FitMi AD: a safe and motivating computer-guided exercise system for individuals with MCI or mild dementia due to Alzheimer's disease

阿尔茨海默病(AD)在美国影响着500多万老年人。广告与加速相关 身体机能恶化，导致摔倒的风险更高，行动能力下降，质量下降 生命，以及失去独立性。对阿尔茨海默病或轻度认知障碍患者的运动干预 (MCI)在整体健康、身体功能和独立性方面显示出有希望的改善。 不幸的是，出于安全考虑，这些人很难维持常规锻炼，而且 需要监督和指导。为了满足这一需求，我们开发了一款运动指导应用程序 触摸屏Flint片剂，连接到感应式、低调静止循环(Cycli)。我们评估了 该系统在促进MCI或轻度痴呆患者家庭锻炼方面的可行性。 第一阶段SBIR。运动指导APP和整体方法得到了积极的反馈。然而， Cycli Hardware有许多关键问题，使其无法成为可行的家庭锻炼选择 对于这一人群(例如，它造成了潜在的绊倒危险，并且对一些用户来说没有吸引力)。至 为了解决这些限制，我们建议在第二阶段整合在第二阶段开发的指导练习应用程序 我喜欢我们现有的FitMi系统，它最初是一种无线的、感应式的居家锻炼设备 为中风患者开发的。我们在这里将这个新系统称为FitMi AD。现有的FitMi 硬件包括获得专利的多用途无线输入设备(Puck)和可穿戴无线设备 测量运动和压缩力的输入装置(“夹子”)。因此，我们认为有了 适当的、临床知情的设计改进，FitMi AD将促进个人的家庭锻炼 患有MCI或由于AD而导致的轻度痴呆。具体地说，除了将日程安排、跟踪、 在第一阶段开发和验证的目标设定功能，FitMi AD将包括一个新的 运动中的练习：来自国家老龄研究所(NIA)的指南。FitMi AD还将使用REAL- 来自蓝牙心率监测器的时间数据，可自动调整运动强度，实现 有益的努力水平。我们对此二期项目的具体目标是：目标1)执行结构化 对临床专家和轻度认知障碍或阿尔茨海默病患者及其照顾者的访谈 优化FitMi AD设计(n=25)；目的2)迭代开发FitMi AD练习软件 专家和用户反馈；目的3)确定家庭运动训练的安全性和有效性 FitMi AD在一项随机对照试验中进行，对象为患有MCI或AD所致轻度痴呆的个体 (n=30)。我们的假设是，在家中使用FitMi AD锻炼的参与者将显著表现出 治疗组在体能方面较对照组有较大改善。如果成功，FitMi AD将是一个安全的， 有效且商业上可行的家庭锻炼工具，适用于MCI或轻度痴呆症患者，原因是 广告，从而提高他们的生活质量，减轻照顾者的负担。

Alzheimer’s disease (AD) affects over 5 million older adults in the US. AD is associated with accelerated deterioration in physical function, resulting in a higher risks of falls, decline in mobility, reduced quality of life, and loss of independence. Exercise interventions for individuals with AD or mild cognitive impairment (MCI) have shown promising improvements to overall health, physical function, and independence. Unfortunately, routine exercise is difficult to maintain for these individuals due to safety concerns and the need for supervision and guidance. To address this need, we developed an exercise guidance app for our touchscreen Flint Tablet that connects to a sensorized, low-profile stationary cycle (Cycli). We evaluated the feasibility of this system in promoting home exercise in individuals with MCI or mild dementia in a Phase I SBIR. The exercise guidance app and overall approach received positive feedback. However, the Cycli hardware had a number of critical issues that prevent it from being a viable home exercise option for this population (e.g. it created a potential tripping hazard and was not engaging for some users). To address these limitations, we propose in Phase II to integrate the guided exercise app developed in Phase I with our existing FitMi system, which is a wireless, sensorized at-home exercise device originally developed for individuals with stroke. We refer to this new system here as FitMi AD. The existing FitMi hardware includes a patented, multipurpose wireless input device (a “Puck”) and a wearable wireless input device (a “Clip”) that measure both movement and compression force. Thus, we believe that with appropriate, clinically informed design improvements, FitMi AD will facilitate home exercise in individuals with MCI or mild dementia due to AD. Specifically, in addition to incorporating the scheduling, tracking, and goal-setting features developed and validated in Phase I, FitMi AD will include a new library of exercises from Exercise: A Guide from the National Institute on Aging (NIA). FitMi AD will also use real- time data from a Bluetooth heart rate monitor to automatically adjust the exercise intensity to achieve a beneficial level of exertion. Our specific aims for this Phase II project are to: Aim 1) Perform structured interviews with clinical experts and individuals with MCI or mild dementia due to AD and their caregivers to optimize the design of FitMi AD (n=25); Aim 2) Develop the FitMi AD exercise software with iterative expert and user feedback; Aim 3) Determine the safety and effectiveness of home-based exercise training with FitMi AD in a randomized controlled trial with individuals with MCI or mild dementia due to AD (n=30). Our hypothesis is that participants who exercise at home with FitMi AD will show significantly greater improvements in physical function than the control group. If successful, FitMi AD will be a safe, effective, and commercially viable home exercise tool for individuals with MCI or mild dementia due to AD, thus improving their quality of life and reducing the burden on caregivers.