A Therapeutic Wearable Sensor for Dysphagia

用于治疗吞咽困难的可穿戴传感器

基本信息

批准号：
9791154
负责人：
Shuai Xu
金额：
$ 24.17万
依托单位：
SONICA, LLC
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-30 至 2022-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9791154
关键词：
Accelerometer Address Affect Alzheimer&apos s Disease Alzheimer&apos s disease related dementia Anatomy Aspiration Pneumonia Behavioral Biofeedback Blinded Bluetooth Breathing Caregivers Cellular Phone Cessation of life Charge Clinic Clinical Consumption Cues Dangerousness Data Deglutition Deglutition Disorders Dehydration Dementia Deterioration Development Devices Diagnosis Diagnostic Elderly Engineering Equipment Exercise Exhalation Exhibits Feedback Focus Groups Food Frequencies Funding Geriatrics Goals Gold Heart Rate High Prevalence Home environment Hour Individual Ingestion Intake Language Liquid substance Malnutrition Measurement Medical Modality Modification Morbidity - disease rate Motor Oral Outcome Output Pathologist Pathway interactions Patients Pattern Performance Persons Pharyngeal structure Phase Physical Medicine Physical activity Physiological Prevalence Prevention Psychometrics Reflex action Rehabilitation Research Rehabilitation device Rehabilitation therapy Research Respiration Self-Help Devices Severities Silicones Speech Stroke Structure Surveys System Tablets Technology Testing Therapeutic Thick Time Training Visual Vulnerable Populations Wireless Technology awake base cohort cost design experience expiration flexibility functional improvement haptics high risk improved innovative technologies mortality multidisciplinary multimodality neuromuscular stimulation new technology notch protein novel novel therapeutics nutrition operation personalized therapeutic preference prevent programs respiratory sensor standard of care success visual feedback wearable device wireless communication

项目摘要

1 PROJECT SUMMARY: Of the 42 million individuals worldwide with Alzheimer’s disease and related dementias (ADRD), 13% to 57% (5.5 to 24 million individuals) suffer dysphagia or swallowing problems. The sequelae of dysphagia in this vulnerable population include malnutrition, dehydration, and aspiration pneumonia. Since swallowing and breathing share a common anatomical pathway, precise coordination is critical. In normal individuals, swallowing occurs in a well-regulated period between mid-to-late respiratory expiration, which imparts airway protective benefits. In dysphagia, this respiratory-swallowing coordination is lost. Despite the high prevalence of dysphagia in individuals with dementia and the seriousness of the consequences, there are limited diagnostic and therapeutic modalities available. The current standard of care for dysphagia in ADRD is behavioral swallowing therapy with specially-trained speech-language pathologists. Specifically, our research team has recently pioneered a novel cross-system training approach with 4-8 in-clinic sessions that directly optimizes respiratory-swallow timing (RST) through visual biofeedback. However, this training must be done in-clinic and requires large, expensive, bulky, and multi-wired systems. Carry over of functional improvements is impeded by the absence in-home training. New technologies addressing dysphagia specifically ADRD requires significant user-centric design, straightforward operation that is deployable at home with minimal caretaker burden, and robustness. We have previously developed a soft, flexible, and fully wireless throat-deployed wearable sensor capable of continuously tracking respiration and swallowing. We propose adding a vibratory haptic motor to enable a home-based therapy that recapitulates RST therapy after therapist training. This new therapeutic wearable would vibrate gently to stimulate swallowing at home as a strengthening exercise whenever a minimum threshold of swallowing is not met. In addition, the device provides additional feedback that reinforces safe swallows personalized to the wearer’s unique expiratory cadence. First, we will conduct focus groups to enable user-centric design. Then, we propose to validate this sensor in a small cohort of persons with mild AD (Clinician Dementia RatingTM≤1). Finally, we will evaluate acceptance of the sensor in a short home trial. This proposal aligns with NIA priorities for this RFA, which aims to develop assistive technologies that are innovative, efficacious, scalable, and low-cost

1项目摘要：在全球有4200万个人患有阿尔茨海默氏病和相关痴呆症（ADRD）中，有13％至57％（5.5至2400万个人）患有吞咽困难或吞咽问题。在这种脆弱人群中，吞咽困难的后遗症包括营养不良，脱水和抽吸肺炎。由于吞咽和呼吸具有共同的解剖途径，因此精确的协调至关重要。在普通人中，吞咽发生在中高呼吸期到期之间的良好调节期，这意味着气道受到保护的益处。在吞咽困难中，这种呼吸焊接的配位丢失了。尽管痴呆症患者的吞咽困难较高，而后果的严重性仍有有限的诊断和治疗方式。当前在ADRD中吞咽困难的护理标准是采用特殊训练的言语病理学家的行为吞咽治疗。具体而言，我们的研究团队最近使用4-8个临床课程开创了一种新型的跨系统训练方法，该方法直接通过视觉生物反馈直接优化了呼吸供应剂时机（RST）。但是，该培训必须在链接中进行，并且需要大型，昂贵，笨重和多连接的系统。缺席的家庭培训阻碍了功能改进的范围。针对吞咽困难的新技术需要大量的以用户为中心的设计，可以在家中可部署的直接操作，而伯恩（Burnen）则可以在家中部署。我们以前已经开发了一种柔软，柔性且完全无线喉咙部署的可穿戴传感器，能够连续跟踪呼吸和吞咽。我们建议添加振动性触觉运动，以实现一种基于家庭的治疗，该治疗在治疗师培训后概括了RST疗法。这种新的疗法可穿戴会轻轻振动，以刺激家里的吞咽，以加强运动，每当不满足最低吞咽阈值时。此外，该设备还提供了其他反馈，可以增强安全的吞咽个性化，以使佩戴者独特的到期节奏。首先，我们将进行焦点小组以实现以用户为中心的设计。然后，我们提议在一小部分温和AD的人群中验证该传感器（临床医生痴呆症评估TM≤1）。最后，我们将在短暂的家庭试验中评估传感器的接受。该提案与此RFA的NIA优先级保持一致，该RFA旨在开发创新，高效，可扩展和低成本的辅助技术