Head-Mounted Vibrotactile Prosthesis for Patients with Chronic Postural Instabili

适用于慢性姿势不稳患者的头戴式振动触觉假肢

• 批准号: 7669969
• 负责人: B EUGENE PARKER
• 金额: $ 20万
• 依托单位: BARRON ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7669969
• 关键词: Acceleration; Activities of Daily Living; Acute; Address; Affect; Age; Aging; Analysis of Variance; Ankle; Apple; Area; Bilateral; Body part; Brain; Chairperson; Chronic; Cognitive; Collaborations; Color; Complex; Cues; Development; Devices; Disabled Persons; Disease; Dizziness; Elderly; Electronics; Emotional; Equilibrium; Equipment and supply inventories; Etiology; Exercise; Feedback; Figs - dietary; Financial compensation; Freedom; Functional disorder; Gait; Generations; Gravity Perception; Head; Head and Neck Surgery; Hip region structure; Home environment; Human; Individual; Joints; Laboratories; Lead; Learning; Life; Literature; Manufactured Baseball; Marketing; Measurement; Measures; Motion; Movement; Neck; Neuraxis; Noise; Oral; Otolaryngology; Outcome; Output; Patients; Performance; Peripheral; Phase; Population; Posture; Process; Proprioception; Proprioceptor; Prosthesis; Protocols documentation; Published Comment; Publishing; Quality of life; Questionnaires; Reaction Time; Rehabilitation therapy; Research; Residual state; Self Assessment; Semicircular canal structure; Sensory; Small Business Innovation Research Grant; Speed; Sternum; Structure; Subgroup; Subject Headings; Support Groups; Surface; Surveys; System; Temperature; Testing; Time; Time Study; Tongue; Training; Transducers; Treatment Protocols; Universities; Vestibular loss; Visual; Walking; Washington; Weight; Work; balance prosthesis; base; computerized; cost; design; disability; equilibration disorder; expectation; falls; handicapping condition; improved; indexing; instrument; otoconia; patient population; performance tests; preference; professor; programs; prototype; public health relevance; receptor; research study; sensor; sensory system; somatosensory; usability; vibrotactile prosthesis; volunteer

DESCRIPTION (provided by applicant): Recent advances in the size and performance of micro-electromechanical systems (MEMS)-based inertial instruments enable the development of a balance prosthesis to provide feedback regarding head orientation to patients with chronic balance dysfunction. There is a need for balance prostheses to assist patients with such chronic balance disorders, as well for devices that can facilitate rehabilitation of such disorders through training. The one-piece, noninvasive, and discreet BALCAP prosthesis proposed herein offers the potential to satisfy both requirements via a simple, adjustable or presized hat, available in different styles/colors. With the BALCAP prosthesis, low-amplitude vibrotactile cues are provided directly to the head via hatband tactors that furnish the wearer with feedback concerning head tilt in the pitch and roll planes, whether he/she is stationary or moving. To evaluate the utility of the proposed BALCAP balance prosthesis, patients with chronic balance dys- function spanning a range of etiologies (e.g., peripheral dysfunction, central dysfunction, and multi-factorial disequilibrium, also referred to as disequilibrium of aging) will undergo postural stability and gait assessments to determine if the device offers: (1) assistive benefit; i.e., significantly improves assessment scores when the BALCAP is enabled vs. disabled; and (2)rehabilitation benefit; i.e., yields significantly-improved assessment scores when the BALCAP is disabled (turned off) following 6 weeks of rehabilitation training with the device enabled. Regarding the first hypothesis, prior work by the proposing team demonstrated significant assistive improvements in postural stability in patients with bilateral vestibular loss (BVL) based on a first-generation head-mounted vibrotactile prosthesis. The proposed work will evaluate the assistive efficacy of such a balance prosthesis in a population of chronic imbalance patients spanning a wider range of disease etiologies than was addressed in the prior study, the inclusion of which will greatly expand the size of the commercial market. Concerning the second hypothesis, published findings from one research group supports the notion that rehabilitation training using such a substitute sensory channel can lead to post-training retention of residual balance improvement. However, directly contradictory findings-at least concerning BVL patients-have been published by an independent group. To reconcile these disparate outcomes, the work proposed herein will also investigate the rehabilitative potential of the BALCAP device based on a 6-week structured training regimen that includes both static and dynamic exercises. If rehabilitative training to achieve residual balance retention is possible, expanding training to include both static and dynamic activities is most likely to make it evident. If the hypothesis concerning the assistive benefit is supported, a head-mounted vibrotactile prosthesis product would enable immediate benefit to be provided to a large number of patients with chronic postural instability. If rehabilitative training to achieve residual balance retention is possible, it would open new areas of research, such as how to optimize training to maximize residual retention of balance improvements. PUBLIC HEALTH RELEVANCE: Products resulting from this research are anticipated to offer significant benefit to patients with chronic postural instability to help them improve their balance in both static and dynamic activities, allowing them to function more normally. The availability of a simple, one-piece, noninvasive, discreet, and low-cost balance prosthesis will enhance the quality of life for balance-disordered patients and could lead to further advancements in this area. The use of such a device as an assistive aid, both inside and outside of the home, could yield both immediate (assistive) and longer-term (rehabilitation) benefits. An assistive prosthesis might also allow patients to "train" while performing their normal activities (in contrast to structured exercises), substantially reducing patient burden.

描述（由申请人提供）：基于微电动机电系统（MEMS）基于惯性仪器的大小和性能的最新进展，可以开发平衡假体，以提供有关慢性平衡功能障碍患者的头部方向的反馈。需要平衡假体来帮助患有这种慢性平衡障碍的患者，以及可以通过培训来促进这种疾病的设备。本文提出的一件式，无创和谨慎的Balcap假体提供了通过不同样式/颜色的简单，可调节或预定的帽子来满足这两种要求的潜力。借助Balcap假体，直接通过帽带触摸器直接向头部提供低振幅的纤维状效应提示，这些触手带有有关佩戴者的反馈，无论他/她是固定的还是移动的，都会在球场和滚动飞机上倾斜。 为了评估拟议的BALCAP平衡假体的实用性，具有慢性平衡功能的患者涵盖了一系列病因（例如，外围功能障碍，中心功能障碍和多因素不平衡，也称为不平等的效力，也将效率不足。即，当启用BALCAP与残疾人时，可以显着提高评估得分； （2）康复益处；即，在使用该设备进行了6周的康复培训后，当BALCAP被禁用（关闭）后，将BALCAP禁用（关闭）时，收益率明显得到了改良的评估评分。关于第一个假设，提议团队的先前工作表明，基于第一代头部固定的纤维骨动作假体，双侧前庭损失（BVL）患者的姿势稳定性有了显着改善。拟议的工作将评估这种平衡假体在涉及疾病病因更广泛的慢性不平衡患者中的辅助功效，而不是先前的研究所解决的，其中包括大大扩大了商业市场的规模。 关于第二个假设，发表的一个研究小组的发现支持这样的观念：使用这种替代感觉渠道进行康复训练可以导致培训后保留剩余平衡的改善。但是，直接矛盾的发现至少是关于BVL患者的，由一个独立组发表。为了调和这些不同的结果，本文提出的工作还将根据6周的结构化训练方案研究BALCAP设备的康复潜力，其中包括静态和动态练习。如果可以实现剩余余额的康复培训，则将培训扩大到包括静态和动态活动的培训最有可能使其显而易见。 如果支持有关辅助益处的假设，则可以为大量具有慢性姿势不稳定的患者提供直接益处的头部纤维状假体假体。如果可以实现剩余余额的康复培训，它将开放新的研究领域，例如如何优化培训以最大程度地提高余额改善的剩余保留。 公共卫生相关性：预计由这项研究产生的产品将为慢性姿势不稳定患者带来重大好处，以帮助他们在静态和动态活动中提高其平衡，从而使他们更正常地运作。一个简单的，单件，无创，谨慎和低成本平衡假体的可用性将提高平衡有序患者的生活质量，并可能导致该领域的进一步进步。使用这种设备作为内部和外部的辅助援助，可以立即（辅助）和长期（康复）福利。辅助假体可能还可以使患者在执行正常活动时“训练”（与结构化练习相比），从而大大减轻了患者负担。