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

项目摘要/摘要： 前庭康复已被证明在减少老年人的头晕和跌倒方面有效，但 患者的坚持是一个主要问题。最近的研究表明，只有不到一半的患者完成了他们的 康复。出现这种情况的一些主要原因是所需的访问次数和可访问性。在……里面 特别是对于经历头晕和/或跌倒的老年人来说，可能很难旅行去参加 康复课程。此外，康复方案在设备和设备方面变得昂贵 健康专业人士的时间。计划也可能不会提供给所有可能因地理位置而受益的人 限制。以前的研究表明，远程监控和游戏元素具有巨大的潜力 解决这些问题，即使是在老年人口中也是如此。然而，当前的解决方案是通用的，并且有效性可以 前后不一致。 这个项目的总体目标是开发一款前庭康复应用程序，供家中的老年人使用。 该应用程序将通过游戏、自我管理和远程监控来提高遵从性。患者将使用 在他们的身体(头部和腰部)上放置低成本传感器，以便在应用程序上玩游戏。这使得 在进行锻炼的同时，同步监测患者的进展。此数据可与 临床医生通过电子邮件或云，允许患者在家中和临床医生进行康复 以监测患者锻炼的情况。前庭康复组件包括 打包在手机和平板电脑应用程序中，便于老年人导航，并采用模块化设计， 允许个性化康复。通过提高患者的参与度和幸福感，康复依从性 也应该有所改进。第一阶段论证了这一方法的可行性。在第二阶段，游戏将是 添加以涵盖完整的家庭康复课程，并提高应用程序的可用性。此外，机器 将开发学习算法，以便在练习执行不正确时提供实时反馈。这 确保患者在家时能够正确地进行锻炼。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 在商业化过程中被采用。 这个项目使用了一种新的方法，它开发了专门为前庭设计的康复游戏 通过一款为老年人量身定做的移动应用程序进行康复。当前的游戏方法 康复通常使用现有的或商业游戏。使用传感器进行远程监测也是 这是这一领域的创新，允许患者在家中进行康复，同时由 临床医生。因此，该项目可能会产生很高的临床影响。它将促进临床实践，使 前庭康复对老年人来说更容易获得，并有助于坚持方案。成功 该方案的实施将减少跌倒，提高患者的生活质量。

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.