SENSORY/MOTOR INPUT EFFECTS ON GAIT IN SCI SUBJECTS

描述(改编自申请人的描述：在 不完全脊髓损伤(SCI)所致的痉挛性瘫痪 脊柱上对下肢运动输出的贡献导致 一系列运动异常。其中包括不受监管的脊椎 反应、运动招募不足和延迟，以及平衡缺陷。 如果个体是活动的，这些异常表现在 由此产生的步态模式是肌肉之间异常的时间关系 群体、负重能力缺陷和肌肉不适当 站立时延长、阵挛、剪刀等活动。感官 来自多个来源的信息有助于生产 脊椎动物的运动，因此，通过操纵感官输入 可以修改电机输出。两项创新技术似乎可以 实现这一目标的有效方法是体重支持(BWS)和 功能性电刺激(FES)。 人类脊髓对压力的反应能力并从中受益 将评估创新的跑步机训练方案。FES将用于 与BWS结合以促进在跑步机上的运动性能 有不完全脊髓损伤的个体。初步研究表明，通过 结合这些干预措施，步态表现得到改善，从而使更多 高效率和功能性的运动被允许出现。的影响 体重支持和适当时机的刺激对身体的影响 由此产生的同侧和对侧马达输出将被描述。 全程FES增强BWS运动能力的训练效果 将研究多节课的培训计划。修改的步态参数 通过培训将确定这些变化的性质 特色化的。为了进一步研究BWS可能如何影响脊髓神经细胞， 第二组实验将调查对阿尔法运动神经元的影响 以下肢负荷者的兴奋性 不完全脊髓损伤和健全(AB)对照。 拟议的实验是为了检验(1)运动的假设 不完全脊髓损伤患者的能力可以受到以下因素的积极影响 由BWS和FES组成的训练方案，以及(2) 下肢卸载对大鼠运动神经元兴奋性的影响 人类。预计这项工作的结果将为以下工作提供基础 为残存脊髓损伤患者制定康复方案 运动能力。

DESCRIPTION (Adapted from Applicant's Description: In the presence of spastic paresis due to incomplete spinal cord injury (SCI), inadequate supraspinal contributions to motor output of the lower extremities result in a number of abnormalities of movement. Among these are unregulated spinal reflexes, inadequate and delayed motor recruitment, and balance deficits. If the individual is ambulatory, these abnormalities are manifest in the resulting gait pattern as aberrant temporal relationships between muscle groups, deficits in weight bearing capacity and inappropriate muscle activity such as prolonged stance phase, clonus and "scissoring." Sensory information from multiple sources contributes to the production of vertebrate locomotion, therefore, by manipulating sensory input it is possible to modify motor output. Two innovative technologies that appear to be effective for achieving this end are body weight support (BWS) and functional electrical stimulation (FES). The capacity of the human spinal cord to respond to and benefit from an innovative treadmill training regimen will be assessed. FES will be used in conjunction with BWS to facilitate locomotor performance on a treadmill in individuals with incomplete SCI. Preliminary studies indicate that, by combining these interventions, gait performance is improved such that more efficient and functional movement is allowed to emerge. The influence of the body weight support and of appropriately timed stimulation on the resulting ipsilateral and contralateral motor outputs will be characterized. The training effects of BWS locomotion augmented by FES over the course of a multi-session training program will be examined. Gait parameters modified by training will be identified and the nature of these changes will be characterized. To further study how BWS may affect spinal neural elements, a second set of experiments will investigate the effects on alpha motoneuron excitability of unloading the lower extremities, in individuals with incomplete SCI and able-bodied (AB) controls. The proposed experiments are to test the hypothesis that (1) locomotor capacity in individuals with incomplete SCI can be positively influenced by a training regimen consisting of BWS in conjunction with FES, and (2) unloading of the lower extremities influences motoneuron excitability in humans. Results from this work are envisioned to provide the foundation on which to develop rehabilitation protocols for SCI individuals with residual locomotor capacity.