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Rehabilitation Using Community-Based Affordable Robotic Exercise Systems (Rehab CARES)

使用基于社区的经济实惠的机器人运动系统进行康复（Rehab CARES）

基本信息

批准号：
10923752
负责人：
MICHELLE J. JOHNSON
金额：
$ 6.78万
依托单位：
RECUPERO ROBOTICS LLC
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-22 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10923752
关键词：
Adult Adverse event Algorithms Caring Characteristics Clinic Clinical Clinical Trials Clinical assessments Collaborations Communities Compensation Computer software Control Groups Data Day Care Docking Dose Equation Exercise Feedback Fingers Freedom Frequencies Friends Goals Hand Health Health Care Costs Health Insurance Health care facility Heart Rate Hospitals Hour Impaired cognition Impairment Improve Access Individual Infrastructure Insurance Coverage Intelligence Intervention Lead Lower Extremity Monitor Motivation Motor Movement Muscle Occupational Therapy Patient-Focused Outcomes Patients Performance Persons Phase Physical therapy Play Play Therapy Population Positioning Attribute Quality of Care Randomized Rehabilitation Centers Rehabilitation therapy Resource-limited setting Resources Robot Robotics Rural Safety Socioeconomic Status Speech Therapy Stroke System Technology Testing Therapeutic Time Upper Extremity arm base care seeking clinical predictors cloud based cohort community based care cost cost effective design disability empowerment exercise rehabilitation experience follow up assessment force feedback functional improvement functional outcomes haptics health care disparity improved individualized medicine innovative technologies instrument kinematics motor control motor impairment multidisciplinary neurological rehabilitation novel nursing skill post stroke recruit rehabilitation technology rehabilitative care robot assistance robot control robot rehabilitation safety and feasibility safety testing sensor stroke patient stroke survivor stroke therapy success targeted treatment treatment duration usability

项目摘要

PROJECT SUMMARY Stroke is the leading cause of serious long-term disability. It is estimated that 5.8–6.5 million people currently live with stroke related disability in the US and that this number will increase by 20.5% by 2030. The current US health infrastructure is not prepared for these increasing numbers. Limitations in health insurance coverage and the shortage of rehabilitation practitioners decrease access to rehabilitation. Community-based settings are becoming viable venues for delivering long-term post-stroke care, however, they are plagued by staff with limited expertise, low number of therapists and lack of financial resources for rehabilitation. Because of this, the quality of care is compromised, and functional outcomes of patients are not equal to hospital-based rehabilitation settings. We seek to develop a novel solution to this problem. Implementing affordable design is a fundamental strategy for increasing access to rehabilitation technology for patients regardless of socio-economic status. Doing so, decreases healthcare disparities and reduces long-term healthcare costs. We propose to use affordable robots to improve access to quality rehabilitation care in low-resource, community-based settings. In Phase 1, we leverage a 1 degree of freedom haptic robot with control algorithms to develop a beta version of the robot hardware and software. The new robot have a novel end-effector to allow more diverse arm and hand exercises, be connected to cloud-based gaming, and provide patient-specific therapy that adjusts for motor impairment and cognitive impairment. 15 stroke patients with a wide range of motor impairment levels will complete clinical assessments of motor and cognitive impairment followed by robot-based assessment and therapy games. Subjects will be instrumented with sensors monitoring key upper extremity muscle activity, trunk activity and heart rate during robot tasks. A key milestone will be to identify kinematic metrics from the robot tasks that strongly correlate and predict clinical scores of motor and cognitive impairment. Another milestone will to drive patient-specific strategies by adjusting the robot’s control parameters and the game parameters. In Phase 2, we will develop the hardware to allow three haptic robots to dock (a gym) and be configured to allow patients to play therapy games alone or collaboratively. We will test the safety and feasibility of the gym in a community-based rehabilitation setting where stroke patients typically receive 1 hour each of physical therapy (PT), occupational therapy (OT) and speech therapy (SLP). 36 patients will be randomized to either a robot (RT) or a control group (CT). Both groups will receive PT and SLP, but the RT will receive the robot gym therapy targeting the upper limb and the CT will receive a dose-matched hour of OT. Therapy will occur over 4 weeks with two follow-up assessments. Key milestones will be to show that the RT has the same or better functional outcomes, motivation, and adverse events as the CT. Also, to show that the robot gym is a cost-effective solution to increasing access to quality rehabilitation care in low-resource, community-based settings. Success here will validate this potential solution, justify design changes revealed via user-feedback and a larger clinical trial.

项目总结