Option 1: Small-Business ERC Collaborative Opportunity for the Virtual Coach for Home-Based Therapy

选项 1：小型企业 ERC 家庭治疗虚拟教练合作机会

• 批准号: 1347496
• 负责人: Gene Tacy
• 金额: $ 20万
• 依托单位: Myomo
• 依托单位国家: 美国
• 项目类别: Fixed Amount Award
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1347496&HistoricalAwards=false
• 关键词: Option; Small; Business; ERC; Collaborative

Stroke occurs in 2.9% of the US adult population and there are nearly 800,000 new or recurringcases annually. Neuromuscular impairment is a common consequence, though one from which recoveryis possible with appropriate therapy. Though most healthcare plans cover post-stroke therapy,insurance reimbursement caps typically limit it to a few weeks, despite a growing body ofevidence that therapeutic gains are possible months and even years after a stroke. Addingthe fact that patients generally prefer out-of-clinic care, there is a compelling case fordelivery of physical therapy in the home setting. The new product that will result from thisproject will increase dosing of meaningful exercises that promote recovery and minimize co-morbiditiessuch as pain, swelling, spasticity and (shoulder) subluxation.This project?s outputs respond to other trends in the US healthcare system, including thedwindling supply of qualified care providers, the movement toward evidence based medicineand the economic requirement for increased self-care. The ultimate goal of our Virtual Coachtechnology is to leverage scarce human-based care with computer based solutions at substantiallylower cost. The self-adjusting goal-setting capability developed in the proposed researchwill enable professional therapists to extend their reach to patients.One significant challenge in computer-based coaching is devising algorithms that affect humanbehavior in an intended way. It is difficult to predict how people will react to commands,instructions, prompts and rewards. Some respond well to a nurturing "atta boy!" while othersrespond better to a drill sergeant?s "that?s not good enough!" Moreover, not only is therevariability among people, but also within a particular individual from day-to-day. To be aviable, pervasive solution, Virtual Coaches will need to be responsive to the psychologyof the people they serve. Pursuit of our objectives, especially the exploratory research objective,addresses this challenge in the context of motivating people to adhere to an exercise regimen.A second challenge is designing exercise software factoring in the heterogeneous presentationof individuals with neuromuscular impairments. Such patients have varying levels of motorcontrol, cognitive ability and co-morbidities associated with their impairments. Off theshelf exercise packages do not account for their limitations. Our translational research objectiveis to overcome this challenge by leveraging research conducted on impaired patients and analready developed software architecture for coaching them through movements that promote longterm recovery.

2.9% 的美国成年人患有中风，每年有近 80 万新发或复发病例。神经肌肉损伤是一种常见的后果，尽管通过适当的治疗可以恢复。尽管大多数医疗保健计划涵盖中风后治疗，但保险报销上限通常将其限制在几周内，尽管越来越多的证据表明中风后数月甚至数年的治疗效果是可能的。考虑到患者通常更喜欢诊所外护理，因此在家庭环境中提供物理治疗是有说服力的。该项目产生的新产品将增加有意义的锻炼剂量，从而促进康复并最大限度地减少疼痛、肿胀、痉挛和（肩部）半脱位等合并症。该项目的成果响应了美国医疗保健系统的其他趋势，包括合格护理人员供应的减少、循证医学的发展以及增加自我护理的经济需求。我们虚拟教练技术的最终目标是以显着降低的成本利用基于计算机的解决方案来利用稀缺的人力护理。拟议研究中开发的自我调整目标设定能力将使专业治疗师能够将其接触范围扩大到患者。基于计算机的辅导的一个重大挑战是设计以预期方式影响人类行为的算法。很难预测人们对命令、指示、提示和奖励的反应。有些人对养育“atta boy！”的反应很好。而其他人则对教官的“这还不够好！”的反应更好。此外，不仅人与人之间存在可变性，而且特定个体内部也存在日复一日的可变性。为了成为可行、普遍的解决方案，虚拟教练需要对其服务对象的心理做出反应。追求我们的目标，特别是探索性研究目标，在激励人们坚持锻炼方案的背景下解决了这一挑战。第二个挑战是设计锻炼软件，考虑到神经肌肉损伤个体的异质表现。这些患者有不同程度的运动控制、认知能力和与其损伤相关的共病。现成的练习包并没有考虑到它们的局限性。我们的转化研究目标是通过利用对受损患者进行的研究和已经开发的软件架构来克服这一挑战，以指导他们进行促进长期康复的运动。