for remote monitoring is also novel in this area and allows patients to perform rehabilitation at their home, while being monitored by a clinician. This project is therefore likely to have a high clinical impact. It will advance clinical practice, make vestibular rehabilitation more accessible to older individuals, and help adherence to programs. Successful implementation of this program will reduce falls and improve quality of life of for patients.

项目概要/摘要： 前庭康复已被证明可以有效地减少老年人的头晕和福尔斯，但 患者依从性是一个主要问题。最近的研究表明，不到一半的患者完成了他们的治疗。 康复活动.造成这种情况的一些主要原因是需要多次访问和无障碍。在 特别是对于经历头晕和/或福尔斯的老年人， 康复治疗此外，康复计划在设备方面变得昂贵， 健康专家的时间计划也可能不提供给所有谁可能受益，因为地理位置， 局限性。以前的研究表明，远程监控和游戏元素具有很大的潜力， 解决这些问题，即使是在老年人口中。然而，目前的解决方案是通用的，有效性可以 不一致。 该项目的总体目标是开发一个前庭康复应用程序，供老年人在家使用。 该应用程序将通过游戏，自我管理和远程监控来提高依从性。患者将使用 低成本的传感器放置在他们的身体（头部和腰部）玩游戏的应用程序。这使得 在进行锻炼的同时同时监测患者的进展。此数据可以与 通过电子邮件或云与临床医生联系，允许患者在家中进行康复， 来监测病人的锻炼情况。前庭康复的组成部分是 打包在手机和平板电脑应用程序中，便于老年人导航，并具有模块化设计， 允许个性化康复。通过提高患者的参与度和享受度， 也应该得到改善。第一阶段证明了这种方法的可行性。在第二阶段，游戏将 增加了一个完整的家庭康复课程，并提高了应用程序的可用性。此外，机器 将开发学习算法，以便在练习不正确时提供实时反馈。这 确保患者在家中正确进行锻炼。与第一阶段一样，临床合作者将 在整个开发过程中提供持续的指导和测试，以确保临床相关性并促进 在商业化过程中。 这个项目使用了一种新颖的方法，它开发了专门为前庭设计的康复游戏。 通过为老年人量身定制的移动的应用程序进行康复。目前的游戏方法， 康复通常使用现有的或商业游戏。使用传感器进行远程监控也是 在这方面是新颖的，允许患者在家中进行康复，同时由一个 临床医生因此，该项目可能具有很高的临床影响。它将推动临床实践， 前庭康复更容易获得老年人，并帮助坚持计划。成功 该计划实施将减少福尔斯并改善患者的生活质量。