Over 50% of the 700,000 individuals who survive a stroke each year have persistent movement impairments. Intensive rehabilitation could reduce their impairments, but access to such therapy is limited. Home therapy could supplement time with a therapist, but the current standard of care is simply providing individuals printed sheets of exercises, an approach that is not motivating and often not effective. Technological solutions do exist, but none provide an effective means for individuals to directly practice activities of daily living in a motivating way on their own at home. The goal of this Fast Track SBIR is to develop and test FitMi Plus, an improved version of Flint Rehab?s commercially successful FitMi system for motivating at-home therapeutic exercise. The original FitMi system consists of two wireless input devices called Pucks that each contain an array of sensors and connect to a software application that detects when simple exercises are completed. FitMi Plus will expand the capabilities of FitMi to detect the completion of activities of daily living by coupling common objects to the Pucks via distinct Functional Modules. This approach has the key advantage of allowing the most expensive and complex components of the system to be reused with each Functional Module, thus minimizing cost and maximizing system flexibility. We hypothesize that home therapy with FitMi Plus will be feasible for individuals with motor impairment due to stroke and more motivating and effective than the current standard of practice, printed sheets of exercises.
The aims of this Fast Track project are to: 1) Establish the feasibility of FitMi Plus by pilot testing an initial set of 4 Functional Modules that can detect turning a doorknob, zipping a zipper, turning on a light switch, and pouring liquid into a glass; 2) Expand the library of Functional Modules based on feedback from PTs and OTs; and 3) Compare the efficacy of home- based functional training with FitMi Plus to non-functional exercise in a randomized controlled trial with individuals with chronic stroke. We hypothesize that individuals who exercise with FitMi Plus will have significantly greater increases in functional ability than individuals who do not perform functional exercises during their home therapy. If successful, this project will result in a commercially-ready, clinically validated home therapy tool that could become widely adopted in actual practice, thus improving long-term functional recovery after stroke.
This research is relevant to public health because it will increase the accessibility, lower the costs, and improve the outcomes of rehabilitation therapy. This will provide a pathway to a better life for millions of U.S citizens suffering from motor impairment after stroke and other neurologic injuries. Not only does rehabilitation therapy reduce the likelihood of devastating complications, it also improves functional ability, increasing the standard of living of individuals with impairment and reducing the burden on society caused by disability.
