Movement Ability Changes with Balance-Based Torso-Weighting in Multiple Sclerosis

描述（由申请人提供）：多发性硬化症（MS）是一种影响全球约250万人的神经退行性疾病，是年轻人致残的最常见原因。平衡和步态障碍在多发性硬化症中很常见，然而，平衡和活动障碍的表现是可变的，这取决于特定多发性硬化症患者的神经处理中断集。迄今为止，大多数多发性硬化症患者的步态和平衡的运动学和动力学分析都集中在最小临床残疾的个体上。通过6-8周的运动治疗，可以改善这一人群的步态和平衡。一种新的干预，基于平衡的躯干加权（BBTW），一种针对个体定向平衡丧失的加权技术，已经显示出ms患者的平衡和步态的立即改善。增加到躯干的重量是最小的（<体重的1.5%），并根据人的不平衡有策略地放置。然而，其即时有效性背后的机制仍然是神秘的，关于MS或其他疾病患者将受益的建议仍然模糊。对于本研究的具体目标1，我们将对MS患者和健康对照者进行有和没有BBTW的站立和行走的运动学和动力学分析。对于本研究的特定目标2，我们将在新的MS参与者样本中与健康对照组相比，检查几种感觉和运动系统损伤中哪一种最能预测BBTW对平衡和活动能力的直接改善。研究的目的是完善关于BBTW干预背后机制的假设，并澄清谁将获得最大的利益。未来的研究可以检验这项工作产生的假设。如果我们实现了我们的两个具体目标，我们将有证据增加关于轻体重作为改变姿势控制策略的感官补充机制的科学知识。这项研究将帮助我们了解对BBTW的反应机制，以及可能对其他补充感官输入的干预措施的反应机制。有了这些知识，我们可以为患有多发性硬化症或其他神经疾病的人开发更有效的干预措施，改善临床结果和生活质量。如果我们能确定哪些病人最有可能从这种干预中受益，医疗保健服务就能更高效、更有效。

DESCRIPTION (provided by applicant): Multiple sclerosis (MS) is a neurodegenerative disease affecting approximately 2.5 million people worldwide and is the most frequent cause of disability in young adults. Balance and gait impairments are common in MS, however, the manifestation of balance and mobility impairments is variable depending on the set of neural processing disruptions in the particular individual with MS. Most kinematic and kinetic analyses of gait and balance in MS have thus far focused on individuals with minimal clinical disability. Rehabilitation to improve gait and balance in this population have shown results in 6-8 weeks of exercise therapy. A novel intervention, balance-based torso-weighting (BBTW), a weighting technique tailored to individual directional balance loss, has shown immediate improvements in balance and gait in people with MS. The weight added to the torso is minimal (<1.5% body weight) and strategically placed according to the person's imbalance. However, the mechanisms behind its immediate effectiveness remain mysterious, and recommendations regarding people with MS or other disorders that will benefit remain vague. For Specific Aim 1 of this study, we will perform kinematic and kinetic analyses of standing and walking with and without BBTW in people with MS and healthy controls. For Specific Aim 2 of this study, we will examine which of several impairments of the sensory and motor systems best predicts immediate improvement in balance and mobility with BBTW in a new sample of participants with MS compared to healthy controls. The research goal is to refine hypotheses regarding the mechanism behind BBTW intervention, and clarify who will receive the most benefit. Future research could then test the hypotheses generated from this work. If we achieve our two specific aims, we will have evidence to add to the scientific knowledge regarding the mechanism of light weighting as a sensory supplement to change strategies for postural control. This study will help us understand the mechanisms for responsiveness to BBTW, and possibly to other interventions that supplement sensory input. With that knowledge, we can develop more effective interventions for people with MS or other neural disorders, improving clinical outcomes and quality of life. If we can determine which patients are most likely to benefit from this type of intervention, health care delivery can be more efficient as well as effective. PUBLIC HEALTH RELEVANCE: By beginning to unravel the mechanisms behind light torso-weighting we can develop more effective interventions for people with MS or other neural disorders that impair balance and gait. Such interventions will improve clinical outcomes and quality of life. When we determine the patients most likely to benefit from this type of intervention, health care delivery can be more efficient as well as effective.