Multihaptic wearable sensor enabled by biomimetic polymer to stoke engagement in swallowing rehabilitation therapy

在许多残疾中，患者可以从使用可穿戴设备进行康复或预防中受益。然而，患者对可穿戴传感器的接受程度并不高；在这个项目中，建议通过设计为佩戴者提供强化触觉提示的设备来增加采用率。该项目将首次在“表皮”可穿戴设备（即类似于临时纹身的设备）中使用触觉效果。触觉效果将推动模拟物理治疗的参与。作为一个用例，吞咽困难（或吞咽困难）的治疗将是本研究的重点。大约3%的美国人口和15%以上的老年人患有这种疾病，它可能与疼痛有关，在许多情况下，吞咽困难患者的生活质量是毁灭性的。此外，吞咽动作不协调可能导致食物进入肺部和吸入性肺炎，这是危及生命的。一种能检测燕子和其他运动的脖子上装置的设计可以增加物理治疗的过程。最终，希望在设备工程和行为科学的界面上创造的知识将使患者能够负责自己的康复。该项目利用了新开放的加州大学圣地亚哥分校（UCSD）市中心中心，该中心将成为触觉基础工作中产生的多个动手演示的场所；这些演示将与从社区招募不同群体的参与者一起进行。该项目的目标是增加流动卫生干预措施的采用和参与。具体来说，通过赋予表皮可穿戴传感器触觉能力。也就是说，通过触摸与佩戴者互动的能力。该项目利用了数十年来在无数设备上的工作，这些设备可以高精度地测量大量生理量。然而，未来患者和消费者对这些“表皮”传感器的采用并不是理所当然的。以预防和康复吞咽困难（吞咽功能丧失）为疾病模型，本项目提出了一种用于治疗的表皮贴片，每当正确执行治疗动作时，它就会提供肯定的触觉刺激。关键的使能元件是一种可拉伸的仿生导电聚合物，具有优异的导电性和体积电容。这种材料在设备中用作设备的三个组成部分：(1)应变片和(2)肌电电极和(3)触觉刺激电极，其电压比现成的电极低。在闭环设计中，该设备测量信号并立即产生触觉效果，以鼓励人体受试者实验中期望的行为。这项工作所创造的知识可以释放过去15年来围绕表皮电子设备建立的创造力和创新的潜力，并可能对家庭治疗技术产生变革性影响。此外，55名参与者的可行性测试将在加州大学圣地亚哥分校的市中心社区中心进行，该中心位于圣地亚哥一个高度多样化的地区。设备的设计和工程将在吞咽困难患者和有吞咽困难风险的人的参与下进行。测试将与在这个项目中生产的触觉材料和设备的实际展览一起进行。这项工作的影响将通过年龄、吞咽困难状态、社会经济地位和技术素养的主题池分层而扩大。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

There are many disabilities in which the patient could benefit from the use of a wearable device for rehabilitation or prevention. However, the adoption of wearable sensors by patients is not strong; in this project, it is proposed that adoption could be increased by designing devices that provided reinforcing tactile cues to the wearer. This project will use haptic effects for the first time in an “epidermal” wearable device (that is, a device akin to a temporary tattoo). The haptic effects will drive engagement in simulated physical therapy. As a use case, treatment of dysphagia (or difficulty swallowing) will be the focus of this study. This condition, which afflicts approximately 3% of the US population and ≥15% of the elderly, can be associated with pain, and in many cases is devastating to the quality of life of persons with dysphagia. Moreover, uncoordinated swallowing movements can lead to the entry of food into the lungs and aspiration pneumonia, which is life-threatening. The engineering of a device worn on the neck capable of detecting swallows and other movements could augment the course of physical therapy. Ultimately, it is hoped that the knowledge created at the interface of device engineering and behavioral science will enable patients to take charge of their own rehabilitation. This project leverages the newly opened University of California San Diego (UCSD) Downtown Center, which will be the site of multiple hands-on demonstrations arising from the fundamental work on haptics; these demos will be held in conjunction with recruiting a diverse group of participants from the community for the study.The goal of this project is to increase the adoption and engagement of mobile health interventions. Specifically, by endowing epidermal wearable sensors with haptic capabilities. That is, the ability to interact with the wearer by touch. The project leverages decades of work on myriad devices that can measure a large array of physiological quantities with high accuracy. Nevertheless, the future adoption of these “epidermal” sensors by patients and consumers cannot be taken for granted. Using prevention and rehabilitation of dysphagia (loss of swallowing function) as a disease model, this project proposes a type of epidermal patch for therapy that delivers affirming tactile stimuli whenever a therapeutic movement is performed correctly. The key enabling element is a stretchable, biomimetic conductive polymer that exhibits exceptional conductivity and volumetric capacitance. This material is used in the device as three components of the device: (1) strain gauges and (2) electrodes for electromyography and for (3) haptic stimulation, at lower voltages than is possible with off-the-shelf electrodes. In a closed-loop design, the device measures a signal and immediately produces a haptic effect to encourage desired behavior in human subject experiments. The knowledge created by this work could unleash the potential of the creativity and innovation surrounding epidermal electronic devices built up over the last 15 years and could have a transformative impact on technologies for at-home therapy. Moreover, the feasibility testing with 55 participants will be performed at UCSD’s Downtown Community Center, located in a highly diverse area in San Diego. The design and engineering of devices will be conducted with the participation of dysphagic patients and those at risk of dysphagia. Testing will be held in conjunction with a hands-on exhibit of haptic materials and devices produced during this project. The impact of this work will be broadened by stratification of the subject pool by age, dysphagia status, socioeconomic status, and technological literacy.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.