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TeleExergame: An Interactive Tele-Rehabilitation Platform for Improving Motor Function in Older Adults with Cognitive Deficit

Award Information
Agency: Department of Health and Human Services
Branch: National Institutes of Health
Contract: 4R44AG067909-02
Agency Tracking Number: R44AG067909
Amount: $2,646,167.00
Phase: Phase II
Program: SBIR
Solicitation Topic Code: NIA
Solicitation Number: PAS19-316
Solicitation Year: 2019
Award Year: 2022
Award Start Date (Proposal Award Date): 2022-06-15
Award End Date (Contract End Date): 2024-04-30
Small Business Information
57 Chapel St, Suite 200
Newton, MA 02458-1080
United States
DUNS: 802270988
HUBZone Owned: No
Woman Owned: No
Socially and Economically Disadvantaged: No
Principal Investigator
 (888) 589-6213
Business Contact
Phone: (888) 589-6213
Research Institution

Many individuals with mild cognitive impairment (MCI) and/or mild dementia experience both cognitive deficits
and decline in motor function and postural balance. This results in an increased risk of falls. Conventional balance
programs are not tailored for patients with cognitive impairment. Motor-cognitive exercises that are developed
for these patients can be effective, but these rehabilitation programs are underutilized. Many patients who were
referred exercise programs never attend; even fewer complete prescribed programs. For patients with cognitive
impairment, transportation and scheduling are some of the key challenges that limit their adherence and
commitment. However, unsupervised in-home exercise programs are not adequate for these individuals because
of poor adherence, apathy, and inability to follow exercise instructions. Therefore, there is a need for a remotely-
supervised in-home exercise program for older adults with MCI and/or mild dementia.
To address this need, we propose to develop a tele-exercise system that allows a qualified therapist to remotely
supervise and interact with the patient during goal-oriented game-like and low risk exercise tasks
(TeleExergame) that have been designed to improve balance and cognition. The exercises are interactive
balance tasks with explicit goal-oriented augmented visual feedback (i.e., the patient’s movement controls a
virtual object on the screen, thus providing real-time visual and audio feedback that is critical for engagement
and motor learning). This is achieved by a wearable sensor worn on a body segment of interest (e.g., shin) that
measures body joint kinematics (e.g., position of foot/ankle during a virtual obstacle crossing task).
For this Fast-Track submission, we conducted a preliminary study in a cohort of 22 patients with amnestic MCI,
which demonstrated the effectiveness of the proposed Exergame training paradigm in the target population. In
Phase I, we will create the first prototype of an easy-to-use Exergame solution for in-home use that includes a
telemedicine interface to assist the patient or his/her caregiver with sensor positioning, running the program,
remote supervision, and monitoring of the patients during exercise. We will evaluate the feasibility, perception of
benefit, and ease of use of the proposed system in the target population and focus group of therapists. In Phase
II, we will complete the development of the TeleExergame system to enable HIPAA compliant remote supervision
by a qualified therapist and provide quantitative metrics for remote monitoring and personalization of the exercise
program by the therapist. We will then conduct a clinical study to evaluate the efficacy of the solution.
The proposed interactive tele-rehabilitation system would have an immediate and appreciable impact on patient
care by providing an interactive exercise program for individuals with MCI and/or mild dementia. However, MCI
and dementia represent only a fraction of the potential market for the proposed technology, which could also be
used in other patient populations that exhibit poor balance, such as Parkinson’s disease, diabetics, stroke
survivors with lower-extremity paresis, and older adults who cannot perform conventional exercises.

* Information listed above is at the time of submission. *

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