Sensorimotor Training to Affect Balance, Engagement and Learning in Children with

感觉运动训练可影响儿童的平衡、参与和学习

• 批准号: 7941997
• 负责人: TRACY L JIRIKOWIC
• 金额: $ 19.14万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7941997
• 关键词: Address; Affect; Aftercare; Age; Animal Model; Area; Attention; Balance training; Behavior; Behavioral; Biometry; Cerebral Palsy; Child; Childhood; Clinical; Clinical assessments; Collaborations; Complex; Computers; Conflict (Psychology); Control Groups; Controlled Environment; Data; Development; Developmental Disabilities; Diagnosis; Disease; Dose; Educational Intervention; Effectiveness; Effectiveness of Interventions; Emerging Technologies; Engineering; Environment; Equilibrium; Evaluation; Fetal Alcohol Spectrum Disorder; Foundations; Funding; Goals; Home environment; Intervention; Laboratories; Learning; Maintenance; Matched Group; Measures; Motor; Movement; Musculoskeletal Equilibrium; Nature; Neurodevelopmental Disability; Neurodevelopmental Disorder; Neurodevelopmental Impairment; Neuronal Plasticity; Occupational Therapy; Outcome; Outcome Measure; Performance; Phase; Physical therapy; Pilot Projects; Play; Population; Process; Protocols documentation; Rehabilitation therapy; Relative (related person); Reporting; Research; Research Proposals; Risk; Safety; Sample Size; Sampling; Secondary to; Sensorimotor functions; Sensory; Shapes; Simulate; Sports; System; Technology; Testing; Time; Training; Weight; alcohol exposure; base; behavioral health; computer science; daily functioning; developmental disease; equilibration disorder; falls; functional outcomes; high risk; improved; meetings; motor learning; neurobehavioral; neuromuscular; novel; postnatal; prenatal exposure; public health relevance; remediation; response; sensory integration; sensory system; skills; social; somatosensory; stem; treatment effect; trend; virtual reality; visual-vestibular

DESCRIPTION (provided by applicant): Prenatal exposure to alcohol can increase the risk for lifelong neurobehavioral problems, as well as developmental disabilities that fall under the umbrella term of fetal alcohol spectrum disorders (FASD). Poor sensorimotor function, specifically balance deficits, is one area of neurodevelopmental impairment described among children with FASD. Efficient balance and postural control are important foundations for engagement in higher level functional skills such as maintaining attention, navigating an environment, controlling complex movements, and participating in childhood activities that promote physical and behavioral health and development. Balance is a complex process involving the integration sensory information and the coordination of neuromuscular responses. Despite evidence that balance deficits are problematic among children with FASD and preliminary reports that poor sensorimotor integration is suspect, the nature of these balance and postural control deficits are not fully understood. Nor have interventions to improve daily function and behavior through the remediation of underlying sensorimotor deficits been considered and tested among this population, Yet, evidence from alcohol exposed animal models indicates the capacity for neural plasticity, motor learning, and improved motor performance following complex rehabilitative training. Therefore, the overarching goal of this combined R21/R33 proposal is to determine the preliminary effectiveness of a sensorimotor intervention to improve balance and related functional and behavioral outcomes among children with FASD. Our proposed intervention will employ the use of virtual reality computer technology to train the ability to weight and reweight sensory information during balance perturbations invoked by simulated conditions of sensory conflict. As a first step, this research (R21) proposes to more fully describe balance impairments and subsequent functional impact of sensorimotor problems in children with FASD. This will be done by comparing the performance of children with FASD ages 7.0-14.9 years to a matched group of children with typical development on a battery of clinical tests and a novel assessment system that specifically examines how visual, vestibular and somatosensory information is used during balance. This data will shape the development of our proposed sensorimotor intervention technology and preliminary intervention protocol, which will be tested with a small group of children with FASD to gauge initial feasibility and responsiveness. Data from the R21 will lay the groundwork for the next phase of research (R33) that aims to refine the sensorimotor training for balance intervention technology and establish and test the effectiveness of the intervention delivered via a short-term intensive laboratory protocol or a longer term home-based protocol. Collectively, these studies lay the essential groundwork for a larger multisite efficacy study to determine the effectiveness of the intervention with a larger sample of children with FASD and other groups of children with neurodevelopmental disabilities. PUBLIC HEALTH RELEVANCE: The development and preliminary evaluation of a new sensorimotor training to affect balance, engagement and learning will address specific gaps in the understanding, diagnosis and treatment of balance disorders in children with fetal alcohol spectrum disorders (FASD). Given proof of concept, safety, feasibility, tolerability and preliminary effectiveness, the sensorimotor training for balance intervention can be used to improve the sensory component of postural control, that in turn will improve functional balance, movement, engagement and learning in children with FASD and other developmental disorders with similar balance deficits.

描述（由申请人提供）：产前接触酒精会增加终身神经行为问题的风险，以及胎儿酒精谱系障碍（FASD）下的发育障碍。感觉运动功能差，特别是平衡缺陷，是FASD儿童神经发育障碍的一个领域。有效的平衡和姿势控制是参与高级功能技能的重要基础，如保持注意力，导航环境，控制复杂动作，参与促进身体和行为健康和发展的儿童活动。平衡是一个复杂的过程，涉及感觉信息的整合和神经肌肉反应的协调。尽管有证据表明，FASD儿童的平衡缺陷是有问题的，并且初步报告怀疑感觉运动整合不良，但这些平衡和姿势控制缺陷的性质尚未完全了解。通过修复潜在的感觉运动缺陷来改善日常功能和行为的干预措施也没有在这一人群中得到考虑和测试。然而，来自酒精暴露动物模型的证据表明，在复杂的康复训练后，神经可塑性、运动学习和运动表现的能力得到了改善。因此，这项R21/R33联合建议的总体目标是确定感觉运动干预对改善FASD儿童的平衡及相关功能和行为结果的初步有效性。我们提出的干预措施将采用虚拟现实计算机技术来训练在模拟感官冲突条件引起的平衡扰动期间对感官信息进行加权和重新加权的能力。作为第一步，本研究（R21）提出更全面地描述FASD儿童感觉运动问题的平衡障碍和随后的功能影响。这将通过将7.0-14.9岁的FASD儿童的表现与一组匹配的典型发展儿童进行一系列临床测试和一种新的评估系统来完成，该系统专门检查视觉，前庭和体感信息在平衡过程中是如何使用的。这些数据将影响我们提出的感觉运动干预技术和初步干预方案的发展，将在一小群患有FASD的儿童中进行测试，以评估初步的可行性和反应性。来自R21的数据将为下一阶段的研究（R33）奠定基础，该研究旨在完善平衡干预技术的感觉运动训练，并通过短期强化实验室协议或长期家庭协议建立和测试干预的有效性。总的来说，这些研究为更大规模的多地点疗效研究奠定了基础，以确定更大样本的FASD儿童和其他神经发育障碍儿童群体的干预效果。

项目成果

Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis.

• DOI: 10.1186/s12887-016-0731-6
• 发表时间: 2016-11-29
• 期刊: BMC pediatrics
• 影响因子: 2.4
• 作者: Lucas BR;Elliott EJ;Coggan S;Pinto RZ;Jirikowic T;McCoy SW;Latimer J
• 通讯作者: Latimer J

Sensory control of balance: a comparison of children with fetal alcohol spectrum disorders to children with typical development.

• 发表时间: 2013
• 期刊: Journal of population therapeutics and clinical pharmacology = Journal de la therapeutique des populations et de la pharamcologie clinique
• 作者: T. Jirikowic;S. Mccoy;A. Lubetzky-Vilnai;R. Price;M. Ciol;D. Kartin;L. Hsu;B. Gendler;S. Astley