Frailty Syndrome, Intelligent POWER Rehabilitation Cluster Machine
Conditions
Keywords
frailty syndrome, Intelligent POWER Rehabilitation Cluster Machine, Internet of Things, wearable
Brief summary
Elderly care has become one of the most important subjects in Taiwan and frailty syndrome are the most common problems among the elderly. In view of this trend, Taipei Veteran Memorial Hospital imported POWER rehabilitation from Japan in 2008. While showing significant clinical benefits, investigators have found that the system still has certain limitations (e.g. high cost, requires large space, patients must commute to the center, lacks real-time objective feedback , boring routines makes staying power to motivate patients for long term rehabilitation programs.) To overcome the above limitations, this project proposes an evidence-based rehabilitation model that accounts for actual clinical need and collaborates with our engineering team to develop a cluster , wearable and Brain-Computer Interface System version of POWER rehabilitation system. Combining cloud technology, investigators now introduce internet-of-things into the POWER rehabilitation procedure. The result will lower the burden of clinical support personnel, and provide an opportunity to quantify frailty syndromes so as to allow objective and quantitative scientific evaluation, leading to a more objective clinical diagnosis. In addition, this project further proposes a virtual-reality (VR) system for POWER rehabilitation, as well as designs for the VR sceneries. Through the use of different animated 3D VR sceneries and interactive game design, investigators can make rehabilitation interesting and fun for the patients, motivating long-term compliance of the patients, thereby, improving the clinical outcome of POWER rehabilitation. This project has the potential to create an innovative solution to address the current bottlenecks of our rehabilitation treatment model. Successful development of the system will offer rehabilitation clinicians more treatment options, lower the cost of supporting staff, reduce commuting cost for the patients, and elevate patient desire to comply with the treatment program. Finally, the system will not only enhance Taiwan's academic reputation in the international arena, it will also generate new commercial opportunities for Taiwan and contribute to Taiwan economic development.
Interventions
DEVICEIntelligent POWER Rehabilitation Cluster Machine
Sponsors
Taipei Veterans General Hospital, Taiwan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
60 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* aged 60 to 85 * Cardiovascular Health Study (CHS) frailty criteria * willing to sign agreement
Exclusion criteria
* fracture w/o healing * severe joint injury * acute stroke or myocardial infarction (\< 3 months) * cardiac arrhythmia / unstable blood pressure * disorientation or intellectual deterioration * muscle contracture deformity * pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Tilburg Frailty Indicator (TFI) | Changes from baseline in physical examination at 12, 16 weeks | The TFI contains two parts, sociodemographic questions including questions on multimorbidity, lifestyle, life events and living environment (part A) and the assessment of components of frailty (part B). Frailty is assessed with 15 items divided into physical, social and psychological domains. All item scores are summed into a frailty score ranging from 0-15. Persons with a total TFI score ≧5 are considered to be frail. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| flexibility test_1st (cm) | Changes from baseline in physical examination at 12, 16 weeks | truck flexion test in standing position |
| flexibility test_2nd (cm) | Changes from baseline in physical examination at 12, 16 weeks | truck flexion test in sitting position |
| general mobility test (sec) | Changes from baseline in physical examination at 12, 16 weeks | timed up and go test |
| hand-eye coordination test (sec) | Changes from baseline in physical examination at 12, 16 weeks | grasp an falling rod |
| muscle endurance test (times/2 min) | Changes from baseline in physical examination at 12, 16 weeks | step in place with hip raising to level |
| muscle strength test (kgw) | Changes from baseline in physical examination at 12, 16 weeks | grip strength |
| balance test (sec) | Changes from baseline in physical examination at 12, 16 weeks | single leg stance with eyes open |
| hearing test (sec) | Changes from baseline in physical examination at 12, 16 weeks | traditional hearing test with high frequency(4096Hz) and low frequency(512Hz) tuning fork |
| Activity of daily living (ADL) | Changes from baseline in ADL at 12, 16 weeks | This index measures the extent to which somebody can function independently and has bowel control, bladder control, toileting, chair transfer, ambulation and stair climbing. The index also indicates the need for assistance in care. Scores range from 0 to 100 with higher scores indicating greater independence. |
| Instrumental Activities of Daily Living (IADL) | Changes from baseline in physical examination at 12, 16 weeks | IADL's are activities related to independent living and include preparing meals, managing money, shopping for groceries or personal items, performing light or heavy housework, doing laundry, and using a telephone. The total score may range from 0 - 8. A lower score indicates a higher level of dependence. |
| Functional Independence Measure (FIM) | Changes from baseline in physical examination at 12, 16 weeks | The Functional Independence Measure (FIM) scale assesses physical and cognitive disability. This scale focuses on the level of disability indicating the burden of caring for them. The scale includes 18 items. Each item is scored from 1 to 7 based on level of independence, where 1 represents total dependence and 7 indicates complete independence. Possible scores range from 18 to 126, with higher scores indicating more independence. |
| 36-Item Short Form Health Survey (SF-36) | Changes from baseline in physical examination at 12, 16 weeks | The SF-36 consists of eight sections: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning and mental health. It consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability. |
| visual test | Changes from baseline in physical examination at 12, 16 weeks | traditional visual test in the letter C |
Countries
Taiwan
Outcome results
None listed