STIMULATION-AUGMENTED EXERCISE AND NEUROMOTOR THERAPY

描述(申请人提供)：该项目建议开发一种电刺激增强运动装置，用于不完全脊髓损伤(ISCI)患者。该设备将提供一种闭链、负重的腿部锻炼，有可能增加肌肉质量、力量和耐力，并可能另外逆转或减缓骨矿密度的丧失速度。将鼓励用户自愿进行锻炼，并通过电刺激来增加锻炼，以完成规定的锻炼范围。刺激控制器将不断调整刺激曲线，以仅提供完成练习所必需的刺激，同时鼓励使用者在每个练习周期中尽其最大的意志努力。我们推测，这项运动除了锻炼腿部肌肉和骨骼外，还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，以供有能力自愿激活受刺激肌肉的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)在没有神经运动缺陷的受试者的研究中验证显示范式；以及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来改善用户/刺激的协调性，并在一项长期研究中展示该方法的有效性，其中有不完全脊髓损伤的个人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提供服务的诊所，如不完全脊髓损伤、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上具有竞争力的定价。 与公共健康相关：该项目与公共健康相关，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的骨质疏松症的发病时间，并可能在作为全面的脊髓损伤后康复计划的一部分时，改善对瘫痪的下肢肌肉的自愿控制。

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.