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：全球 4200 万名阿尔茨海默病及相关痴呆症 (ADRD) 患者中，13% 至 57%（5.5 至 2400 万人）患有吞咽困难或吞咽问题，这一弱势群体的吞咽困难后遗症包括营养不良、脱水。由于吞咽和呼吸具有共同的解剖途径，因此在正常个体中，吞咽发生在一个良好调节的时期是至关重要的。尽管痴呆症患者吞咽困难的发生率很高且后果严重，但诊断和治疗方式有限。目前治疗 ADRD 吞咽困难的标准是由经过专门培训的言语病理学家进行的行为吞咽治疗，我们的研究团队最近开创了一种新颖的跨系统训练方法，包括 4-8 人。通过视觉生物反馈直接优化呼吸吞咽时间 (RST) 的临床课程然而，这种训练必须在诊所进行，并且需要大型、昂贵、笨重的多线系统，这会阻碍功能改进的延续。解决吞咽困难的新技术需要以用户为中心的设计、可在家中部署且看护人员负担最小的简单操作以及坚固性。我们建议添加一个振动触觉电机，以实现家庭治疗，在治疗师培训后重现 RST 治疗，这种新型治疗可穿戴设备会轻轻振动，以刺激在家中的吞咽。每当未达到吞咽的最低阈值时，该设备就会提供额外的反馈，根据佩戴者独特的呼气节奏加强安全吞咽。然后，我们建议在一小群患有轻度 AD（临床痴呆评级TM≤1）的人群中验证该传感器。最后，我们将在短期家庭试验中评估该传感器的接受程度。 NIA 在本次 RFA 中的优先事项，旨在开发创新、有效、可扩展且低成本的辅助技术