StrokeWear: A Novel Wrist Wearable Sensor System to Promote Hemiparetic Upper Extremity Use in Home Daily Life.

摘要 中风幸存者经常会经历一种令人衰弱的运动控制丧失，通常影响到身体的一侧。 在日常生活活动(ADL)中进行上肢运动时，中风幸存者 自然倾向于使用功能更强的UE，从而导致偏瘫UE的使用受到限制 阻碍了运动的恢复。虽然治疗师使用传统技术在偏瘫UE期间进行靶向治疗 在临床访问期间，患者接受关于在其家庭环境中使用偏瘫UE的有限的直接培训。 家庭环境中缺乏治疗性训练对UE运动功能的恢复有负面影响。 然而，通过足够的运动练习，运动能力的提高是可以实现的。根据这一证据，通过 在完成SBIR快速跟踪研究后，我们开发了一种基于传感器的专利技术，称为StrokeWearTM。 StrokeWearTM由专有软件和双边手腕佩戴传感器组成，可持续监控UE 患者在家中和社区环境中进行的活动。该系统还生成真实的- 目标导向运动(GDM)表现的时间反馈。 此阶段IIB的目标是通过增强StrokeWearTM的 平台的功能将支持和鼓励患者与他们的偏瘫UE一起参与GDM 支持专家临床医生在远程保健环境中促进更多的活动。系统 促进行为改变，优化UE的运动模式，以促进神经恢复。在这个项目中，我们将 将目标设定、自我效能、行为成就和运动反馈整合到StrokeWearTM中。至 为了更好地吸引用户，我们将开发一款配套的智能手机应用程序，鼓励患者 积极监测他们的进展情况。最后，我们将开发一个网络门户，允许患者和临床医生 在康复计划中通过按需设定目标和 咨询。我们将进行两项为期6个月的随机临床试验，以评估这种综合治疗的疗效。 平台在慢性和亚急性卒中幸存者中都有。对照组将接受常规护理，而 干预组将获得StrokeWearTM平台以及以运动和行为为基础的家庭 干预。

Abstract Stroke survivors often experience a debilitating loss of motor control typically affecting one side of the body. When performing upper-extremity (UE) movements during activities of daily living (ADLs), stroke survivors naturally favor using the more functional UE, thus leading to restricted use of the hemiparetic UE thereby hindering motor recovery. While therapists use conventional techniques to target the hemiparetic UE during clinical visits, patients receive limited direct training on the use of their hemiparetic UE in their home environment. The lack of therapeutic training in the home environment negatively impacts the recovery of UE motor function. Yet, motor improvements are achievable with sufficient motor practice. Based on this body of evidence, through our completed SBIR Fast-Track study, we developed a patented sensor-based technology, called StrokeWearTM. StrokeWearTM consists of a proprietary software and bilateral wrist-worn sensors to continuously monitor UE movements performed by patients in their home and community environments. The system also generates real- time feedback on the performance of goal directed movements (GDM). The objective of this Phase IIB is to further develop StrokeWearTM for commercialization by enhancing the platform with features that will empower and encourage patients to engage in GDM with their hemiparetic UE in the home and to support expert clinicians to foster increased activity in a telehealth environment. The system promotes behavior changes that optimize UE movement patterns for neuro-recovery. In this project, we will integrate goal setting, self-efficacy, behavioral achievements, and movement feedback into StrokeWearTM. To better engage the users, we will develop a companion smartphone application that will encourage patients to be active in monitoring their progress. Finally, we will develop a web-portal that will allow patients and clinicians to be more engaged and interactive during the rehabilitation program through on-demand goal setting and consultation. We will conduct two 6-month randomized clinical trials to assess the efficacy of this integrated platform in both chronic and subacute stroke survivors. The control group will receive usual care, while the intervention group will receive the StrokeWearTM platform in addition to a motor and behavioral home-based intervention.