Arm Motor Rehabilitation, Entertainment and Cognition System for the Elderly

描述(申请人提供)：假设对于老年中风后患者，改善上肢协调能力以及加强其肌肉可能与认知训练同时完成，并以一种娱乐的方式完成。这一目标实施的是“健康的身体中有健康的心灵”的单点护理方法。该项目的长期目标是开发一种改进的联合治疗方法，该方法优于目前在同一患者群体中单独进行物理治疗和认知训练的方式。本研究的目的是开发和可行性测试BC100原型系统，该系统集成了定制的类游戏虚拟现实模拟、重力梯度辅助/阻力和抓握用力。这个系统应该同时适合中风后高功能和低功能患者，比现成的游戏系统更好，比康复机器人更安全。具体目标第一个目标是开发BC 100系统，用于改善中风后(亚急性或慢性)老年患者的手臂/肩部运动、运动控制、耐力、握力、记忆力、预期和反应时间。第二个目标是通过对患中风的上肢进行为期4周的强化同时物理治疗和认知训练，评估中风后1个月以上的老年人原型的功能。方法1)构建BC 100系统，创建一个低摩擦、视觉跟踪的康复工作台，自动倾斜，以帮助/抵抗任何手臂的运动；2)开发用于老年中风后患者的虚拟康复软件，通过游戏同时训练他们的身体和认知方面的残疾，而他们仅限于长期护理；3)开发一个安全的网络可访问的数据库，用于报告和远程数据分析。BC 100的数据将在比赛过程中实时透明采样，并上传到光明云国际刀片服务器。4)对4名无残疾的老年受试者进行初步研究，以揭示技术问题；5)对6名中风后偏瘫的老年受试者进行为期4周的患侧上肢训练计划和对BC-100系统的认知的可行性临床研究。在训练开始和结束时，受试者将使用标准化测试来评估身体和认知功能。计算机化的非标准化测量(手臂伸展、手臂速度、游戏分数等)将被比较，以确定是否与标准化测试有关联。NIH相关性这个项目将开发一种新的设备和治疗方法，以综合的方式训练上肢和认知，提供单点护理解决方案。同样的方法可以扩展到其他患者群体和年龄段。 公共卫生相关性：一种同时增强长期护理的老年患者的体力、认知和幸福感的产品，改善了他们的生活/参与质量，并通过允许他们在空闲时间从事康复游戏而无需治疗师干预来降低医疗成本。通过将肩部/手臂/抓握控制和力量康复与认知(记忆、推理)训练相结合，该产品通过促进单点团队护理疗法改善了获得医疗保健的机会。该产品还可以在未来用于急性康复，通过加速恢复生产生活，进一步降低了医疗成本。

DESCRIPTION (provided by applicant): It is hypothesized that for elderly post-stroke patients improving upper extremity coordination, as well as strengthening its muscles may be accomplished simultaneously with cognitive training, and done in an entertaining way. This objective implements "a healthy mind in a healthy body" single-point-of-care approach. The long-term objective of this project is to develop an improved combined therapy approach that is superior to the way physical therapy and cognitive training are done separately today on the same patient population. The purpose of this investigation is to develop and feasibility test the prototype BC 100 system integrated with custom game-like virtual reality simulations, gravity-gradated assistance/resistance and grasp exertion. This system should accommodate both high-functioning and low-functioning patients post-stroke, being superior to off-the-shelf gaming systems and safer than rehabilitation robots. SPECIFIC AIMS The first aim is to develop the BC 100 system for improving arm/shoulder motion, motor control, endurance, grasp strength, memory, anticipation and reaction time in elderly patients post-stroke (subacute or chronic). The second aim is to evaluate the functionality of the prototype for elderly adults more than 1 moth post-stroke by piloting a 4-week intensive and simultaneous physical therapy and cognitive training of the affected upper extremity. METHODS 1) Construct the BC 100 system by creating a low-friction, vision-tracked rehabilitation table that tilts automatically to allow assistance/resistance to either arm motion; 2) develop virtual rehabilitation software for elderly patients post-stroke with games training simultaneously the physical and the cognitive aspects their disability, while they are confined to log-term care; 3) Develop a secure web-accessible database for reporting and remote data analysis. Data from the BC 100 will be sampled transparently in real time during play and uploaded to Bright Cloud International bladed servers. 4) pilot study with 4 elderly subjects without disability to uncover technology problems; 5) Feasibility clinical study with 6 elderly subjects with hemiplegia following stroke participating in a 4-week training program of their affected upper extremity and cognition on the BC 100 systems. Subjects will be evaluated for physical and cognitive function using standardized tests at the start and end of training. Computerized non-standardized measures (arm reach, arm velocity, game scores, etc) will be compared to determine if there is a correlation with the standardized tests. NIH RELEVANCE This project will develop a new device and therapeutic method for training upper extremity and cognition in an integrated way providing a single-point-of-care solution. The same approach can be extended to other patient populations, and age groups. PUBLIC HEALTH RELEVANCE: A product that simultaneously augments the physical strength, cognition and well being of elderly patients confined to long-term care improves their quality of life/participation, and reduces health care costs by allowing them to work on rehabilitation games in their free time without the intervention of a therapist. By integrating rehabilitation for shoulder/arm/grasp control and strength with cognitive (memory, reasoning) training the product improves access to health care by facilitating a single-point team-care therapy. The ability of the product to also be used in the future in acute rehabilitation further reduces health care costs by accelerating return to productive life.