STIMULATION-AUGMENTED EXERCISE AND NEUROMOTOR THERAPY

描述（由申请人提供）：本项目拟为不完全性脊髓损伤（iSCI）患者开发一种电刺激增强运动器械。该器械将提供一种闭合链、承重下肢运动，有可能增加肌肉质量、力量和耐力，还可能逆转或减缓骨矿物质密度的损失速率。将鼓励用户自愿进行运动，并通过电刺激增强运动，以完成规定的运动范围。刺激控制器将连续地调整刺激曲线以仅提供完成锻炼所必需的刺激，同时鼓励用户在每个锻炼周期上贡献他们的最大意志力。我们假设，除了锻炼下肢肌肉和骨骼外，这项运动还可以为一些用户提供运动再训练益处。在第一阶段，我们建议：1）修改我们现有的自适应刺激控制器，以供具有主动激活被刺激肌肉的能力的iSCI个体使用，2）开发简单的视觉反馈显示以促进用户和刺激控制器之间的协调，3）在对没有神经运动缺陷的受试者的研究中验证显示范例，和4）通过在iSCI受试者的研究中测试该装置来证明我们的方法的可行性。在第二阶段，我们将进一步开发自适应刺激控制器，开发简单，用户友好的视觉反馈范例，以提高用户/刺激协调，并证明在长期研究中，不完全SCI的个人使用该设备在运动再训练设置的方法的有效性。该设备的目标市场是为患有神经运动障碍的个人提供服务的诊所，如不完全SCI，创伤性脑损伤或中风。该设备将在基于电刺激的运动设备市场中具有竞争力的价格。 与公共卫生的关系：该项目与公共卫生相关，因为它可能导致为iSCI患者开发一种实用的锻炼设备，该设备可能会延长腿部长骨骨质疏松症的发作，并可能导致改善瘫痪下肢肌肉的自主控制，当用作综合性SCI后康复计划的一个组成部分时。

DESCRIPTION (provided by applicant): This project proposes to develop an electrical stimulation augmented exercise device for individuals with incomplete spinal cord injury (iSCI). The device will provide a closed-chain, load bearing lower extremity exercise that has the potential to increase muscle mass, strength, and endurance, and may additionally reverse or slow the rate of loss of bone mineral density. The user will be encouraged to voluntarily perform the exercise, which will be augmented with electrical stimulation to complete the prescribed exercise range of motion. The stimulation controller will continuously adjust the stimulation profile to provide only the stimulation that is necessary to complete the exercise while encouraging the user to contribute their best volitional effort on each exercise cycle. We hypothesize that this exercise may provide motor retraining benefits to some users in addition to exercising lower extremity muscles and bones. In Phase I, we propose: 1) to modify our existing adaptive stimulation controller for use by individuals with iSCI who have the ability to voluntarily active the stimulated muscles, 2) to develop a simple visual feedback display to facilitate coordination between the user and stimulation controller, 3) to validate the display paradigm in a study with subjects without neuromotor deficits, and 4) to demonstrate feasibility of our approach by testing the device in a study with subjects with iSCI. In Phase II, we will further develop the adaptive stimulation controller, develop simple, user-friendly visual feedback paradigms to improve user/stimulation coordination, and demonstrate efficacy of the approach in a long-term study where individuals with incomplete SCI use the device in a motor retraining setting. The target market for the device is clinics who serve individuals with neuromotor disabilities such as incomplete SCI, traumatic brain injury, or stroke. The device will be competitively priced within the electrical stimulation-based exercise equipment market. RELEVANCE TO PUBLIC HEALTH: This project in relevant to public health because it may lead to development of a practical exercise device for individuals with iSCI that may prolong the onset of osteoporosis in the long bones of the legs and may lead to improved voluntary control of paralyzed lower extremity muscles when used as one component of a comprehensive post-SCI rehabilitation program.