Kinematic Biofeedback for Independent Motor Retraining

描述(由申请人提供)：该项目建议开发一种设备，以提高中风或不完全脊髓损伤所致神经运动障碍患者的运动再训练的质量和可用性。体位控制变量如地面反作用力和压力摆动中心的生物反馈已经得到了有效的应用，但现有的装置并不适合许多患者使用，也没有得到广泛的应用。我们建议开发一种治疗系统，使患者能够练习与临床相关的、闭链的下肢任务(坐-立转换和平衡转换)，并使用运动学变量的视觉生物反馈来鼓励使用受影响的肢体(S)。我们预计，使用拟议的设备将提高传统治疗的有效性，允许患者在康复过程中更早地开始坐-立和平衡换位练习，因为拟议的机械设备将降低跌倒的风险。 在第一阶段，我们将：1)修改现有的运动设备，以提供测量变量的视觉生物反馈，2)开发临床相关的生物反馈练习，3)在一项涉及没有神经运动缺陷的年龄匹配个人的研究中评估生物反馈展示，以及4)在一项试点研究中展示该方法的可行性，在该研究中，患者在中风后的急性康复期间将该设备作为其传统治疗的一部分。这项试点研究将提供对以下目标的洞察：1)确定该设备是否可以安全地用于这一人群，2)确定患者是否能够理解生物反馈信息并完成指定的任务，3)确定该设备是否被物理治疗师和患者视为一种有益的治疗锻炼形式，以及4)确定使用该设备的康复计划是否提高了传统治疗的恢复率和/或疗效。 在第二阶段，我们将改进生物反馈界面，优化协议以改善传输，开发定制电子设备来生成生物反馈显示，并在广泛的临床试验中测试该系统。 该设备的目标市场是为中风或不完全性脊髓损伤患者提供服务的康复医院和诊所。

DESCRIPTION (provided by applicant): This project proposes to develop a device that will improve the quality and availability of motor retraining for individuals with neuromotor disorders due to stroke or incomplete spinal cord injury. Biofeedback of postural control variables such as ground reaction force and center of pressure sway has been used effectively, however, existing devices are not suitable for use by many patients and are not widely available. We propose to develop a therapeutic system that enables patients to practice clinically-relevant, closed chain, lower-extremity tasks (sit-to-stand transitions and balance shifts) and that uses visual biofeedback of kinematic variables to encourage use of the affected limb(s). We anticipate that use of the proposed device will improve the efficacy of traditional therapy by allowing patients to begin sit-to-stand and balance shift exercises earlier in the rehabilitation process because the proposed mechanical device will reduce the risk of falls. In Phase I we will: 1} modify an existing exercise device to provide visual biofeedback of measured variables, 2) develop clinically relevant biofeedback exercises, 3) evaluate the biofeedback displays in a study involving age-matched individuals without a neuromotor deficit, and 4) demonstrate feasibility of the approach in a pilot study where patients use the device as one component of their traditional therapy during acute rehabilitation following stroke. The pilot study wilt provide insight into the following objectives: 1) determine if the device can be used safely for this population, 2} determine if patients can understand the biofeedback information and complete the specified tasks, 3) determine if the device is viewed as a beneficial form of therapeutic exercise by both physical therapists and patients, and 4) determine if a rehabilitation program using the device improves the rate of recovery and/or the efficacy of traditional therapy. In Phase II we will improve the biofeedback interface, optimize the protocols to improve transference, develop custom electronics to generate the biofeedback displays, and test the system in an extensive clinical trial. The target market for the device is rehabilitation hospitals and clinics that serve patients following stroke or incomplete spinal cord injury.