Robust Blink-based Communication System for Patients in Bed

描述(申请人提供)：美国每年约有5,000人被诊断为肌萎缩侧索硬化症(ALS)，这是最常见的神经肌肉疾病之一。这种疾病最终会影响到几乎所有的随意肌肉，患者通常会失去移动肢体、说话、呼吸和吞咽的能力。患者通常会保留他们的认知能力，但随着他们失去行动和说话的能力，沟通变得极其困难。类似的沟通问题也可能影响到患有其他疾病的人，例如中风或创伤性脑损伤的患者，以及使用呼吸机的肌营养不良症患者。虽然这些患者中只有一小部分人会经历像ALS患者在疾病晚期面临的严重沟通问题，每年有近80万美国人中风，约170万人遭受创伤性脑损伤，但受影响的人群是很大的。已经开发了各种技术来帮助ALS患者进行交流。其中包括从低技术印刷通信板到一系列高科技增强和替代通信(AAC)设备，其中许多设备包括一些专门软件和替代输入策略的某种组合，以方便计算机的使用。Tabii和DyaVox系列产品等AAC设备提供了非常强大的通信功能，但几乎所有可用的设备都受到护理人员需要经常以某种方式与设备交互的限制。这可能涉及定位或插入Tobii产品等设备，定位机械开关以使患者可以接触到它，或者直接与通信板等设备一起工作。现有技术没有很好地解决的一个非常重要的问题是，需要高度可靠的通信，这种通信不需要护理员在手边，也不要求护理员记住提前放置设备。当患者在夜间卧床时，这一点尤其重要，因为(1)照顾者可能不在附近，甚至可能不醒着，(2)ALS患者在卧床时也可能需要相对频繁的帮助，以重新定位、如厕和其他需要。这项拟议的研究将开发基于眨眼的通信(Blinc)系统，该系统使用安装在患者卧室天花板或墙壁上的红外(IR)摄像头，以提供对患者的持续监控，检测眨眼信号，并提供用于呼叫帮助的虚拟呼叫按钮。此外，拟议的系统将提供一种简单而强大的手段，在护理员到达后传达基本请求。 与公共卫生相关：虽然ALS患者的规模不大，但这种疾病完全使人虚弱，患者严重依赖技术解决方案来满足许多需求，包括通信。当前可用的系统提供强大的通信能力，但在物理侵入性和护理人员需要频繁操作以保持系统对患者可用方面具有显著限制。拟议的研究将为ALS患者开发一种非侵入性、高可靠性、高可用性、低成本的通信解决方案。

DESCRIPTION (provided by applicant): Every year approximately 5,000 people in the United States are diagnosed with amyotrophic lateral sclerosis (ALS), one of the most common neuromuscular diseases. The disease ultimately affects nearly all voluntary muscles, and patients typically lose the ability to move their limbs, talk, breathe, and swallow. Patients do generally retain their cognitive abilities, though as they lose their ability to move and talk, communication becomes extremely difficult. Similar communication issues may also affect people with other medical conditions, such as patients who have suffered a stroke or traumatic brain injury, and muscular dystrophy patients using ventilators. Although only a small percentage of these patients will experience communication issues as severe as those faced by ALS patients in the late stages of the disease, with nearly 800,000 Americans suffering a stroke and approximately 1.7 million sustaining a traumatic brain injury each year, the effected population is significant. A variety of technologies have been developed to assist ALS patients with communication. These range from low-tech printed communication boards to an array of high-tech Augmentative and Alternative Communication (AAC) devices, many of which include some combination of specialized software and alternate input strategies to facilitate use of a computer. AAC devices such as the Tobii and DynaVox lines of products offer very powerful communication capabilities, but nearly all available devices suffer from the limitation of requirin a caregiver to frequently interact with the device in some fashion. This might involve positioning or plugging in a device like a Tobii product, positioning a mechanical switch so that it is accessible to the patient, or directly working with a device like a communication board. A very important issue that is not well addressed by the available technology is the need for highly reliable communication that does not require a caregiver to be close at hand, and does not require the caregiver to remember to place a device ahead of time. This is particularly important when a patient is in bed at night because (1) a caregiver is likely not close by and may not even be awake, and (2) ALS patients are also likely to need relatively frequent assistance while in bed for repositioning, toileting, and other needs. The proposed research would develop the Blink-based Communication (BLINC) System using infrared (IR) cameras mounted unobtrusively on the ceilings or walls of a patient's bedroom to provide persistent monitoring of the patient, detecting blink signals and providing a virtual call button for summoning assistance. Additionally, the proposed system will provide a simple and robust means to communicate basic requests after a caregiver has arrived. PUBLIC HEALTH RELEVANCE: While the ALS patient population is modest in size, the disease is completely debilitating and patients rely heavily on technology solutions for many needs including communication. Currently available systems provide powerful communication capabilities, but have significant limitations in terms of physical intrusiveness and the need for frequent action on the part of a caregiver to keep the systems available to the patient. The proposed research would develop a non-intrusive, high reliability, high availability, low-cost communication solution for ALS patients.