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装置。该装置将提供一个封闭链，承重的下肢运动，有可能增加肌肉质量，力量和耐力，并可能额外逆转或减缓骨密度的损失率。用户将被鼓励自愿进行锻炼，并辅以电刺激来完成规定的运动范围。刺激控制器将不断调整刺激轮廓，只提供完成锻炼所需的刺激，同时鼓励用户在每个锻炼周期中贡献他们最好的意志努力。我们假设，除了锻炼下肢肌肉和骨骼外，这种锻炼可能为一些使用者提供运动再训练的好处。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，供有能力主动激活受刺激肌肉的iSCI患者使用；2)开发一种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)在无神经运动缺陷的受试者的研究中验证显示范例；4)通过在iSCI受试者的研究中测试该设备来证明我们方法的可行性。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，以改善用户/刺激协调，并在一项长期研究中证明该方法的有效性，该研究中，不完全性脊髓损伤患者在运动再训练环境中使用该设备。该设备的目标市场是为神经运动障碍患者（如不完全性脊髓损伤、创伤性脑损伤或中风）提供服务的诊所。该设备的价格将在电刺激运动设备市场中具有竞争力。

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.