Quantifying the energetic cost of support and stabilization during walking in children with cerebral palsy

量化脑瘫儿童行走过程中支撑和稳定的能量消耗

• 批准号: 10301594
• 负责人: Max Donelan
• 金额: $ 24.22万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10301594
• 关键词: Activities of Daily Living; Adult; Balance training; Biomechanics; Carbon Dioxide; Cerebral Palsy; Child; Communities; Development; Device Designs; Devices; Eating; Fatigue; Food Energy; Foundations; Future; Gait; Goals; Human; Impairment; Indirect Calorimetry; Individual; Intervention; Jogging; Knowledge; Lateral; Leg; Life; Limb structure; Measures; Metabolic; Methods; Monitor; Movement; Muscle; Nervous System Trauma; Operative Surgical Procedures; Orthotic Devices; Oxygen; Participant; Pattern; Pelvis; Performance; Population; Prevalence; Quality of life; Recording of previous events; Regimen; Rehabilitation therapy; Reporting; Research; Research Personnel; Research Priority; Running; Self-Help Devices; Speed; System; Testing; Time; Training; Training Programs; Walkers; Walking; Work; biomechanical model; cost; crouch gait; design; equilibration disorder; evidence base; exhaustion; exoskeleton; experience; experimental study; fitness; improved; innovative technologies; insight; muscle metabolism; peer; relative cost; research and development; respiratory gas; spasticity; strength training; theories; therapy design; walking speed

Project Summary Walking promotes independence, participation, fitness, and exploration in daily life. Like other activities, walking requires metabolic energy from the food we eat, which is ultimately used by our muscles to power movement. Experimentally, we can measure this energy using indirect calorimetry, which monitors oxygen and carbon dioxide as the body converts stored energy into the form used by muscles during activities of daily living. Decades of energetics research has demonstrated that human walking is incredibly efficient. However, for people with cerebral palsy the energetic cost of walking is significantly increased, on average over two times higher than typically-developing individuals. This means that for people with cerebral palsy, walking is as tiring as jogging or climbing stairs. An energetic cost of this magnitude restricts activities of daily living and causes exhaustion. While our team and many others have sought to reduce these costs through surgical interventions, rehabilitation, orthotics, or other assistive devices, these strategies have failed to result in meaningful reductions in energy. To design strategies that successfully reduce walking costs, we must first understand the underlying mechanisms contributing to elevated cost in people with cerebral palsy. The proposed research seeks to fill this knowledge gap by examining biomechanical factors that contribute to elevated energy for people with cerebral palsy. Specifically, we will evaluate the energetic cost of supporting the body (Aim-1) and stabilizing the body (Aim-2) during walking for children with cerebral palsy, and compare these costs to typically-developing peers. These tasks require very little energy during unimpaired walking (e.g., <10% of total walking cost), but their costs remain unknown for people with cerebral palsy and have direct implications for treatment decisions and assistive device design. Building upon decades of energetics research of unimpaired walking, this research will use a mechatronic device to precisely provide support and stabilization assistance during walking and quantify the impact of this assistance on walking cost. In unimpaired adults, similar methods have led to the design of exoskeletons and training programs that effectively reduce walking and running energy. This research will provide the foundation to create evidence-based strategies to decrease energy costs, minimize fatigue, and increase quality of life for people with cerebral palsy and other neurologic injuries.

项目摘要 散步促进日常生活中的独立、参与、健康和探索。像其他活动一样， 走路需要我们所吃的食物中的新陈代谢能量，这些能量最终被我们的肌肉用来提供动力 有动静。在实验上，我们可以使用间接量热法来测量这种能量，它监测氧气和 二氧化碳作为身体将储存的能量转化为肌肉在日常活动中使用的形式 活着。数十年的能量学研究表明，人类行走的效率令人难以置信。然而， 对于脑瘫患者来说，行走的能量成本显著增加，平均增加两倍以上 比正常发育的个体要高。这意味着，对于脑瘫患者来说，行走同样令人疲惫 如慢跑或爬楼梯。如此巨大的能源成本限制了日常生活的活动和原因 疲惫不堪。虽然我们的团队和其他许多人试图通过手术干预来降低这些成本， 康复、矫形或其他辅助设备，这些策略都没有产生有意义的结果 能源的减少。要设计成功降低步行成本的策略，我们必须首先了解 脑性瘫痪患者费用升高的潜在机制。拟议的研究 试图通过检查导致能量增加的生物力学因素来填补这一知识空白 脑瘫患者。具体来说，我们将评估支持身体的能量成本(AIM-1)和 脑瘫儿童步行时稳定身体(AIM-2)，并将这些成本与 典型的发展中的同龄人。这些任务在不受损的行走过程中只需要很少的能量(例如， 总步行成本)，但对于脑瘫患者来说，它们的成本尚不清楚，并有直接影响 用于治疗决策和辅助设备设计。建立在几十年的能量学研究的基础上 在不损害行走的情况下，这项研究将使用机电设备来精确地提供支撑和稳定 并量化这种辅助对步行成本的影响。在未受损的成年人中， 类似的方法也导致了外骨骼的设计和有效减少步行的训练计划 和源源不断的能量。这项研究将为制定基于证据的减少战略提供基础 能源成本，最大限度地减少疲劳，并提高脑瘫和其他神经病患者的生活质量 受伤。