Interactive Telehealth and Auto-Biofeedback Sensor System for Individuals Who Use a Wheelchair

适用于轮椅使用者的交互式远程医疗和自动生物反馈传感器系统

• 批准号: 9345724
• 负责人: Joseph T Gwin
• 金额: $ 75万
• 依托单位: BIOSENSICS, LLC
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-10 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9345724
• 关键词: Acceleration; Accelerometer; Achievement; Algorithms; Biofeedback; Biomedical Technology; Cardiovascular system; Caregivers; Caring; Cellular Phone; Chronic; Clinic; Clinical Trials; Clinical effectiveness; Community Participation; Comorbidity; Complication; Control Groups; Dangerousness; Data; Decubitus ulcer; Detection; Devices; Diabetes Mellitus; Education; Electronic Mail; Electronics; Engineering; Esthetics; Feedback; Goals; Health; Health Insurance Portability and Accountability Act; Home environment; Incidence; Individual; Internet; Intervention; Life; Link; Manual wheelchair; Manuscripts; Measurement; Measures; Medical Records; Methods; Modification; Monitor; Morbidity - disease rate; Movement; Obesity; Osteoporosis; Participant; Patient Care; Patient risk; Patients; Pattern; Performance; Phase; Physical activity; Provider; Publications; Quality of life; Randomized Clinical Trials; Recommendation; Recruitment Activity; Rehabilitation Centers; Research Infrastructure; Role; Scientist; Secondary Prevention; Secure; Self Management; Self-Help Devices; Skin; Small Business Innovation Research Grant; Spinal cord injury; System; Technology; Testing; Thinness; Tissues; United States; Wheelchairs; Wireless Technology; Work; base; cost; cost efficient; depressive symptoms; disability; group intervention; healing; high risk; improved; innovation; innovative technologies; instrument; mortality; novel; post intervention; pressure; prevent; prototype; satisfaction; secondary analysis; sensor; technology development; telehealth; telehealth systems; tool; wearable technology; web site

PROJECT ABSTRACT / SUMMARY Inactivity in individuals with chronic disabilities who use a wheelchair results in significant and costly secondary complications, such as pressure ulcers, obesity, diabetes, osteoporosis, and cardiovascular comorbidities. We propose to develop an interactive telehealth monitoring and biofeedback system to promote physical activity and pressure relief maneuver performance among wheelchair users. In this project we focus on patients with spinal cord injury (SCI) who are at particularly high risk for developing pressure ulcers from sitting too long (31% annual incidence, 85% lifetime incidence). However, the proposed technology is broadly applicable to wheelchair-based telehealth. The proposed technology - which attaches to any wheelchair without modification - has three core components: 1) an activity monitoring system (i.e., detection of wheel-pushes), 2) a pressure relief monitoring system, and 3) reminders and feedback regarding the achievement of pressure relief and physical activity goals. Biofeedback will be delivered locally (to the user) via a smartphone app and remotely (to the clinician) via a secure internet interface. The enabling technologies are innovative sensor systems to monitor wheelchair specific activity patterns but the significant value comes from integrating these novel measurements within a biofeedback system that encourages wheelchair users to actively avoid secondary complications of inactivity and allows care providers to identify at risk patients and intervene efficiently. Existing technologies do not compare with the proposed solution. Products exist to monitor wheelchair seat pressure but these products are costly, cumbersome, and not designed for home use. Products exist to monitor wheelchair specific physical activity but these devices cannot distinguish passive from active wheelchair movement. No existing technology combines these measures with biofeedback and telehealth functionality. The team we have assembled for this collaborative project includes engineers, clinicians, and scientists from BioSensics (a privately held biomedical technology development company) and Rancho Los Amigos National Rehabilitation Center (one of the largest comprehensive rehabilitation centers in the United States). During Phase I of this project we developed and validated a prototype version of wheelchair sensor and smartphone app (Dowling et. al., Wireless Health, 2015; Dowling et. al., Assistive Technologies, In Press). During Phase II we will improve the seat sensor hardware and develop the remote monitoring and telehealth aspects of the proposed system including 1) a secure HIPAA compliant website so patients, caregivers, and clinicians can remotely view activity and pressure relief data, 2) an automated method for pushing alerts to clinicians and caregivers (via SMS or e-mail) if pressure relief or activity goals are not met, and 3) a simple interface so clinicians and caregivers can send telehealth reminders to the wheelchair user’s smartphone app.

项目摘要 /摘要 使用轮椅的慢性疾病患者的不活跃导致较大且昂贵的次要 并发症，例如压疮，肥胖，糖尿病，骨质疏松症和心血管合并症。我们 提出开发交互式远程医疗监测和生物反馈系统以促进物理的建议 轮椅使用者之间的活动和压力缓解操纵性能。在这个项目中，我们专注于 脊髓损伤患者（SCI）坐着出现压力溃疡的风险特别高 太长（每年31％，终身事件85％）。但是，拟议的技术广泛 适用于基于轮椅的远程医疗。 提出的技术 - 无需修改的任何轮椅 - 都有三个核心 组件：1）活动监控系统（即检测轮盘），2）压力缓解监控 系统，以及3）有关实现压力和体育锻炼的提醒和反馈 目标。 BioFeDback将通过智能手机应用在本地（用户）交付，并远程（临床）交付 通过安全的Internet界面。支持技术是可以监视轮椅的创新传感器系统 特定的活动模式，但显着的值来自将这些新颖测量结果整合在 鼓励轮椅使用者积极避免次要并发症的生物反馈系统 并允许护理提供者识别在风险患者中并有效干预。现有技术不 与建议的解决方案进行比较。存在用于监视轮椅座椅压力的产品，但这些产品 昂贵，繁琐，并且不是为家庭使用而设计的。存在用于监视轮椅特定物理的产品 活动，但是这些设备无法将被动式轮椅运动区分开。没有现有的技术 将这些措施与生物反馈和远程医疗功能相结合。 我们为这个合作项目组成的团队包括工程师，临床医生和科学家 生物密度（一家私有生物医学技术开发公司）和兰乔·洛斯·阿米戈斯国家（Rancho Los Amigos） 康复中心（美国最大的综合康复中心之一）。期间 该项目的第一阶段我们开发并验证了轮椅传感器的原型版本和 智能手机应用程序（Dowling等人，无线健康，2015年； Dowling等，辅助技术， 按）。在第二阶段，我们将改善座椅传感器硬件，并开发远程监视和 拟议系统的远程医疗方面，包括1）一个安全的HIPAA符合HIPAA的网站，因此患者， 护理人员和临床医生可以远程查看活动和压力减轻数据，2）一种自动化方法 如果不满足压力或活动目标，向临床医生和看护人提高警报（通过SMS或电子邮件） 3）一个简单的界面，以便临床医生和看护人可以将远程医疗提醒到轮椅用户 智能手机应用程序。