Sensor Network for Monitoring Real-world Arm Activity of Rehabilitation Patients

描述（由申请人提供）：证据和理论表明，实验室测量的损伤和功能并不能预测老年人在日常生活中的实际功能。例如，托马斯·格拉斯（Thomas Glass，1998）在《麦克阿瑟成功老龄化研究》（MacArthur Studies of Successful Aging）的调查数据中报告了社区居民“能做”和“做”的功能活动之间的显著差异。因此，大量的努力已经花费在开发日常生活中的功能的措施。然而，大多数新工具都依赖于自我报告。PI的研究小组和其他人使用了加速度计，检测运动的传感器，以客观地测量脑损伤幸存者社区中上肢活动的量。PI表明，他的小组的测量与脑损伤后日常生活中自我报告的受损手臂使用相关，并且是康复结果的可靠和有效指标。然而，与其他加速度计测量一样，它不能区分给定的手臂运动是功能性的还是非功能性的，并且不能识别执行了什么任务。我们建议开发一种测量上肢活动的方法，使用射频识别（RFID）标签与运动和接近传感器配对。有源RFID标签体积小，价格便宜（<25美元），足以贴在日常物品上，并可以向中央接收器发送指示物体状态变化的无线电信号。加速度传感器将被用来触发RFID标签时，被标记的对象被移动。一个低射频接近传感器将被开发，以触发RFID标签时，感兴趣的手臂是一个移动的标签对象。将开发软件来跟踪哪些物体被操纵（每个物体具有唯一标签ID的运动传感器），何时被操纵（每个触发事件上的时间戳），它们是否被感兴趣的人和手臂操纵（无线电接近传感器），以及它们被操纵的时间（接近传感器保持“ON”的时间）。因此，拟议的系统可能允许收集比现在更丰富的客观数据。在这个为期6个月的项目中，我们将进行基准测试以评估其极限，并使用选定的日常物品对健康个体（N = 26）进行实验室研究，以初步评估其可靠性和有效性。最初的应用将是通过在治疗前后标记患者家中常用物体的随机样本，确定上肢康复对在家庭环境中用受损较重的手臂进行的功能活动的数量和类型的影响。然而，所提出的方法具有更广泛的应用。例如，可以将RFID标签贴在锻炼对象上，以监测对家庭锻炼计划的依从性。结合家庭中基于PC的虚拟治疗师，RFID系统可以用于在真实的时间内加强家庭环境中的功能活动，从而帮助将临床环境中取得的收益转移到真实的世界。由于RFID标签已经在广泛的商业应用中，考虑可能的应用的一个重要因素是其成本可能会大幅下降。 公共卫生相关性：该项目的目标是开发和测试一个无线传感器网络，用于测量中风和其他脑损伤幸存者在家中使用受损手臂的时间和活动。如果成功，该工具将允许康复研究人员和临床医生更准确地测量手臂康复治疗对患者日常生活功能的影响，最终导致更有效的治疗。此外，当与患者家中笔记本电脑上运行的虚拟治疗师软件配对时，该工具可能会被纳入现有的治疗方法中，以直接加强受损手臂的日常使用。

DESCRIPTION (provided by applicant): Evidence and theory indicate that laboratory measures of impairment and function do not predict how older adults actually function in daily life. Thomas Glass (1998), for example, reports marked differences between functional activities that community residents "can do" and "do do" in survey data from the MacArthur Studies of Successful Aging. Therefore, substantial effort has been spent on developing measures of function in daily life. Most of the new instruments, however, rely on self-report. The PI's research group and others have employed accelerometers, sensors that detect movement, to objectively measure the amount of upper- extremity activity in the community among brain injury survivors. The PI has shown that his group's measure is correlated with self-reported more-impaired arm use in daily life after brain injury, and is a reliable and valid index of rehabilitation outcome. Like other accelerometer measures, however, it can not discriminate whether a given arm movement is functional or non-functional and can not identify what tasks were performed. We propose to develop a measure of upper-extremity activity using radio frequency identification (RFID) tags paired with movement and proximity sensors. Active RFID tags are small and inexpensive (< $25) enough to be affixed to everyday objects, and can send radio signals indicating changes in object status to a central receiver. An acceleration sensor will be used to trigger the RFID tag when a tagged object is moved. A low radio frequency proximity sensor will be developed to trigger the RFID tag when the arm of interest is the one moving the tagged object. Software will be developed to track which objects are manipulated (movement sensor with unique tag ID for each object), when they are manipulated (time stamp on each trigger event), whether they are manipulated by the person and arm of interest (radio proximity sensor), and for how long they are manipulated (time for which the proximity sensor stays "ON"). Thus, the proposed system might permit collection of much richer objective data than possible now. In this initial, 6-month project, we will conduct benchmark testing to evaluate its limits and a laboratory study with healthy individuals (N = 26) using selected everyday objects to evaluate its reliability and validity on preliminary basis. An initial application would be determining the effect of upper-extremity rehabilitation on amount and type of functional activity performed with the more-impaired arm in the home setting by tagging a random sample of commonly used objects in the patients' homes before and after therapy. The proposed approach, however, has much wider application. For example, RFID tags could be affixed to exercise objects to monitor compliance with home exercise programs. In conjunction with a PC-based virtual therapist in the home, an RFID system could be used to reinforce functional activity in the home setting in real time, and thereby help transfer gains made in the clinical setting to the real world. Because RFID tags are already in widespread commercial use, an important factor in considering possible applications is that their cost is likely to fall sharply. PUBLIC HEALTH RELEVANCE: The goal of this project is to develop and test a network of wireless sensors for measuring how long and for what activities stroke and other brain injury survivors use their impaired arm at home. If successful, this tool will permit rehabilitation researchers and clinicians to more accurately measure the effects of arm rehabilitation therapy on how patients function in their daily life, ultimately leading to more effective treatments. When paired with virtual therapist software running on a laptop in patients' home, this tool, in addition, might be incorporated into existing therapies to directly reinforce everyday use of the impaired arm.