Reducing Gait Asymmetry in Lower-LImb Amputees Using Real-Time Rehab to Train-to-

DESCRIPTION (provided by applicant): This Small Business Innovation Research Phase I project seeks to demonstrate the feasibility of a novel device for rehabilitation in the home environment, by using wireless instrumentation and smartphone technology forfeedback to amputees about their real-time performance in situ. The mission of Veristride is to improve the mobility and quality of life of persons with ambulatory disabilities (5.2% of U.S. adults ages 18-64). Real-Time Rehab provides a new paradigm for rehabilitation that occurs throughout the patient's daily life. This is in contrast to current rehabilitation techniques that expect patientsto continue learned exercises on their own, an open-loop procedure of questionable efficacy and sustainability, as visits to the clinic are limited by increasing costs of healthcare. Alternative approaches are clinic-based, limited in capability, and/or prohibitively expensive. This Phase I proposal targets the lower-limb amputee population because little has been done to address gait asymmetry in amputees, with existing interventions to improve gait symmetry generally qualitative and/or clinic-based. The modern rehabilitation process begins immediately following the removal of the limb and uses a variety of activities to improve muscle strength and motor skills, restore daily activities, and improve independence, but fails to quantitatively address the typical force and timing asymmetries beyond symptom relief and treatment of conditions (e.g. arthritis) once they occur. Loss of a limb results in decreased proprioception, which is the sense of where limbs are in space. We hypothesize that amputees can more readily make improvements in their gait and mobility with access technology capable of proprioceptive feedback anytime and anywhere to enhance the impaired by disability. Veristride, Inc. is a new company formed out of the University of Utah. It was recently formed to explicitly address the need for affordable and personal rehabilitative devices for persons with mobility disabilities. The PI and CSO Stacy Bamberg received her bachelor's and master's degrees in mechanical engineering at MIT. She subsequently expanded her training through medical school courses and clinical experiences, receiving her doctorate in medical engineering from the Harvard/MIT Div. of Health Sciences and Technology. Her expertise includes designing, validating, and using sensors and instrumentation to evaluate human physiological conditions, specifically for gait and movement analysis, and shehas been implementing sensors in shoes for more than a decade. PUBLIC HEALTH RELEVANCE PUBLIC HEALTH RELEVANCE: Nearly 10 million (5.2%) U.S. adults between 18-64 years are classified with an ambulatory (walking) disability, and many experience gait asymmetry, which corresponds to changes gait between the right and left limbs, such as unequal loading or stance times (more weight or time on one foot). The resulting observable change in gait can result in serious long-term medical problems-including low back pain, joint overuse, pain, osteoarthritis, osteoporosis changes, and muscle imbalance-and a greatly reduced quality of life, as well as in social stereotyping, reduced self-image, and negative impact on social and employment opportunities. This Small Business Innovation Research Phase I project will address this public health problem by introducing a novel device for rehabilitation in the home environment, by using wireless instrumentation and smartphone technology for feedback to amputees about their real-time performance in situ.