Identifying and predicting subgroups related to function in individuals after stroke.

项目总结/摘要 中风后两种常见的长期缺陷是活动能力和认知能力受损。行动不便， 认知与许多负面的健康后果有关，包括福尔斯、生活质量差， 再次入院。中风后的活动能力和认知能力的恢复是高度可变的，并且知之甚少。 因此，康复专业人员无法提供针对每个具体情况的干预措施。 他们治疗的患者，有助于中风后康复的“一刀切”方法，其特征是 不完全恢复和高昂的医疗费用。恢复和模型的全面表征 预测复苏对于转向针对特定个人的干预措施至关重要， 中风因此，本提案的总体目标是建立模型，预测 中风后的活动能力和认知能力的个体将遵循。恢复轨迹完全描述了患者 恢复并表征它们的程度（即，大的、中等的或有限的）和时间模式（即， 快或慢）。恢复的程度和模式都会影响康复的类型、时间和剂量 然而，恢复的程度一直是以前工作的重点。模型预判 恢复轨迹，而不仅仅是恢复的程度，用于中风后个体的移动性和认知 对于实现针对特定个人的康复干预至关重要， 中风过去与中风后上肢恢复相关的研究表明，存在与以下相关的亚组： 恢复轨迹和个人的特点可以用来开发预测模型。 因此，这项工作的中心假设是，我们可以1）表征恢复轨迹的流动性 2）利用中风后个体的特征来建立模型来预测中风后的认知能力。 移动性和认知恢复轨迹。该提案的结果将提供一个全面的 了解中风后活动和认知的恢复，以及中风后活动和认知的准确预测模型。 运动和认知的恢复轨迹。这将指导制定和实施干预措施， 在正确的时间找到正确的人，以优化功能恢复并提高我们的医疗保健效率 系统此外，拟议的工作是实现该研究金长期目标的第一步 申请人，这是为了了解患者恢复的可变性，以推动中风后康复 针对每个特定患者提供量身定制的干预措施，从而改善患者 在一个更有效的医疗保健系统中。通过在指导下完成本研究金提案， 在强大的研究环境中，由经验丰富的导师组成，申请人将接受所需的培训， 成为一名富有成效的独立科学家，并实现她的长期职业目标。

PROJECT SUMMARY/ABSTRACT Two common, long-lasting deficits after stroke are impaired mobility and cognition. Impairments in mobility and cognition are associated with numerous negative health consequences, including falls, poor quality of life, and hospital readmissions. Recovery of mobility and cognition after stroke is highly variable and poorly understood. Therefore, rehabilitation professionals are unable to provide interventions that are tailored to each specific patients they treat, contributing to a “one size fits all” approach to post stroke rehabilitation that is characterized by incomplete recovery and high healthcare costs. A comprehensive characterization of recovery and models that predict recovery are essential to shifting towards interventions that are tailored to specific individuals after stroke. Thus, the overall objective of this proposal is to develop models that predict what recovery trajectory of mobility and cognition individuals after stroke will follow. Recovery trajectories completely describe patient recovery and are characterized both their extent (i.e., large, moderate, or limited) and temporal pattern (i.e., fast or slow). Both the extent and pattern of recovery can impact the type, timing, and dosing of rehabilitation interventions; however, the extent of recovery has been the focus of previous work. Models that predict the recovery trajectory, rather than just the extent of recovery, for mobility and cognition for individuals after stroke are essential to moving towards rehabilitation interventions that are targeted towards specific individuals after stroke. Past work related to upper extremity recovery after stroke suggest that there are subgroups related to recovery trajectories and that the characteristics of individuals can be used to develop predictive models. Therefore, the central hypothesis of this work is that we can 1) characterize recovery trajectories for mobility and cognition after stroke and 2) use characteristics of individuals after stroke to develop models to predict mobility and cognition recovery trajectories. The results of this proposal will provide a comprehensive understanding of the recovery of mobility and cognition after stroke and an accurate predictive model of the recovery trajectories of mobility and cognition. This will guide the development and delivery of interventions to the right person at the right time to optimize functional recovery and improve the efficiency of our healthcare system. Additionally, the proposed work serves as a first step towards the long-term goal of this fellowship applicant, which is to understand variability in patient recovery in order to move post-stroke rehabilitation towards the delivery of interventions that are tailored to each specific patient, thereby, improving patient outcomes within a more efficient healthcare system. By completing this fellowship proposal under the guidance of experienced mentors in a strong research environment, the applicant will receive the training needed to become a productive, independent scientist and to achieve her long term career goals.