Establishing the Functional Viability and Dose-Response of Duck, Duck Punch: A Stroke Rehabilitation Computer Game

建立鸭子、鸭子拳的功能活性和剂量反应：卒中的康复 电脑游戏 摘要 只有15%的中风幸存者的手臂/手活动完全恢复。长期手臂运动 障碍限制了自理和职业活动的独立性，增加了照顾者的负担， 降低生活质量。有强有力的证据表明，传统的治疗方案不能提供足够的 汽车恢复所需的大量运动练习，目前的财政压力越来越有限 中风康复计划。因此，需要创新技术来增强传统节目 在当前康复环境的限制下提供必要的动作练习。至 为了满足这一需求，我们开发了一个基于Kinect的中风后康复游戏原型Duck Duck 冲压(DDP)。在保持游戏吸引力的同时，DDP有一个治疗重点，因为它独特 设计得出了符合循证中风康复原则的手臂运动恢复过程。 玩家移动他/她的物理手臂来控制虚拟化身手臂以到达并“击打”虚拟鸭子。自定义 功能允许对游戏进行量身定做，因此患者的成功需要得到治疗师批准的健康手臂 动静。治疗师可以将DDP整合到诊所或家庭计划中，以获得额外的准监督 运动练习，因为性能报告量化和监控运动恢复的进展 目标。我们向DDP发放了许可，并成立了一家名为Recovr的公司，该公司已收到初始投资资金 初创企业和市场调研。在一个由NIH/NIGMS CTR资助的试验项目中，我们确立了技术优势 DDP作为加强住院、门诊和家庭卒中康复的工具的可行性。非常 令人振奋的结果推动了当前的项目，该项目试图测试DDP的功能可行性并确定 它的商业潜力。在本项目中，我们建议(1)评估家庭是否使用顺铂6周 改善中风后手臂的运动能力；(2)通过关联运动来检验剂量-反应关系 手臂运动技能的重复；以及(3)确定DDP报告的治疗有效性作为衡量 损伤和反应。我们将招募n=60名中风患者参加单盲平行试验- ARM研究，根据ARM损伤程度分组随机，以检验游戏的假设 DDP有助于提高手臂运动技能，而不是玩商业游戏。此外，中风 幸存者(n=16)、中风幸存者的照顾者(n=16)和中风康复治疗师(n=32)将 参加重点小组，以指导进一步制定DDP总结执行情况报告，以便 提高其有效性，以便为未来的治疗决策提供信息。这个项目很重要，因为有必要 开发和营销新的选择，以延长中风后手臂运动康复计划。这个项目将会产生效益 关于DDP对恢复、剂量的影响以及其业绩报告的可译性的数据。因此，这一点 直接到第二阶段SBIR将为未来的最终研究奠定基础，以便能够就 顺铂对治疗师和中风幸存者的临床应用和商业化。

Establishing the functional viability and dose-response of Duck, Duck Punch: A Stroke Rehabilitation Computer Game ABSTRACT Only 15% of stroke survivors experience full recovery of arm/hand movement. Long-term arm movement impairment restricts independence with self-care and vocational activities, increases caregiver burden and reduces quality of life. Strong evidence is emerging that traditional therapy programs do not provide adequate amounts of movement practice needed for motor recovery yet, current financial pressures increasingly limit stroke rehabilitation programs. Thus, there is a need for innovative technology to augment traditional programs to provide the necessary movement practice within the constraints of the current rehabilitation landscape. To meet this need, we developed a prototype Kinect-based post-stroke rehabilitation game called Duck Duck Punch (DDP). While maintaining the appeal of a game, DDP has a therapeutic focus because its unique design elicits an arm motor recovery process consistent with evidence-based stroke rehabilitation principles. The player moves his/her physical arm to control an avatar arm to reach and “punch” virtual ducks. Custom features allow tailoring of the game so that patients' success requires “therapist approved” healthy arm movements. Therapists can integrate DDP into in-clinic or in-home programs for additional quasi-supervised movement practice because a performance report quantifies and monitors progress toward motor recovery goals. We licensed DDP and formed a company, Recovr, which has received investment funding for initial start-up and market research. In a funded NIH/NIGMS CTR pilot project, we established the technical merit and feasibility of DDP as a tool to augment inpatient, outpatient and home-based stroke rehabilitation. Very promising results motivated the current project that seeks to test the functional viability of DDP and determine its commercial potential. In this project we propose to (1) evaluate whether home use of DDP for 6 weeks improves post-stroke arm motor ability; (2) examine the dose-response relationship by relating movement repetitions to arm motor skills; and (3) determine the treatment validity of the DDP report as a measure of impairment and response. We will enroll n=60 subjects with stroke to participate in a single blinded, parallel- arm study with blocked randomization according to arm impairment level to test the hypothesis that playing DDP facilitates improves arm motor skills more than playing a commercially available game. In addition stroke survivors (n=16), caregivers of stroke survivors (n=16) and stroke rehabilitation therapists (n=32) will participate in focus groups to guide further development of the DDP summary performance report in order to improve its validity for informing future treatment decisions. This project is important because there is a need to develop and market new options to extend post-stroke arm motor rehabilitation programs. This project will yield data regarding DDP's effect on recovery, dosing, and the translatability of its performance report. Thus, this Direct-to-Phase-II SBIR will set the stage for a future definitive study to enable clear decisions regarding the clinical utility and commercialization of DDP to therapists and stroke survivors.