Systematic evaluations of a new smartphone-based wearable telerehabilitation system for use by people with Parkinson's disease

项目总结 帕金森氏病(PD)是一种进行性神经退行性脑疾病，至少影响1000万人 全世界。主要的运动障碍是震颤、运动迟缓、肌肉僵硬和姿势不稳。它 已经证明帕金森病患者的姿势不稳定通常对多巴胺能反应不足。 药物和手术治疗，这反过来会导致失去平衡、摔倒的风险和不良反应 关于生活质量。 帕金森病通常在门诊神经科或运动障碍诊所进行治疗。许多研究都有 研究了身体和平衡康复疗法改善体位稳定性的有益效果。 警局的人。不幸的是，许多挑战(例如，成本、有限的物理治疗师、有限的 使用临床设施、遵守规定的运动等。)限制参与临床和 主页设置。基于智能手机的远程康复技术可以提供另一种选择来帮助人们 在进行居家平衡康复练习时，帕金森病患者。开发了第一个基于智能手机的 用于静态站立练习的振动触觉生物反馈系统，近年来，PI开发并评估了一种 高级原型，称为智能平衡系统(SBS)，供帕金森病患者使用 治疗师建议在实验室进行短期(不到一小时)的动态平衡练习 家庭环境和长时间(连续6周)环境。SBS由一部智能手机和一部 可穿戴腰带，支持多模式(视觉和触摸)生物反馈作为辅助指导，并提供真正的 物理治疗师推荐的动态移重平衡练习的时间误差大小。 PI的调查结果强调了对静态/动态持续改进进行系统评估的必要性 帕金森病患者的表现、长期表现保持和延续效应之间的平衡 家庭平衡训练或通过SBS的远程康复方案或典型的纸质方案。 因此，目标1将评估和比较SBS和纸质方案在长期治疗中的效果。 家庭康复平衡训练，目标2将对结转进行定量和定性的分析 SBS长期康复训练对静/动平衡能力、日常体能的影响 与使用典型纸质养生法的对照组相比，他们在活动、对摔倒的恐惧方面更有信心。 这项拟议的工作将为家庭平衡训练如何与SBS一起产生持久的 平衡性能的改善，转化为有益的效果(即，提高对日常生活的信心 体力活动，减少摔倒的恐惧，降低摔倒的风险)，并提供比典型的更好的结果 以纸张为基础的养生法。SBS的用户友好和可穿戴特性应该会减少对内部- 由家庭成员和照顾者提供家庭援助。作为理疗师，理疗应该有所改进 监控家庭平衡训练方案的遵守情况，跟踪运动进度，并提出建议 远程的。

PROJECT SUMMARY Parkinson’s disease (PD) is a progressive neurodegenerative brain disorder affecting at least 10 million people worldwide. The cardinal motor impairments are tremor, bradykinesia, muscle rigidity, and postural instability. It has been shown that postural instability in people with PD often responds insufficiently to dopaminergic medication and surgical treatment, which in turn results in loss of balance, risk of falling, and adverse effects on quality of life. PD is commonly managed in outpatient neurology or movement disorder clinics. Numerous studies have examined the beneficial effects of physical and balance rehabilitation regimens to improve postural stability in people with PD. Unfortunately, many challenges (e.g., cost, limited availability of physical therapists, limited access to clinical facilities, compliance with prescribed exercises, etc.) restrict participation in the clinical and home settings. Smartphone-based telerehabilitation technology can provide an alternative to assist people with PD in performing in-home balance rehabilitation exercises. Having developed the first smartphone-based vibrotactile biofeedback system for static standing exercises, recently, the PI developed and assessed an advanced prototype, called Smarter Balance System (SBS), for use by people with PD performing physical therapists’ recommended dynamic balance exercises over short periods (less than an hour) in a laboratory setting and long periods (6 consecutive weeks) in a home setting. The SBS, consisting of a smartphone and a wearable belt, supports multimodal (visual and touch) biofeedback as assistive guidance and provides real- time error magnitudes for the dynamic weight-shifting balance exercisesrecommended by physical therapists. The PI’s findings underscore the need to systematically evaluate persistent improvements in static/dynamic balance performance, long-term performance retention, and carry-over effects in people with PD performing in- home balance training with either the telerehabilitation regimen via the SBS or a typical paper-based regimen. Therefore, Aim 1 will assess and compare the results of the SBS and a paper-based regimen for long-term in- home rehabilitative balance training, and Aim 2 will quantitatively and qualitatively analyze the carry-over effects of long-term rehabilitative training with the SBS on static/dynamic balance performance, daily physical activities, and confidence in less fear of falling compared to a control group with a typical paper-based regimen. The proposed work will provide insights into how in-home balance training with the SBS can produce persistent improvements in balance performance, translate into beneficial effects (i.e., improved confidence in daily physical activities, reduced fear of falling, and decreased risk of falling), and give better results than typical paper-based regimens. The SBS’s user-friendly and wearable characteristics should reduce the need for in- home assistance by family members and caregivers. Physical therapy should improve as physical therapists monitor compliance with in-home balance training regimens, track exercise progress, and give suggestions remotely.