Motivating Occupational Virtual Experiences In Therapy for kids

激发儿童治疗中的职业虚拟体验

• 批准号: 10264174
• 负责人: Richard J. Adams
• 金额: $ 92.8万
• 依托单位: BARRON ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-04-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10264174
• 关键词: Address; Adherence; Affect; Award; Blinded; Brain Injuries; Cerebral Palsy; Child; Childhood; Childhood stroke; Clinical; Clinical Research; Clinical Trials; Computer software; Development; Disease; Elements; Evidence based treatment; Exercise; Goals; Gold; Hand functions; Healthcare; Hemiplegia; Home; Human; Improve Access; Intervention; Interview; Learning; Marketing; Measures; Medical; Modeling; Monitor; Motion; Motivation; Motor; Motor Skills; Movement; Neuronal Plasticity; Occupational; Outcome; Parents; Participant; Patient Participation; Patients; Pediatric Hospitals; Performance; Phase; Pilot Projects; Play; Production; Provider; Public Health; Questionnaires; Randomized Controlled Trials; Recovery; Regimen; Rehabilitation therapy; Role playing therapy; Safety; Secure; Self Care; Small Business Innovation Research Grant; Specialist; Supervision; Support System; System; Technology; Testing; Toy; Training; Trauma; Universities; Upper Extremity; User-Computer Interface; Video Games; Virginia; Visual; base; cohort; commercialization; compliance behavior; constraint induced movement therapy; constraint induced therapy; cost; cost effective; dashboard; data fusion; design; dosage; efficacy study; evidence base; exercise program; experience; haptic feedback; improved; improved outcome; individual patient; individualized medicine; innovation; innovative technologies; kinematics; mixed reality; multisensory; programs; prototype; psychologic; remote monitoring; sensor; skills; standard measure; success; telehealth; therapy adherence; therapy duration; treatment as usual; treatment group; tumor; underserved area; usability; virtual; virtual world

PROJECT SUMMARY/ABSTRACT Introduction: The Motivating Occupational Virtual Experiences In Therapy for kids (MOVE-IT) SBIR Phase II program will support telehealth delivery of intensive rehabilitation for pediatric hemiplegia through smart toy- enabled games that inspire high-dosage, task-directed upper extremity (UE) movements. Although higher- dosage training is almost uniformly associated with better outcomes in UE rehabilitation [1], [2], [3], [4], achieving the repetitions necessary to attain lasting results through neuroplasticity is a formidable challenge. The MOVE- IT system will employ therapy games that combine virtual- and real-world physical elements to provide a turn- key solution suitable for both home and clinical use. MOVE-IT will engage patients in repetitive practice, facilitating an evidence-based approach that integrates proven concepts in constraint-induced movement therapy (CIMT) and other intensive therapy regimes [5]. This innovative solution employs a multi-sensory smart toy, advanced game engine, and low-cost motion tracking to create games that promote sustained adherence. Problem to be Addressed: Pediatric hemiplegia can result from Cerebral Palsy (CP) or acquired brain injury (including pediatric stroke, trauma, tumor, or other disease), and adversely affect motor functions essential to self-care, play, exploratory learning, and other daily activities [6]. Existing systems do not currently support telehealth delivery of the high-dosage, evidence-based therapy required for improvement in UE function. Long-Term Goals: Provide an effective home exercise program supported by remote guidance and monitoring of evidence-based treatment for pediatric hemiplegia. Improve patient participation and adherence to an intensive therapy regimen. Reduce the cost of, and improve access to, state-of-the-art rehabilitation. Provide validated metrics for remotely tracking patient status and progress. Phase I Results: Phase I produced a prototype smart toy, two UE therapy mini-games, human kinematics tracking software, and validated UE motor performance metrics. A pilot study was conducted at the University of Virginia (UVA) Children’s Hospital involving 10 children with hemiplegia. Analysis confirms the primary Phase I hypothesis that MOVE-IT generated metrics have high criterion validity with gold-standard measures of UE motor function. Patient/parent interviews/questionnaires strongly support the technology’s acceptance and usability. Phase II Summary: MOVE-IT Phase II will produce a commercial system including an enhanced smart toy and quest-based game software for sustained engagement over a full course of therapy; demonstrate efficacy; establish safety and usability; and pursue FDA-clearance. Phase II will culminate in a rater-blinded randomized, controlled trial to investigate efficacy in home use by children with hemiplegia, as measured by change in gold- standard measures of UE function for a cohort using MOVE-IT compared to a usual care treatment (UCT) group. Commercial Opportunity: High likelihood of commercialization is supported by Barron Associates’ past successes in development, clinical trials, FDA-clearance, and marketing of innovative technology for UE therapy.

项目总结/摘要 引言：儿童治疗中的激励职业虚拟体验（MOVE-IT）SBIR第二阶段 该计划将通过智能玩具支持为儿童偏瘫提供密集康复的远程医疗服务， 支持激发高剂量、任务导向的上肢（UE）运动的游戏。虽然更高- 剂量训练几乎一致地与UE康复的更好结果相关[1]，[2]，[3]，[4]， 通过神经可塑性获得持久效果所需的重复是一个艰巨的挑战。移动- IT系统将采用结合联合收割机虚拟和现实世界物理元素的治疗游戏， 适合家庭和临床使用的关键解决方案。MOVE-IT将使患者参与重复练习， 促进采用循证方法，将已证实的概念纳入限制性运动 治疗（CIMT）和其他强化治疗方案[5]。这种创新的解决方案采用了多传感器智能 玩具，先进的游戏引擎，低成本的运动跟踪，以创造游戏，促进持续的坚持。 需要解决的问题：小儿偏瘫可能是由于脑性瘫痪（CP）或后天性脑损伤 （包括儿科中风、创伤、肿瘤或其他疾病），并对运动功能产生不利影响， 自我照顾、游戏、探索性学习和其他日常活动[6]。现有系统目前不支持 远程保健提供高剂量，改善UE功能所需的循证治疗。 长期目标：提供一个有效的家庭锻炼计划，由远程指导和监测支持 儿科偏瘫的循证治疗。提高患者的参与度和依从性， 强化治疗方案降低最先进的康复服务的成本，并改善获得这些服务的机会。提供 经验证的指标，用于远程跟踪患者状态和进展。 第一阶段成果：第一阶段制作了智能玩具原型，两个UE治疗小游戏，人体运动学 跟踪软件和经验证的UE运动性能指标。一项试点研究在哥伦比亚大学进行， 弗吉尼亚州（UVA）儿童医院，涉及10名偏瘫儿童。分析证实了第一阶段 假设MOVE-IT生成的指标与UE运动的金标准测量具有高标准有效性 功能患者/家长访谈/问卷调查强烈支持该技术的接受度和可用性。 第二阶段概要：MOVE-IT第二阶段将生产一个商业系统，包括一个增强型智能玩具， 基于任务的游戏软件，用于在整个治疗过程中持续参与;证明疗效; 建立安全性和可用性;并寻求FDA许可。第二阶段将在一个评分者盲法随机， 对照试验，以调查偏瘫儿童在家中使用的疗效， 与常规护理治疗（UCT）组相比，使用MOVE-IT的队列的UE功能的标准测量。 商业机会：巴伦公司过去的经验支持商业化的可能性很高 在开发、临床试验、FDA批准和销售用于UE治疗的创新技术方面取得成功。