Establishing the Functional Viability and Dose-Response of Duck, Duck Punch: A Stroke Rehabilitation Computer Game

建立鸭的功能活力和剂量反应，鸭拳：中风康复 电脑游戏 摘要 只有15%的中风幸存者的手臂/手运动完全恢复。长期手臂运动 残疾限制了自理和职业活动的独立性，增加了照顾者的负担， 降低生活质量。强有力的证据表明，传统的治疗方案不能提供足够的 运动恢复所需的运动练习量，然而，目前的财政压力越来越限制 中风康复项目因此，需要创新技术来增强传统程序 在目前康复环境的限制下提供必要的运动练习。到 为了满足这一需求，我们开发了一款基于Kinect的中风后康复游戏原型，名为Duck Duck 打孔（DDP）。在保持游戏吸引力的同时，DDP具有治疗重点，因为其独特的 设计符合循证脑卒中康复原则的手臂运动康复流程。 玩家移动他/她的物理手臂来控制化身手臂以达到并“击打”虚拟鸭子。自定义 功能允许定制的游戏，使病人的成功需要“治疗师批准”健康的手臂 动作治疗师可以将DDP整合到诊所或家庭计划中，以进行额外的准监督 运动练习，因为性能报告量化并监控运动恢复的进展 目标.我们获得DDP许可，并成立了一家公司Recovr，该公司已获得初始投资资金， 启动和市场研究。在NIH/NIGMS CTR试点项目中，我们建立了技术优势 DDP作为一种工具，以加强住院，门诊和家庭为基础的中风康复的可行性。非常 有希望的结果激发了目前的项目，该项目旨在测试DDP的功能可行性，并确定 其商业潜力。在这个项目中，我们建议（1）评估家庭使用DDP 6周是否 改善中风后手臂运动能力;（2）通过运动相关检查剂量-反应关系 重复手臂运动技能;（3）确定DDP报告的治疗有效性，作为衡量 损伤和反应。我们将入组n=60例卒中受试者参加一项单盲、平行- 根据手臂损伤程度进行区组随机化的手臂研究，以检验玩耍 DDP比玩商业游戏更有助于提高手臂运动技能。此外，中风 幸存者（n=16）、卒中幸存者的照顾者（n=16）和卒中康复治疗师（n=32）将 参加焦点小组，指导进一步编写多哈发展计划业绩摘要报告， 提高其为未来治疗决策提供信息的有效性。这个项目很重要，因为有必要 开发和销售新的选择，以扩大中风后手臂运动康复计划。该项目将产生 关于DDP对恢复、剂量和性能报告可翻译性的影响的数据。因此， 直接进入第二阶段的SBIR将为未来的最终研究奠定基础，以便就以下问题做出明确的决定： DDP对治疗师和中风幸存者的临床效用和商业化。

Establishing the functional viability and dose-response of Duck, Duck Punch: A Stroke Rehabilitation Computer Game ABSTRACT Only 15% of stroke survivors experience full recovery of arm/hand movement. Long-term arm movement impairment restricts independence with self-care and vocational activities, increases caregiver burden and reduces quality of life. Strong evidence is emerging that traditional therapy programs do not provide adequate amounts of movement practice needed for motor recovery yet, current financial pressures increasingly limit stroke rehabilitation programs. Thus, there is a need for innovative technology to augment traditional programs to provide the necessary movement practice within the constraints of the current rehabilitation landscape. To meet this need, we developed a prototype Kinect-based post-stroke rehabilitation game called Duck Duck Punch (DDP). While maintaining the appeal of a game, DDP has a therapeutic focus because its unique design elicits an arm motor recovery process consistent with evidence-based stroke rehabilitation principles. The player moves his/her physical arm to control an avatar arm to reach and “punch” virtual ducks. Custom features allow tailoring of the game so that patients' success requires “therapist approved” healthy arm movements. Therapists can integrate DDP into in-clinic or in-home programs for additional quasi-supervised movement practice because a performance report quantifies and monitors progress toward motor recovery goals. We licensed DDP and formed a company, Recovr, which has received investment funding for initial start-up and market research. In a funded NIH/NIGMS CTR pilot project, we established the technical merit and feasibility of DDP as a tool to augment inpatient, outpatient and home-based stroke rehabilitation. Very promising results motivated the current project that seeks to test the functional viability of DDP and determine its commercial potential. In this project we propose to (1) evaluate whether home use of DDP for 6 weeks improves post-stroke arm motor ability; (2) examine the dose-response relationship by relating movement repetitions to arm motor skills; and (3) determine the treatment validity of the DDP report as a measure of impairment and response. We will enroll n=60 subjects with stroke to participate in a single blinded, parallel- arm study with blocked randomization according to arm impairment level to test the hypothesis that playing DDP facilitates improves arm motor skills more than playing a commercially available game. In addition stroke survivors (n=16), caregivers of stroke survivors (n=16) and stroke rehabilitation therapists (n=32) will participate in focus groups to guide further development of the DDP summary performance report in order to improve its validity for informing future treatment decisions. This project is important because there is a need to develop and market new options to extend post-stroke arm motor rehabilitation programs. This project will yield data regarding DDP's effect on recovery, dosing, and the translatability of its performance report. Thus, this Direct-to-Phase-II SBIR will set the stage for a future definitive study to enable clear decisions regarding the clinical utility and commercialization of DDP to therapists and stroke survivors.