Virtual Activities of Living for Occupational Rehabilitation

项目摘要/摘要 简介：为职业康复而生活的虚拟活动(Valor)SBIR计划将支持 通过实施上肢卒中康复的远程保健提供和远程监测 日常生活虚拟活动(ADL)和工具性ADL(IADL)。勇士系统与地面联姻- 突破自由虚拟现实(VR)耳机技术和深度学习运行时3D运动跟踪 现有的一套数字ADL/IADL内容，可通过远程医疗在家中实现功能性、重复性任务练习 支持。一项关键的技术突破是无标记跟踪，它使用内置在低成本VR中的摄像头 耳机，使患者能够使用他们受影响的UE手动参与虚拟职业。 Valor第一阶段计划通过由以下机构进行的试点研究实现两个主要调查目标 杜克大学：(1)评估沉浸式VR ADL/IADL实践对UE的可用性和技术接受度 老年中风患者的治疗；以及(2)建立沉浸式虚拟ADL/IADL实践的有效性 跟踪患者的UE运动状态，以实现远程医疗反馈和监控。第一阶段的技术工作 包括用于实时UE跟踪的运行时神经网络与现有的虚拟套件的集成 ADLS/IADL(最初是为使用Kinect的基于PC的非沉浸式系统开发的)以支持沉浸式 使用低成本的独立、自由的头戴式耳机进行VR(不需要PC、显示器和其他传感器)。 有待解决的问题：新冠肺炎疫情暴露出严重缺乏提供 通过远程保健进行循证的UE干预。需要创新的解决方案，使患者能够安全地 在家中参与治疗师监控的治疗计划。约50%的795,000人 在美国，每年因中风住院的患者都患有慢性UE功能缺陷[1]、[2]。现有临床 沉浸式VR的治疗系统过于昂贵、复杂和/或笨重，不适合在患者家中使用。游戏 游戏机、运动游戏或草率的、非基于证据的VR技术改编并不能解决 在日常生活活动中实现功能独立所需的综合运动和认知技能。 长期目标：改善神经损伤患者的预后和功能独立性。 第一阶段总结：第一阶段将生产一个由移动软件组成的Valor原型系统 在Oculus Quest 2非固定(即无线)VR耳机上运行的应用程序。至少3个身临其境的ADL/IADL 活动将被完全集成和测试，利用来自非 沉浸式临床虚拟现实系统。杜克大学对中风患者进行的一项初步研究将证明 可用性和技术接受度，并调查沉浸式过程中捕获的指标的假设 相对于UE功能的黄金标准测量，ADL/IADL实践将具有较高的标准效度。 商业机会：Valor产品将迅速过渡到成熟的 营销和分销渠道，以满足循证远程保健职业治疗的迫切需求。

PROJECT SUMMARY/ABSTRACT Introduction: The Virtual Activities of Living for Occupational Rehabilitation (VALOR) SBIR program will support telehealth delivery and remote monitoring of upper extremity (UE) stroke rehabilitation through the practice of virtual activities of daily living (ADLs) and instrumental ADLs (IADLs). The VALOR system marries ground- breaking untethered virtual reality (VR) headset technology and deep learning runtime 3D motion tracking with an existing suite of digital ADL/IADL content to enable functional, repetitive task practice at home with telehealth support. A key technological breakthrough is markerless tracking that employs cameras built into a low-cost VR headset, enabling patients to manually engage in virtual occupations using their affected UE. The VALOR Phase I program pursues two primary investigational objectives through a pilot study conducted by Duke University: (1) assess the usability and technology acceptance of immersive VR ADL/IADL practice for UE therapy by older adult stroke patients; and (2) establish the validity of immersive virtual ADL/IADL practice for tracking a patient's UE motor status to enable telehealth feedback and monitoring. Technical work in Phase I includes integration of a runtime neural network for real-time UE tracking with an existing suite of virtual ADLs/IADLs (originally developed for a non-immersive, PC-based system using the Kinect) to support immersive VR using a low cost standalone, untethered headset (no PC, no monitor, and no additional sensors required). Problem to be addressed: The COVID-19 pandemic exposed a critical lack of options for delivering an evidence-based UE intervention via telehealth. Innovative solutions are needed to enable patients to safely participate from home in a therapist-monitored therapy program. Approximately 50% of the >795,000 individuals hospitalized due to stroke each year in the U.S. suffer from chronic deficits in UE function [1], [2]. Existing clinical therapy systems for immersive VR are too expensive, complex, and/or bulky for use in patients' homes. Game consoles, exergames, or slipshod, non-evidence-based adaptations of VR technology do not address the integrated motor and cognitive skills required to achieve functional independence in daily living activities. Long-Term Goal: Improved outcomes and functional independence for patients with neurological injury. Phase I Summary: Phase I will produce a prototype VALOR system that consists of a mobile software application that runs on an Oculus Quest 2 untethered (i.e., wireless) VR headset. At least 3 immersive ADL/IADL activities will be fully integrated and tested, leveraging an existing library of virtual world assets from a non- immersive clinical VR system. A pilot study conducted by Duke University with stroke patients will demonstrate usability and technology acceptance, and investigate the hypothesis that metrics captured during immersive ADL/IADL practice will have high criterion validity with respect to gold standard measures of UE function. Commercial Opportunity: The VALOR product is poised to rapidly transition through well-established marketing and distribution channels to meet a critical need for evidence-based telehealth occupational therapy.