Beacon Sensors and Telerehabilitation to Assess and Improve use of Devices for visual functioning (BeST-AID)

项目摘要或摘要 成功应用放大设备进行阅读和日常任务的前提是其 低视力（LV）患者的正确使用。与交通、地理和/或合作有关的障碍 作为低视力的一部分，发病率通常限制LV患者参加几次办公室培训课程的能力 康复（LVR），以利用放大装置优化视觉功能。一个有前途的解决方案是实时的 视频会议，以提供远程康复，涉及由LVR提供者远程提供的LVR服务， 从办公室到病人家里LV的远程康复治疗似乎是可行的，并且患者都可以接受， LVR提供者，但没有关于改善患者视觉功能潜力的已发表结果。 LVR的另一个关键问题是需要一个有效的系统来持续评估患者的功能 在家里理想情况下，这将涉及一种非侵入性的，有效的方法来评估何时放大器设备 发生放弃，以便可以启动及时的远程康复会话。小型蓝牙低功耗 连接在放大镜手柄上的信标传感器可以收集每分钟的实时数据， 环境变化，这可能是LV患者在家中使用放大镜的指标。 具体而言，我们建议通过以下方式评估远程康复对增强视觉功能的潜力： 提供远程LVR培训以使用放大设备。在一次在职培训后 对于新的放大装置，我们的目标是确定是否有额外的增益在视觉功能， 将受试者随机分配至远程康复或额外的诊室LVR（主动对照）。这将提供估计 的视觉功能的变化措施，以计划未来更大规模的随机对照试验的效果大小。 参与者将在连续两个阶段之前和之后进行评估：（1）单次LVR后一个月 培训课程，然后（2）在三个月内通过远程康复进行最多三次LVR课程 在参与者的家中或LVR办公室。我们将确定哪些患者特征和/或放大率 设备最有可能受益于远程康复，在未来的第三阶段临床试验的目标。我们将 还确定来自蓝牙信标传感器的数据是否是手持放大镜设备的有效指示符 LV患者在家中使用。我们将为Aim 1中入组的受试者部署Estimote Sticker信标传感器 在同一研究期间。我们预计，信标传感器将测量显着增加 当放置在LV患者持有的放大装置部分上时， 进行日常活动。信标传感器数据将确定放大时评估是否可行 设备的使用，以及在远程康复或在办公室LVR后放大镜使用频率是否发生变化。 这项工作将评估和完善为LVR实施这些技术的程序，以便 制定未来的随机对照试验方案。我们设想远程康复和信标传感器 可以通过以更有效和及时的方式提供随访LVR服务来改善LV患者的结局。

Project Summary or Abstract The successful application of magnification devices for reading and daily tasks is predicated on their correct use by individuals with low vision (LV). Barriers related to transportation, geography, and/or co- morbidities often limit LV patients’ ability to attend several in-office training sessions as part of low vision rehabilitation (LVR) to optimize visual function with magnification devices. A promising solution is real-time videoconferencing to provide telerehabilitation, involving remotely delivered LVR services by a LVR provider in- office to a patient at home. Telerehabilitation for LV appears to be feasible and acceptable by both patients and LVR providers, yet there are no published outcomes on the potential to improve patients’ visual functioning. Another key issue in LVR is the need for an effective system to continually assess how patients are functioning at home. Ideally this would involve a non-invasive, efficient method to assess when magnifier device abandonment occurs, so that a timely telerehabilitation session can be initiated. Small Bluetooth low energy beacon sensors attached to the handles of magnifiers can collect real-time data regarding minute-to-minute environmental changes, which might serve as an indicator of magnifier use by LV patients at home. Specifically, we propose to assess the potential for telerehabilitation to enhance visual function by providing remotely-delivered LVR training to use magnification devices. Following one in-office training session for new magnification device(s), we aim to determine if there is additional gain in visual functioning by randomizing subjects to telerehabilitation or additional in-office LVR (active control). This will provide estimates of effect size for changes in visual function measures to plan a future larger-scale randomized controlled trial. Participants will be assessed before and after two consecutive periods: (1) one month after a single LVR training session, followed by (2) up to three LVR sessions over a three month period either via telerehabilitation in the participants’ homes or LVR in-office. We will determine which patient characteristics and/or magnification devices are most likely to benefit from telerehabilitation, to be targeted in a future, phase III clinical trial. We will also determine whether data from Bluetooth beacon sensors are valid indicators of hand-held magnifier device usage by LV patients at home. We will deploy Estimote Sticker beacon sensors to subjects enrolled in Aim 1 during the same study period. We anticipate that beacon sensors will measure significantly increased temperature and/or motion when placed on the part of the magnification device held by LV patients while performing daily activities. Beacon sensor data will determine if it is feasible to assess when magnification devices are used, and if the frequency of magnifier use changes following telerehabilitation or in-office LVR. This work will evaluate and refine the procedures for implementing these technologies for LVR, in order to develop future randomized controlled trial protocols. We envision that telerehabilitation and beacon sensors could improve LV patient outcomes by providing follow-up LVR services in a more efficient and timely manner.