Prone Locomotion in Infants with or at Risk for Disabilities

患有残疾或有残疾风险的婴儿的俯卧运动

基本信息

批准号：
8121435
负责人：
Hlapang A. Kolobe
金额：
$ 17.72万
依托单位：
UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-05 至 2014-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8121435
关键词：
Adult Affect Age-Months Algorithms Area Back Bicycling Brain Build-it Cells Cerebral Palsy Child Clinical Trials Cognition Complement Computer software Data Detection Development Devices Experimental Designs Feedback Frequencies Future Generations Goals Home environment Human Hypogravity Infant Infant Behavior Infant Development Intervention Kinetics Learning Lesion Life Limb structure Locomotion Longevity Measures Mechanics Motor Skills Movement Outcome Pattern Performance Phase Physically Handicapped Protocols documentation Recruitment Activity Research Rewards Risk Robotics Sensory Signal Transduction Synapses System Technology Testing Therapeutic Time Trackball Device Component Training United States User-Computer Interface Videotape Work base cost design disability experience improved infancy information gathering innovation kinematics limb movement motor learning neuron loss public health relevance research study response sensor skills stroke rehabilitation success tool

项目摘要

DESCRIPTION (provided by applicant): The purpose of the proposed exploratory study is to develop and test an integrated robotics and sensor technology system designed to influence movement learning in infants with cerebral palsy (CP). CP is the most disabling condition for children in the United States with locomotion being the most affected functional skill. Of particular concern to the proposed project is that children with CP do not only show paucity of self-initiated movements critical for locomotion, but that these movements diminish as the children grow (learned disuse/non-use). Many of the mobility constraints that confront adults with CP can be traced back to infancy. Prone locomotion is the earliest and, in some cases the only form of locomotion available to infants during the first year of life, that infants with or at risk for CP rarely attain. Not only is prone locomotion integrated with other systems essential for functional independence and learning, its development in infants who are typically developing also coincides with a period of highly active synaptic formation in the brain, making it a critical gateway and target for intervention. No tested interventions exist to promote this skill in infants. The proposed study is the next step in our work on the use of a self-initiated prone progression crawler (SIPPC) to promote and help sustain limb and body movements by infants with CP during prone locomotion. It builds on promising results of our earlier trials that showed that the 1st generation SIPPC (SIPPC-1), which used device-based positional input sensors as control signals, tended to reward later rather than earlier efforts. The proposed 2nd generation SIPPC (SIPPC-2) will add infant-based sensors (limb-mounted accelerometers and load cells) that will not only serve as control signals, but will also generate kinematic and kinetic data about how infants with or at risk for CP learn to move during prone locomotion. Two (2) related studies will be used to test whether the SIPPC-2 controls will enhance motor learning and promote prone locomotion. In the first study we will gather information to create a menu of canonical limb and body movement patterns that predictably result in infant-driven movement of the SIPPC-2. The second study will test the device- and infant-driven control algorithms and compare the development of movement strategies of infants using active and inactive SIPPC-2 systems. Thirty (30) infants with and without CP will be recruited and tested at 3 - 4 months to determine risk for CP. Training will begin at 4.5 - 6.5 months of age. The design protocol will comprise 15-20 minutes of training on the SIPPC-2 for 12 weeks. The training sessions will be videotaped. The Bayley Scales of Infant Development III will be used to assess domains of development that are associated with prone locomotion. The SIPPC-2 design is unique and innovative in that it is not only an intervention device, but can also be used to gather comprehensive information about the infants' learning and mobility patterns. The results will generate information on how infants with brain lesions learn a new motor skill, provide information on the use of reinforced learning in infants, help determine the feasibility of the SIPPC-2 as a valid intervention system, and refine a self-contained portable battery powered SIPPC-2 to be used in homes and in future clinical trials. PUBLIC HEALTH RELEVANCE: The SIPPC-2 system is unique in that it is not only an intervention device that simultaneously generates performance outcomes, but it can also be used to gather comprehensive information about how infants (with and without CP) learn a movement-related task like crawling. The kinematic and kinetic data generated by the SIPPC-2 will allow us to begin to speculate about brain plasticity in infants with brain lesions. We expect that the use of a menu of patterns of limb movement will help deter learned non-use/disuse by challenging infants with a brain insult, such as cerebral palsy, to attain high levels of psychomotor abilities, and minimize the long term deleterious effects that immobility has on other domains of development and functional independence. Because early prone locomotion is associated with emergence of a wide variety of skills, assisting infants with or at risk for CP to attain this skill have far reaching effects.

描述（由申请人提供）：拟议的探索性研究的目的是开发和测试旨在影响脑瘫（CP）婴儿运动学习的综合机器人技术和传感器技术系统。 CP是美国儿童最残疾的状况，运动是最受影响的功能技能。拟议项目特别关注的是，患有CP的儿童不仅表现出对运动至关重要的自我启发运动的稀少，而且随着孩子的成长，这些运动会减少（学识渊博的失败/不使用）。与CP面临的成年人面临的许多活动限制可以追溯到婴儿期。俯卧的运动是最早的运动，在某些情况下，婴儿在生命的第一年中可用于唯一的运动形式，即患有或面临CP风险的婴儿很少获得。俯卧的运动不仅与其他对于功能独立性和学习必不可少的系统集成在一起，而且其通常正在发展的婴儿的发展也与大脑中高度活跃的突触形成时期相吻合，这使其成为干预的关键门户和目标。没有经过测试的干预措施来促进婴儿的这种技能。拟议的研究是我们在使用自我启发的前进轨道（SIPPC）方面的下一步，以促进和帮助维持俯卧运动期间CP的肢体和身体运动。它建立在我们较早的试验的有希望的结果的基础上，该试验表明，使用基于设备的位置输入传感器作为控制信号的第一代SIPPC（SIPPC-1）倾向于以后奖励而不是早期的努力。拟议的第二代SIPPC（SIPPC-2）将添加基于婴儿的传感器（肢体安装的加速度计和负载电池），不仅将充当控制信号，而且还将产生有关患有CP或处于CP风险的婴儿在prone狂时学习运动的风险或动力学数据。两（2）项相关研究将用于测试SIPPC-2控制是否会增强运动学习并促进易发动。在第一项研究中，我们将收集信息，以创建一个规范的肢体和身体运动模式菜单，这些菜单可预见地导致SIPPC-2的婴儿运动。第二项研究将测试设备和婴儿驱动的控制算法，并比较使用主动和无效SIPPC-2系统的婴儿运动策略的发展。将在3-4个月的时间招募和没有CP的30（30）个婴儿，以确定CP的风险。培训将从4.5-6.5个月大。该设计方案将在SIPPC-2上进行15-20分钟的训练12周。培训课程将进行录像。婴儿发育的Bayley量表III将用于评估与俯卧运动有关的发育领域。 SIPPC-2设计是独特而创新的，因为它不仅是一种干预装置，而且还可以用于收集有关婴儿学习和流动性模式的全面信息。结果将生成有关脑病变的婴儿如何学习新的运动技能，提供有关婴儿使用增强学习的信息，有助于确定SIPPC-2作为有效的干预系统的可行性的信息，并完善自动连接的便携式电池供电的SIPPC-2用于家庭和将来的临床试验。公共卫生相关性：SIPPC-2系统是独一无二的，因为它不仅是一种同时产生绩效结果的干预装置，而且还可以用于收集有关婴儿（有或没有CP）如何学习与移动相关的任务（例如Crawling）的全面信息。 SIPPC-2产生的运动学和动力学数据将使我们能够开始推测患有脑损伤的婴儿的脑可塑性。我们预计，使用肢体运动模式菜单将有助于通过挑战脑损伤的婴儿（例如脑瘫）来阻止学习的不使用/失业，以获得高水平的精神运动能力，并最大程度地减少固定性对发展和功能独立性的其他固定性具有的长期有害影响。因为早期俯卧的运动与各种技能的出现有关，因此协助有或有CP风险获得这种技能的婴儿具有很大的影响。