Effects of Motor-Assisted Cycling in Cerebral Palsy

电机辅助自行车对脑瘫的影响

• 批准号: 7140538
• 负责人: DIANE L. DAMIANO
• 金额: $ 16.06万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-05 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7140538
• 关键词: assistive device /technology; cerebral palsy; children; chordate locomotion; clinical research; electromyography; energy source; functional ability; human subject; human therapy evaluation; medical rehabilitation related tag; muscle tone; nervous system disorder therapy; neural plasticity; neuroanatomy; patient oriented research; rehabilitation

DESCRIPTION (provided by applicant): Spinal locomotor circuits can be accessed and trained in humans with appropriate stimuli and practice. Treadmill training and FES-cycling protocols are being increasingly utilized for persons with CMS injuries to exploit this potential in an effort to improve coordination and, if possible, to restore or promote ambulation. Activation of spinal circuits may also drive cortical reorganization and further augment motor recovery. Cerebral palsy (CP), the most prevalent physical disability originating in childhood, is characterized by abnormal motor control as a result of a static brain lesion in a developing nervous system. A consequence of the resultant inappropriate descending input is that spinal mechanisms that promote coordinated reciprocal movements in the lower extremities are often underutilized and therefore may develop abnormally. This has a direct negative effect on motor development and initiates a cascade whereby restricted amounts and types of movements limit the reinforcement or development of motor pathways in the nervous system, further reducing motor potential. Our specific aim in this initial investigation is to conduct a three month motor-assisted (passive) cycling program using a special computerized motor-driven cycle in 20 ambulatory and non-ambulatory children with CP with the primary goal to train spinal locomotor circuits and thereby improve motor coordination and function. Secondary goals are to modulate spasticity and muscle stiffness, and enhance cortical plasticity. Cycling is a form of locomotion shown to have similar timing and phasing to walking and evidence of shared neural circuitry, and could provide a more effective and feasible in-home alternative to therapist-assisted supported treadmill training regimens. Fast (50RPM) motor-driven cycling produces reciprocal muscle activation in normals that may be even greater in persons with spasiticy. If it is found that cycling stimulates neural and motor recovery in CP, the data obtained in this prospective observational study will be used to support a RCT of passive and perhaps active-assisted cycling in CP.

描述（由申请人提供）：通过适当的刺激和练习，人类可以访问和训练脊髓运动回路。跑步机训练和fes骑行方案越来越多地用于CMS损伤患者，以开发这种潜力，努力改善协调，并在可能的情况下恢复或促进行走。脊髓回路的激活也可能驱动皮层重组并进一步增强运动恢复。脑瘫（CP）是儿童时期最常见的身体残疾，其特点是由于发育中的神经系统发生静态脑损伤而导致运动控制异常。由此产生的不适当的下行输入的后果是，促进下肢协调相互运动的脊柱机制往往未得到充分利用，因此可能发育异常。这对运动发育有直接的负面影响，并引发了一个级联反应，即运动的数量和类型受到限制，限制了神经系统中运动通路的加强或发展，进一步降低了运动电位。在这项初步研究中，我们的具体目标是对20名患有CP的流动和非流动儿童进行为期3个月的运动辅助（被动）骑行计划，使用一种特殊的计算机控制的运动驱动自行车，主要目的是训练脊髓运动回路，从而改善运动协调和功能。次要目标是调节痉挛和肌肉僵硬，增强皮质可塑性。骑车是一种运动形式，与步行具有相似的时间和相位，并且有证据表明它们具有共同的神经回路，并且可以提供一种更有效和可行的家庭替代治疗师辅助的跑步机训练方案。快速（50RPM）电机驱动的循环在正常情况下产生肌肉的相互激活，在痉挛患者中可能更大。如果发现骑车能刺激脑瘫患者的神经和运动恢复，本前瞻性观察研究获得的数据将用于支持脑瘫患者被动或主动辅助骑车的随机对照试验。