NewGait: A Low-Cost Rehabilitation System to Improve Post-Stroke Gait

NewGait：一种改善中风后步态的低成本康复系统

• 批准号: 10611686
• 负责人: CHANDRAMOULI KRISHNAN
• 金额: $ 34.48万
• 依托单位: ELITE ATHLETE PRODUCTS INC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-22 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10611686
• 关键词: Address; Adoption; Adult; Affect; Biomechanics; Caregivers; Caring; Clinic; Clinical; Communities; Computer software; Cross-Over Studies; Data; Developing Countries; Devices; Economically Deprived Population; Effectiveness; Equilibrium; Exhibits; Fatigue; Feasibility Studies; Feedback; Foundations; Gait; Gait speed; Goals; Grant; Home; Impairment; Individual; Intervention; Joints; Legal patent; Length; Long-Term Effects; Lower Extremity; Mechanics; Medical; Michigan; Modeling; Modification; Muscle; Musculoskeletal; Nervous system structure; Neuronal Plasticity; Outcome; Participant; Patients; Periodicity; Phase; Physical therapy; Population; Power Sources; Randomized; Randomized Controlled Trials; Rehabilitation device; Rehabilitation therapy; Resources; Rural Community; Rural Population; Series; Small Business Technology Transfer Research; Specialist; Sports; Stroke; System; Techniques; Testing; Therapeutic; Traction; Training; United States; Universities; Walking; base; biomechanical model; biomechanical test; chronic stroke; comparative; cost; design; disability; disadvantaged population; dosage; evidence base; exosuit; experience; gait rehabilitation; human centered design; improved; innovation; insight; light weight; mechanical behavior; mobility rehabilitation; neurological rehabilitation; neurophysiology; novel therapeutic intervention; physical therapist; portability; post stroke; preference; prototype; restoration; robotic device; satisfaction; stroke rehabilitation; stroke survivor; treadmill; usability; walking speed; wearable sensor technology

PROJECT SUMMARY More than 795,000 individuals suffer from a stroke each year in the United States, making stroke a leading cause of adult disability in the United States and worldwide. More than half of stroke survivors exhibit reduced independence and functional mobility due to stroke-related gait impairments. Despite significant advancements in post-stroke medical care and rehabilitation, current treatments are not successful in optimally restoring gait function after stroke. It is well established that intense, repetitive task-oriented rehabilitation interventions are essential for inducing experience-dependent neuroplasticity (defined as the ability of the nervous system to adapt and optimize its resources through structural and functional changes)—which is a key factor for post-stroke gait recovery. Accordingly, new therapeutic approaches that rely on specialized gait training devices, such as treadmills, robotic devices, and exosuits have been developed. However, these devices are typically expensive, bulky, and not accessible for home use. Moreover, these devices often require uninterrupted power sources, which is a major barrier for rural communities in developing nations. While some lightweight and “low-cost” commercial devices exist, they are not often designed based on multi-user feedback and robust biomechanical data and their clinical utility have not been tested in stroke survivors, thereby limiting usability and effectiveness. Thus, there is a significant unmet clinical need for an effective, affordable, and portable gait mobility/rehabilitation device that is accessible for most stroke survivors. Elite Athlete Products (EAP) has designed a wearable gait rehabilitation system, NewGait, that specifically addresses this clinical need. In this Phase-I STTR, EAP has assembled an interdisciplinary team to pursue the following specific aims: (1) Identify an optimal NewGait design based on end-user feedback (design sprints) and musculoskeletal modeling to address the needs of stroke rehabilitation, (2) Refine the current prototype using data gathered from design sprints and think aloud technique and perform benchtop testing on the final prototype to validate durability, and (3) Examine short-term gait adaptations and clinical feasibility in stroke survivors by performing a comparative clinical feasibility study in stroke survivors to establish the clinical utility of the NewGait device in comparison with two competitive devices (TheraSuit and TheraTogs). This project combines EAP’s expertise in developing low-cost neurorehabilitation devices with the clinical, biomechanical, and neuroplasticity expertise of our academic partners at the University of Michigan and Wayne State University. The successful completion of this Phase-I STTR will lay the foundation for an evidence-based low-cost gait rehabilitation system that could positively affect the lives of millions of stroke survivors living across the globe.

项目概要 在美国，每年有超过 795,000 人患有中风，使中风成为主要原因 在美国和全世界，超过一半的中风幸存者的残疾率有所下降。 尽管取得了重大进展，但由于中风相关的步态障碍，患者的独立性和功能活动能力仍然较差。 在中风后的医疗护理和康复中，目前的治疗方法未能成功地最佳恢复步态 众所周知，密集的、重复的、以任务为导向的康复干预措施是有效的。 对于诱导经验依赖性神经可塑性（定义为神经系统适应的能力）至关重要 并通过结构和功能的改变来优化其资源）——这是中风后步态的关键因素 因此，新的治疗方法依赖于专门的步态训练设备，例如 跑步机、机器人设备和外骨骼套装已经被开发出来，但是这些设备通常都很昂贵。 此外，这些设备体积庞大，不适合家庭使用，通常需要不间断电源。 这是发展中国家农村社区的一个主要障碍，而一些轻量级和“低成本”。 商业设备存在，但它们通常不是根据多用户反馈和强大的生物力学设计的 数据及其临床实用性尚未在中风幸存者中进行测试，从而限制了可用性和有效性。 因此，对于有效的、负担得起的、便携式步态移动/康复的临床需求存在显着的未满足 大多数中风幸存者都可以使用的设备精英运动员产品（EAP）设计了一种可穿戴步态。 康复系统 NewGait 专门解决了这一临床需求，在这一阶段的 STTR 中，EAP 已经实现了这一目标。 组建一个跨学科团队来实现以下具体目标：（1）确定最佳的 NewGait 设计 基于最终用户反馈（设计冲刺）和肌肉骨骼建模，以满足中风的需求 康复，（2）使用从设计冲刺收集的数据和大声思考技术来完善当前原型 并对最终原型进行台式测试以验证耐用性，以及 (3) 检查短期步态 通过在中风幸存者中进行比较临床可行性研究来了解中风幸存者的适应性和临床可行性 中风幸存者通过与两种竞争设备进行比较来确定 NewGait 设备的临床实用性 （TheraSuit 和 TheraTogs）。该项目结合了 EAP 在开发低成本神经康复方面的专业知识。 具有大学学术合作伙伴的临床、生物力学和神经可塑性专业知识的设备 密歇根大学和韦恩州立大学的第一阶段 STTR 的成功完成将为这一阶段奠定基础。 寻找一种基于证据的低成本步态康复系统，可以对数百万中风患者的生活产生积极影响 生活在全球各地的幸存者。