Phase II STTR: Portable Device for Telecare Monitoring of Elderly People

描述（由申请人提供）：我们建议通过开发一种准确的可穿戴传感器技术来解决两个重要的公共卫生生活质量问题-老年人的跌倒预防和虚弱，该技术可以更准确地表征身体活动，跌倒风险和虚弱的早期指标。在STTR项目的第一阶段，我们开发了一个独特的平台（PAMSysTM：身体活动监测系统），用于客观测量日常生活中的身体活动，并展示了PAMSysTM平台的概念验证，用于客观评估老年人的自发日常身体活动、跌倒风险和活动组织。在该项目的第二阶段，我们提出了两项额外的临床研究，以进一步评估PAMSysTM平台的临床应用，并继续我们的研发工作，将PAMSysTM平台转变为临床上合理的低成本工具，用于跌倒风险的远程筛查和虚弱的早期检测。我们将加强我们的技术，利用非侵入性身体活动远程监测，对跌倒/虚弱的风险进行早期诊断和远程监测。利用这项技术，我们将确定跌倒风险的指示模式，并对高危老年人日益重要的老年衰弱综合征进行早期检测和干预。此外，它将使 远程和连续筛查日常生活活动中跌倒的风险，提高自主性和生活质量，并限制繁重的面对面临床评估的需求。所提出的技术还可以提供一种客观的工具来评估身体活动的减少，并根据临床相关干预措施的相对疗效，帮助规定和测量康复和治疗策略对降低跌倒风险的影响。总之，这些考虑支持迫切需要：a）开发用于客观评估有跌倒或发展虚弱风险的老年人身体活动的频率、持续时间和组织的仪器，以及）开发可走动和低负担的仪器，从而允许评估日常生活中自然的患者运动（在人工实验室环境之外）。我们将 通过以下方式实现这些目标：a）调查由PAMSys TM平台收集的参数对由于虚弱而发生的日常身体活动的变化的敏感程度，B）通过检查PAMSys衍生的活动和运动变量的变化与老年人评估的功能能力测量和自我报告的残疾、跌倒史、跌倒风险和虚弱的变化的对应程度; c）通过改进当前的软件算法，以允许评估对虚弱和跌倒风险的早期诊断敏感的细粒度运动参数，以及e）通过修改我们的传感器的设计，以进行实时无线数据传输。 公共卫生相关性：随着婴儿潮一代的年龄增长，他们的预期寿命增加，美国65岁及以上的老年人数量将急剧增加，对家庭和社区老年人的有效，低成本监测和治疗产生了前所未有的需求。本研究旨在开发一种新型的可穿戴技术，并将其商业化，用于使用单一且易于穿戴的传感器对老年人进行远程健康活动监测。该技术可以远程和连续地对老年人的跌倒风险进行线性相关筛查，并对有虚弱风险的人进行早期检测和有针对性的干预。

DESCRIPTION (provided by applicant): We propose to address two important public health quality of life concerns - fall prevention and frailty in older adults by developing an accurate wearable sensor technology that more accurately characterizes physical activity, risk of falling and early indicators of frailty. In Phase I of this STTR project, we developed a unique platform (PAMSysTM: Physical Activity Monitoring System) for objective measurement of physical activity during everyday living and demonstrated the proof of concept of the PAMSysTM platform for objective assessment of spontaneous daily physical activity, risk of falling and activity organization among older adults. In Phase II of the project, we propose two additional clinical studies to further evaluate the clinical applications of the PAMSysTM platform and to continue our research and development efforts to transform the PAMSysTM platform into a clinimetrically sound low-cost tool for remote screening of risk of falling and early detection of frailty. We will enhance our technology for early diagnosis and remote monitoring of the risk of falling/frailty using non-invasive physical activity telemonitoring. Using this technology we will identify patterns indicative of risk of falling and for early detection and intervention of the increasingly important geriatric syndrome of frailty in at-risk elders. In addition, it will enable remote and continuous screening of the risk of falling during activities of daily living, supportin autonomy and quality of life, and limiting the need for burdensome face to face clinical assessment. The proposed technology can also provide an objective tool to evaluate physical activity decrements and to help prescribe and measure the effects of rehabilitation and treatment strategies on reductions in the risk of falling based on the relative efficacy of clinimetrically relevant interventions. Taken together, these considerations support the urgent need to: a) develop instrumentation for objective assessment of the frequency, duration and organization of physical activity among older adults at risk of falling or developing frailty, and ) develop instrumentation that is ambulatory and low burden, thus allowing the assessment of naturalistic patient movement in everyday life (outside of the artificial lab environment). We will pursue these goals by: a) investigating the degree to which the parameters gathered by the PAMSysTM platform are sensitive to changes in daily physical activity that occur as a result of frailty, b) by examining the degree to which changes in PAMSys-derived variables of activity and movement correspond with changes in geriatric- assessed functional capacity measures, and self-reported disability, history of fall, risk of falling, and frailty; c) by improving current sotware algorithms to allow assessment of fine-grained movement parameters sensitive to early diagnosis of frailty and risk of falling, and e) by modifying the design of our sensor for real-tim wireless data transfer. PUBLIC HEALTH RELEVANCE: As baby boomers age, and their expected life span increases, the number of U.S. elders aged 65 and over will dramatically rise, producing unprecedented need for effective, low cost monitoring and treatment of home and community-dwelling elders. This study aims to develop and commercialize a novel wearable technology for tele-health activity monitoring of elders using a single and easily wearable sensor. The proposed technology allows remote and continuous linimetrically relevant screening of elder's risk of falling as well as early detection and targeted intervention of those at risk of frailty.