TRAJECTORY MODIFICATION IN CHRONIC STROKE PATIENTS

本申请中提出的研究的长期目标是 促进运动恢复，并因此引起功能变化 在某些患者群体中通过上肢轨迹 通过听觉和视觉反馈进行修改。有四个具体的 该项目的目标。首先，一个原型反馈培训装置将是 为商业医疗用途而设计和制造的。第二，正式的 将制定治疗方案。第三，将对系统进行验证 在慢性轻症和左偏瘫中风患者的多个部位， 急性左右偏瘫中风患者和老年人疗养院 有上肢骨关节炎证据的居民。第四, 功能属性，即日常生活活动/自我照顾技能 在REACH的支持下，所有患者中的 在治疗干预之后。中国企业的技术创新 建议的工作在于改编最先进的运动学 技术对生理学的调查，考虑的不同 协同模式中的任务要求，强调培训任务 是近乎自然的，因此在功能上有意义，并且使用 调节感觉反馈，以达到改善效果。拟议的研究 将产生一个原型系统，包括硬件、软件和 用于弹道修改的治疗方案 反馈，已经在几个康复环境中进行了测试，因此 定义了一个巨大的商业市场。如果这项研究也能确定 在统计上显著的功能改进是由于 反馈培训，该系统的潜在商业应用 将是广泛的。 建议的商业应用： 由此产生的系统是基于预期的廉价的 解决方案。最终的系统将被设计成在财务上可以接受的 主要的康复诊所作为对传统康复诊所的补充 治疗，以及个人研究人员和 临床医生。还应该可以将该设备配置为家庭- 基于患者或家庭指导治疗的租赁系统，具有 有可能降低修复成本。

The long-term objective of the research proposed in this application is to enhance the motor recovery and as a consequence elicit functional changes in certain patient populations by means of upper extremity trajectory modification through auditory and visual feedback. There are four specific aims of the project. First, a prototype feedback training device will be designed and fabricated for commercial medical use. Second, a formal treatment protocol will be developed. Third, the system will be validated at multiple sites with chronic light and left hemiplegic stroke patients, acute right and left hemiplegic stroke patients, and elderly, nursing home residents with evidence of osteoarthritis of the upper limbs. Fourth, functional attributes, i.e., activities of daily living/self.care skills subserved by reaching, of all patients will be examined prior to and following therapeutic intervention. The technological innovation of the proposed work lies in the adaptation of state-of-the-art kinematic technology to physiological investigations, the consideration of different synergy patterns in the task requirements, the emphasis on training tasks that are near-natural and hence functionally meaningful, and the use of regulated sensory feedback to effect improvement. The proposed research will result in a prototype system, consisting of hardware, software, and treatment protocols for trajectory modification through the use of feedback, that has been tested in several rehabilitation settings, thus defining a large commercial market. If the study is also able to establish statistically significant functional improvements as a result of the feedback training, the potential commercial applications of the system will be extensive. PROPOSED COMMERCIAL APPLICATION: The commercial application of the resulting system is predicated on the inexpensiveness of the intended solution. The final system will be designed to be financially acceptable to major rehabilitation clinics as an augmentation to conventional therapy, as well as to be affordable by individual researchers and clinicians. It should also be possible to configure the device as a home- based rental system for patient or family directed therapy, with the potential to reduce rehabilitation costs.