SCH: EXP: Collaborative Research: Cognitive Haptic Based Rehabilitation System for Patient-Centric Home

该项目由美国国家科学基金会（National Science Foundation）和国立卫生研究院（National Institutes of Health）联合发起，名为“智能和互联健康”（SCH），旨在加速创新方法的开发和使用，以支持整个人口急需的医疗保健转型。中风是美国老年人致残的主要原因。每年有超过80万例中风发生，近三分之一的中风幸存者有严重的残障，老年人的功能恢复通常较慢。目前这类病人的身体康复主要以医院为中心。然而，由于美国医疗保健系统的经济压力，中风患者接受的治疗越来越少，在几个月的急性治疗后，他们的身体功能没有完全恢复，就回家了。此外，许多患者在中风或其他损伤后完成了急性住院康复，但在返回家中时，获得门诊康复的机会可能有限。这些患者可以通过家庭康复从获得和高质量的护理中受益。家庭康复治疗的成功与否，在很大程度上取决于对患者依从性的监测和对家庭康复方案的设计。提出的研究通过开发一种可在家中使用的基于触觉的康复系统，以两个新颖的命题来解决上述问题。该项目的实施如下：首先，开发一种基于家庭的触觉系统，以恢复患者的主要上肢受到某种残疾影响的影响和非主要/未受影响的上肢的日常生活活动（ADL）技能。其次，该研究通过监测患者的大脑活动来调查以家庭为中心的认知触觉疗法的使用情况。所提出的系统使用认知和触觉反馈来监控患者的进展和他或她的参与，并相应地进行调整。患者的康复进度是通过以下两方面来评估的：1)与任务的准确性和完成相关的分数；2)患者在家治疗期间的精神投入水平。这种评估使医生能够在家庭治疗期间监测受试者的表现，并允许他/她以适当的方式调整触觉和模拟。本研究假设通过使用触觉，以家庭为中心的康复治疗的有效性是有效的授权病人。此外，考虑到通过对受试者的认知监测，有可能在治疗过程中评估和改善患者的参与。

This project is funded under a joint solicitation between the National Science Foundation and the National Institutes of Health, named "Smart and Connected Health" (SCH), which aims to accelerate the development and use of innovative approaches that would support the much needed transformation of healthcare across the entire population. Stroke is the leading cause of disability among older adults in the United States. More than 800,000 strokes occur each year and nearly one third of all stroke survivors have significant residual disability, with older individuals generally experiencing slower functional recovery. Current physical rehabilitation of such patients is primarily hospital centric. However, due to economic pressures on the U.S. health care system, stroke patients are receiving less therapy and going home after few months of acute therapy without regaining the whole functionality of their body. Moreover, many patients who have completed their acute in-patient rehabilitation following a stroke or other injury may have limited access to out-patient rehabilitation upon their return home. These patients can benefit from access and quality of care through home-based rehabilitations. The success of the home-based therapy is highly dependent on monitoring the patient compliance and designing the home-based rehabilitation that can mentally engaged the subjects. The proposed research approaches the above stated problem with two novel propositions by developing a haptic-based rehabilitation system that can be used at home. The project is carried out as follows: First, a haptic home-based system is developed to rehabilitate Activity of Daily Living (ADL) skills in both the affected and the non-dominant/unaffected upper limb of a patient whose dominant upper limbs has been affected by some disability. Second, the research investigates the use of home centered cognitive haptic therapy by monitoring the patient's brain activity. The proposed system uses cognitive and haptic feedbacks to monitor the progress of patient and his or her engagement and adapts itself accordingly. Patient's recovery progress is evaluated through combination of 1) scores related to accuracy and completion of task and 2) subject's level of mental engagement during treatment at home. This evaluation empowers the physician to monitor the subject's performance during in-home therapy and allow him/her to adjust the haptic and simulation in an appropriate fashion. This research hypothesizes that by using haptics the effectiveness of home-centered rehabilitation therapy is effective in empowering the patient. Moreover, it is contemplated that by cognitive monitoring of subjects, it is possible to evaluate and improve patient engagement during the therapy sessions.