Horak Fay, King Laurie, Mancini Martina
F. Horak, PT, PhD, Department of Neurology, Oregon Health and Science University, Balance Disorders Laboratory, 3181 Sam Jackson Park Rd, SJH 2244, Portland, OR 97239 (USA); Portland VA Health Care System (VAPORHCS), Portland, Oregon; and APDM Inc, Portland, Oregon.
L. King, PT, PhD, Department of Neurology, School of Medicine, Oregon Health and Science University.
Phys Ther. 2015 Mar;95(3):461-70. doi: 10.2522/ptj.20140253. Epub 2014 Dec 11.
This perspective article will discuss the potential role of body-worn movement monitors for balance and gait assessment and treatment in rehabilitation. Recent advances in inexpensive, wireless sensor technology and smart devices are resulting in an explosion of miniature, portable sensors that can quickly and accurately quantify body motion. Practical and useful movement monitoring systems are now becoming available. It is critical that therapists understand the potential advantages and limitations of such emerging technology. One important advantage of obtaining objective measures of balance and gait from body-worn sensors is impairment-level metrics characterizing how and why functional performance of balance and gait activities are impaired. Therapy can then be focused on the specific physiological reasons for difficulty in walking or balancing during specific tasks. A second advantage of using technology to measure balance and gait behavior is the increased sensitivity of the balance and gait measures to document mild disability and change with rehabilitation. A third advantage of measuring movement, such as postural sway and gait characteristics, with body-worn sensors is the opportunity for immediate biofeedback provided to patients that can focus attention and enhance performance. In the future, body-worn sensors may allow therapists to perform telerehabilitation to monitor compliance with home exercise programs and the quality of their natural mobility in the community. Therapists need technological systems that are quick to use and provide actionable information and useful reports for their patients and referring physicians. Therapists should look for systems that provide measures that have been validated with respect to gold standard accuracy and to clinically relevant outcomes such as fall risk and severity of disability.
这篇观点文章将讨论穿戴式运动监测器在康复中对平衡和步态评估及治疗的潜在作用。廉价无线传感器技术和智能设备的最新进展促使了大量微型便携式传感器的涌现,这些传感器能够快速准确地量化身体运动。实用的运动监测系统现已问世。治疗师了解此类新兴技术的潜在优势和局限性至关重要。通过穿戴式传感器获取平衡和步态的客观测量数据的一个重要优势是损伤水平指标,它能描述平衡和步态活动的功能表现是如何以及为何受损的。这样一来,治疗就可以聚焦于特定任务中行走或平衡困难的具体生理原因。利用技术测量平衡和步态行为的第二个优势是,平衡和步态测量对于记录轻度残疾以及随康复情况变化的敏感性有所提高。使用穿戴式传感器测量诸如姿势摆动和步态特征等运动的第三个优势是,有机会为患者提供即时生物反馈,这可以集中注意力并提高表现。未来,穿戴式传感器可能使治疗师能够进行远程康复,以监测患者对家庭锻炼计划的依从性以及他们在社区中自然活动的质量。治疗师需要快速易用的技术系统,这些系统能为患者和转诊医生提供可操作的信息和有用的报告。治疗师应寻找那些在金标准准确性以及诸如跌倒风险和残疾严重程度等临床相关结果方面已得到验证的测量系统。