Wearable Sensors for Early Identification of Poor Neurodevelopment in Guatemala

用于早期识别危地马拉神经发育不良的可穿戴传感器

• 批准号: 10259122
• 负责人: Peter Rohloff
• 金额: $ 18.75万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-09 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10259122
• 关键词: Acceleration; Address; Adult; Adverse effects; Adverse event; Affect; Age; Age-Months; Biometry; Birth; California; Characteristics; Child; Childhood; Clinical assessments; Communities; Data; Detection; Development; Developmental Disabilities; Early Intervention; Early identification; Environment; Exposure to; Growth; Guatemala; Guatemalan; Health; Health Alliance; Healthcare; Home environment; Impairment; Infant; Infant Development; Infant Malnutrition; Institution; Leg; Length; Life; Location; Malnutrition; Measurement; Measures; Medicine; Methods; Movement; Neuraxis; Outcome; Output; Parents; Pattern; Physical therapy; Pilot Projects; Plant Roots; Poverty; Prevalence; Preventive healthcare; Publishing; Quality of life; ROC Curve; Reporting; Research; Risk; Risk Factors; Rural; Sensitivity and Specificity; Services; Techniques; Technology; Time; Training; Universities; Visit; Work; doctoral student; improved; infancy; limb movement; low and middle-income countries; motion sensor; multidisciplinary; neurodevelopment; novel; novel strategies; primary outcome; programs; prospective; response; sensor; wearable sensor technology

Project Summary In most low- and middle-income countries (LMICs), more children are surviving into adulthood affected by the developmental sequelae of early illness, undernutrition and adverse experiences. In rural Guatemala, where the proposed study would take place, the number of infants at risk for impaired development is among the highest in the world, due to high rates of undernutrition, poverty, and limited preventive health care. To identify and target services to infants at children at risk, most community programs rely on basic growth indicators or parent- reported concerns, techniques which are indirect measures of development and not sensitive in infancy. As a result, data on the onset of developmental disabilities in infants are almost completely missing, and early interventions are begun well after significant adverse effects have already occurred. Technologies to support earlier identification of atypical development would therefore support earlier intervention and improved neurodevelopmental outcomes. As limb movements are one of the earliest outputs of the developing central nervous system, the novel response to this early identification challenge proposed here is to quantitatively differentiate typical and atypical early limb movement patterns in infants at risk for developmental disability due to stunting in rural Guatemala using wearable motion sensors. The first aim of this project is to determine the relationship between infants’ earliest spontaneous limb movements and developmental outcomes at 12 months in infants at risk using wearable motion sensors. The second aim of this project is to determine whether wearable sensor assessment is more accurate than current clinical assessments in predicting developmental outcomes in infants at risk. Taken together, our work addresses the need for novel approaches for infants with atypical neurodevelopment due to undernutrition and other risk factors. We will conduct this work in rural Guatemala, which has one of the highest rates of these infant risk factors in the world. Our results have the potential to improve quality of life and health outcomes for Guatemalans and other LMIC citizens through earlier identification of atypical development, supporting earlier intervention and improved neurodevelopmental outcomes. Further, this exploratory/developmental research application is a multidisciplinary capacity-building project involving pediatric medicine, physical therapy, and biostatistics. The project will build research capacity in Guatemala, through a partnership between the University of Southern California (a U.S. institution) and Maya Health Alliance (an LMIC institution). The proposed research plan will strengthen the research capabilities at the LMIC institution and in Guatemala, specifically through training of local healthcare staff and PhD students in conducting neurodevelopmental assessments in infants, a critical need given the high local prevalence of developmental disability and stunting.

项目摘要 在大多数低收入和中等收入国家(LMIC)，更多的儿童受到 早期疾病、营养不良和不良经历的发育后遗症。在危地马拉的农村，那里的 拟议的研究将进行，有发育障碍风险的婴儿的数量是最高的 在世界上，由于营养不良、贫困和有限的预防性卫生保健的高比率。识别和确定目标 为高危儿童提供服务，大多数社区项目依赖于基本成长指标或父母- 报告的关注事项，是间接衡量发育的技术，在婴儿期不敏感。作为一名 结果，关于婴儿发育性残疾的数据几乎完全缺失，而且很早 干预措施是在重大不良影响已经发生之后很好地开始的。要支持的技术 因此，及早识别非典型发育将有助于及早干预和改善 神经发育结果。 由于肢体运动是发育中的中枢神经系统最早的输出之一，因此新的反应 对于这一早期识别的挑战，这里提出的是定量区分典型和非典型早期肢体 危地马拉农村地区有发育障碍风险的婴儿的运动模式 可穿戴的运动传感器。该项目的第一个目标是确定婴儿最早的 使用可穿戴设备的高危婴儿12个月时的自发肢体运动和发育结局 运动感应器。该项目的第二个目标是确定可穿戴传感器评估是否比 比目前的临床评估更准确地预测高危婴儿的发育结果。 综上所述，我们的工作解决了对非典型神经发育婴儿的新方法的需求 由于营养不良和其他风险因素。我们将在危地马拉农村开展这项工作，那里有世界上最大的 这些婴儿风险因素的比率是世界上最高的。我们的结果有可能提高生活质量和 通过及早发现非典型发育对危地马拉人和其他LMIC公民的健康结果， 支持早期干预和改善神经发育结果。此外，这一点 探索性/发展性研究应用是一个多学科能力建设项目，涉及儿科 医学、理疗和生物统计学。该项目将在危地马拉建立研究能力，通过一个 南加州大学(一家美国机构)和玛雅健康联盟(LMIC)之间的合作伙伴关系 机构)。拟议的研究计划将加强LMIC机构和#年的研究能力 危地马拉，特别是通过培训当地医疗保健人员和博士生进行 对婴儿进行神经发育评估，鉴于当地发育迟缓的高患病率，这是一项迫切需要 残疾和发育迟缓。