Phase II STTR: Portable Device for Telecare Monitoring of Elderly People

第二阶段 STTR：用于老年人远程护理监控的便携式设备

• 批准号: 8310899
• 负责人: Bor-rong Chen
• 金额: $ 73.67万
• 依托单位: BIOSENSICS, LLC
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-15 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8310899
• 关键词: Accidents; Activities of Daily Living; Address; Age; Aging; Algorithms; Ambulatory Electrocardiography; Arizona; Blood Glucose; Blood Pressure; Cereals; Clinical; Clinical Research; Clinical assessments; Collaborations; Communities; Data; Detection; Devices; Early Diagnosis; Early treatment; Effectiveness; Elderly; Environment; Evaluation; Fall prevention; Fractals; Frequencies; Future; Gait; Goals; Health; Holter Electrocardiography; Home environment; Human; Intervention; Legal patent; Life; Longevity; Measurement; Measures; Medicine; Mental Depression; Monitor; Movement; Outcome; Parkinson Disease; Patient Self-Report; Patients; Pattern; Performance; Pharmaceutical Preparations; Phase; Physical Function; Physical activity; Posture; Public Health; Pulse Oximetry; Quality of life; Real-Time Systems; Recording of previous events; Rehabilitation therapy; Relative (related person); Reporting; Rheumatoid Arthritis; Risk; Science; Screening procedure; Series; Small Business Technology Transfer Research; Structure; Syndrome; System; Technology; Testing; Time; Translating; Universities; Validation; Variant; Walking; Weight; Wireless Technology; aged; base; clinical application; cost; design; disability; efficacy testing; fall risk; falls; frailty; improved; instrumentation; kinematics; novel; performance tests; rehabilitation strategy; research and development; sensor; sound; telecare; tool; treatment strategy

DESCRIPTION (provided by applicant): We propose to address two important public health quality of life concerns - fall prevention and frailty in older adults by developing an accurate wearable sensor technology that more accurately characterizes physical activity, risk of falling and early indicators of frailty. In Phase I of this STTR project, we developed a unique platform (PAMSysTM: Physical Activity Monitoring System) for objective measurement of physical activity during everyday living and demonstrated the proof of concept of the PAMSysTM platform for objective assessment of spontaneous daily physical activity, risk of falling and activity organization among older adults. In Phase II of the project, we propose two additional clinical studies to further evaluate the clinical applications of the PAMSysTM platform and to continue our research and development efforts to transform the PAMSysTM platform into a clinimetrically sound low-cost tool for remote screening of risk of falling and early detection of frailty. We will enhance our technology for early diagnosis and remote monitoring of the risk of falling/frailty using non-invasive physical activity telemonitoring. Using this technology we will identify patterns indicative of risk of falling and for early detection and intervention of the increasingly important geriatric syndrome of frailty in at-risk elders. In addition, it will enable remote and continuous screening of the risk of falling during activities of daily living, supportin autonomy and quality of life, and limiting the need for burdensome face to face clinical assessment. The proposed technology can also provide an objective tool to evaluate physical activity decrements and to help prescribe and measure the effects of rehabilitation and treatment strategies on reductions in the risk of falling based on the relative efficacy of clinimetrically relevant interventions. Taken together, these considerations support the urgent need to: a) develop instrumentation for objective assessment of the frequency, duration and organization of physical activity among older adults at risk of falling or developing frailty, and ) develop instrumentation that is ambulatory and low burden, thus allowing the assessment of naturalistic patient movement in everyday life (outside of the artificial lab environment). We will pursue these goals by: a) investigating the degree to which the parameters gathered by the PAMSysTM platform are sensitive to changes in daily physical activity that occur as a result of frailty, b) by examining the degree to which changes in PAMSys-derived variables of activity and movement correspond with changes in geriatric- assessed functional capacity measures, and self-reported disability, history of fall, risk of falling, and frailty; c) by improving current sotware algorithms to allow assessment of fine-grained movement parameters sensitive to early diagnosis of frailty and risk of falling, and e) by modifying the design of our sensor for real-tim wireless data transfer. PUBLIC HEALTH RELEVANCE: As baby boomers age, and their expected life span increases, the number of U.S. elders aged 65 and over will dramatically rise, producing unprecedented need for effective, low cost monitoring and treatment of home and community-dwelling elders. This study aims to develop and commercialize a novel wearable technology for tele-health activity monitoring of elders using a single and easily wearable sensor. The proposed technology allows remote and continuous linimetrically relevant screening of elder's risk of falling as well as early detection and targeted intervention of those at risk of frailty.

描述（由申请人提供）：我们建议通过开发一种精确的可穿戴传感器技术来解决两个重要的公共卫生生活质量问题——跌倒预防和老年人的虚弱，该技术可以更准确地表征身体活动、跌倒风险和虚弱的早期指标。在 STTR 项目的第一阶段，我们开发了一个独特的平台（PAMSysTM：身体活动监测系统），用于客观测量日常生活中的身体活动，并演示了 PAMSysTM 平台的概念验证，用于客观评估自发的日常身体活动、风险老年人跌倒和活动组织的影响。在该项目的第二阶段，我们建议进行两项额外的临床研究，以进一步评估 PAMSysTM 平台的临床应用，并继续我们的研发工作，将 PAMSysTM 平台转变为临床良好的低成本工具，用于远程筛查风险跌倒和及早发现虚弱。我们将加强利用非侵入性身体活动远程监测来早期诊断和远程监测跌倒/虚弱风险的技术。利用这项技术，我们将识别表明跌倒风险的模式，并尽早发现和干预高危老年人日益重要的老年衰弱综合症。此外，它将启用 远程持续筛查日常生活活动中跌倒的风险，支持自主性和生活质量，并限制繁琐的面对面临床评估的需要。所提出的技术还可以提供客观工具来评估身体活动的减少，并根据临床相关干预措施的相对功效，帮助制定和衡量康复和治疗策略对降低跌倒风险的影响。综上所述，这些考虑因素支持迫切需要：a）开发仪器，用于客观评估有跌倒或虚弱风险的老年人的体力活动的频率、持续时间和组织，以及）开发可移动且低负担的仪器，从而可以评估日常生活中的自然患者运动（在人工实验室环境之外）。我们将 通过以下方式实现这些目标：a) 调查 PAMSysTM 平台收集的参数对因虚弱而发生的日常身体活动变化的敏感程度，b) 通过检查 PAMSys 衍生变量的变化程度活动和运动与老年人评估的功能能力测量、自我报告的残疾、跌倒史、跌倒风险和虚弱的变化相对应； c) 通过改进当前的软件算法，以允许评估对虚弱和跌倒风险的早期诊断敏感的细粒度运动参数，以及 e) 通过修改我们的传感器的设计以实现实时无线数据传输。 公共卫生相关性：随着婴儿潮一代的老龄化和预期寿命的延长，美国 65 岁及以上老年人的数量将急剧增加，对家庭和社区居住的老年人进行有效、低成本的监测和治疗产生了前所未有的需求。本研究旨在开发一种新型可穿戴技术并将其商业化，利用单一且易于穿戴的传感器对老年人进行远程医疗活动监测。所提出的技术可以对老年人跌倒风险进行远程和连续的线性相关筛查，并对有虚弱风险的人进行早期发现和有针对性的干预。