Unraveling posture control in severe cerebral palsy.

解开严重脑瘫患者的姿势控制。

基本信息

  • 批准号:
    2015660
  • 负责人:
  • 金额:
    $ 18.63万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
    Standard Grant
  • 财政年份:
    2019
  • 资助国家:
    美国
  • 起止时间:
    2019-12-12 至 2023-07-31
  • 项目状态:
    已结题

项目摘要

The vast majority of research in cerebral palsy (CP) involves children who have the ability to stand and walk. In contrast, children with severe CP, who do not have the ability to walk, are typically excluded from activity-based research or are studied in very simplistic or nonobjective ways. This project will focus on understanding the complex task of trunk posture control in children with severe CP. Trunk posture control underlies nearly all motor activities, including speech, eating, and socialization. This project uses control systems engineering in an innovative way to determine which neural processes are intact, delayed, or absent in individual children with severe CP. Furthermore, while posture models exist for adults who have the ability to stand, no model exists for individuals who lack independent sitting or for children with CP. The researchers will develop and validate models that quantify specific neural systems in posture control. These models help identify underlying mechanisms used by children with CP when attempting to control their balance. The development, refinement, and testing of models will be a major advance in clinical engineering, in that the quantification of model parameters, e.g., joint stiffness and neural time delay, will have immediate and fundamental implications on clinical practice. Educational activities associated with this project will engage students with and without CP who are in high school, undergraduate, and graduate school. In addition to learning about posture control, students will learn about modeling and control systems. Finally, students will be engaged in creating and testing a unique dissemination tool, "sim CP." In "sim CP," typically developing children and adults can attempt to control their posture while constrained by the computer simulation to adjust to CP-like challenges on motor outcomes. Together, this research project will catalyze the field by combining engineering, parametric modeling, and clinical pediatrics to investigate posture control in children with severe CP with the added impact of mentoring students and creating novel dissemination tools.Due to the inherent complexity of closed loop posture control, it is difficult to identify neural processes underlying healthy posture sway. This difficulty is exacerbated in children with severe CP who lack independent sitting, and who may also have abnormal tone or lack of verbal communication. This project overcomes these barriers by leveraging controls engineering to probe the posture system of children with moderate-to-severe CP. The Research Plan is organized under three objectives. The first objective is to characterize the posture system and potential for learning by collecting a rich experimental data set of posture behavior. Participants sit on an articulating bench with an adjustable trunk system that moves synchronously with surface tilts with high resolution and accuracy. The support stabilizes specific segments of the trunk in vertical upright alignment while requiring static, active and reactive posture control above the supported segments. Posture responses will be evoked with custom external stimuli: sine waves, pseudorandom waveforms, and a novel sitting sway-referenced condition to examine motor learning. Data will be collected with two different levels of trunk support: the lowest level where trunk control is present and one level lower where control is challenged. The second objective is to develop experimentally-valid parametric models of the posture system that explain sway data across frequencies from approximately 0.04 to 1.5 Hz. The posture model will identify underlying systems and control mechanisms, such as neural time delays, sensorimotor noise, sensory-to-motor transformations, joint stiffness and damping, and adaptation of control parameters. Different model assumptions (based on existing motor control research) will be tested. The third objective is to compare results in 15 children, ages 6 to 17 years old with moderate to severe CP (Gross Motor Function Classification Scale levels IV & V), to age-matched controls using the same experimental and modeling techniques.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.
绝大多数脑瘫(CP)的研究涉及有站立和行走能力的儿童。相比之下,患有严重CP的儿童,没有行走能力,通常被排除在基于活动的研究之外,或者以非常简单或不客观的方式进行研究。这个项目将侧重于了解严重CP儿童躯干姿势控制的复杂任务。躯干姿势控制是几乎所有运动活动的基础,包括言语、进食和社交。该项目以创新的方式使用控制系统工程,以确定严重CP儿童的神经过程是否完整,延迟或缺失。此外,虽然姿势模型存在于有站立能力的成年人中,但没有模型存在于缺乏独立坐姿的人或患有CP的儿童中。研究人员将开发和验证量化姿势控制中特定神经系统的模型。这些模型有助于识别CP儿童在试图控制平衡时使用的潜在机制。模型的开发、改进和测试将是临床工程的重大进步,因为模型参数的量化,例如,关节僵硬和神经时间延迟,将对临床实践产生直接和根本的影响。与此项目相关的教育活动将吸引高中,本科和研究生院的CP学生和非CP学生。除了学习姿态控制,学生还将学习建模和控制系统。最后,学生将参与创建和测试一个独特的传播工具,“sim CP。在“模拟CP”中,通常发育中的儿童和成人可以尝试控制他们的姿势,同时受到计算机模拟的限制,以适应CP对运动结果的挑战。总之,这个研究项目将通过结合工程学、参数建模和临床儿科学来促进该领域的发展,以研究严重CP儿童的姿势控制,并增加指导学生和创造新的传播工具的影响。由于闭环姿势控制的固有复杂性,很难识别健康姿势摇摆背后的神经过程。这种困难在患有严重CP的儿童中加剧,这些儿童缺乏独立的坐姿,并且还可能有异常的音调或缺乏语言交流。本研究以控制工程学为工具,探讨中度至重度脑性瘫痪儿童的姿势系统,以克服这些障碍。研究计划有三个目标。 第一个目标是通过收集丰富的姿势行为实验数据集来表征姿势系统和学习潜力。参与者坐在一个带有可调节躯干系统的铰接长凳上,该系统可与表面倾斜同步移动,具有高分辨率和准确性。 该支撑件使躯干的特定部分稳定在垂直直立对齐中,同时需要在所支撑的部分上方进行静态、主动和反应姿态控制。 将用自定义外部刺激诱发电位反应:正弦波、伪随机波形和一种新的坐姿摇摆参考条件,以检查运动学习。 数据将在两个不同的躯干支持水平下收集:存在躯干控制的最低水平和控制受到挑战的较低水平。 第二个目标是开发实验有效的姿态系统的参数模型,解释从大约0.04到1.5 Hz的频率范围内的摇摆数据。 姿势模型将识别潜在的系统和控制机制,例如神经时间延迟、感觉运动噪声、感觉运动转换、关节刚度和阻尼以及控制参数的自适应。将测试不同的模型假设(基于现有的电机控制研究)。 第三个目标是比较结果在15名儿童,年龄6至17岁,中度至重度CP(粗大运动功能分类量表水平IV和V),年龄匹配的控制使用相同的实验和建模techniques.This奖项反映了NSF的法定使命,并已被认为是值得通过使用基金会的智力价值和更广泛的影响审查标准进行评估的支持。

项目成果

期刊论文数量(4)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Postural mechanisms in moderate-to-severe cerebral palsy
  • DOI:
    10.1152/jn.00549.2020
  • 发表时间:
    2021-05-01
  • 期刊:
  • 影响因子:
    2.5
  • 作者:
    Goodworth, Adam;Saavedra, Sandra
  • 通讯作者:
    Saavedra, Sandra
Research Report: Efficacy and Safety of a Novel Aquatic Device for Children With Postural Dysfunction
研究报告:新型水上装置对姿势障碍儿童的功效和安全性
  • DOI:
    10.1097/pxt.0000000000000008
  • 发表时间:
    2021
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Breighner, Joshua;Saavedra, Sandra;Snowdon, Donna
  • 通讯作者:
    Snowdon, Donna
Influence of visual biofeedback and inherent stability on trunk postural control
  • DOI:
    10.1016/j.gaitpost.2020.06.011
  • 发表时间:
    2020-07-01
  • 期刊:
  • 影响因子:
    2.4
  • 作者:
    Goodworth, Adam;Kratzer, Amy;Saavedra, Sandy
  • 通讯作者:
    Saavedra, Sandy
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Adam Goodworth其他文献

Adam Goodworth的其他文献

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{{ truncateString('Adam Goodworth', 18)}}的其他基金

Unraveling posture control in severe cerebral palsy.
解开严重脑瘫患者的姿势控制。
  • 批准号:
    1803714
  • 财政年份:
    2018
  • 资助金额:
    $ 18.63万
  • 项目类别:
    Standard Grant

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