Activity and Participation in Ambulatory Cerebral Palsy

描述（由申请人提供）：候选人Kristie Bjornson，博士，PT，儿科物理治疗师，华盛顿大学医学院/西雅图儿童研究所儿科助理教授。该奖项将使她成为以患者为导向的临床研究项目的独立研究者，该项目专注于改善脑瘫患者的活动和社会参与。这一总体目标将通过一个为期五年的培训、指导和研究项目来实现，具体目标如下：1)在日常生活中发展身体成分、能量消耗、流动和身体活动表现以及社会参与的测量知识和技能。2)在横断面描述性研究中使用技能来测试ICF成分之间的关系。3)增强对矫形器处方和生物力学的理解。4)在横断面矫形干预研究中开发方法和试点。5)拓展临床试验方法、研究管理/领导、拨款开发和学术写作方面的知识。候选人的赞助者是一名成熟的儿科研究人员和职业导师，而她的共同赞助者和咨询委员会代表与研究人群和职业发展计划直接相关的临床和研究专业知识。研究计划首先侧重于定义活动、参与（ICF）和身体组成之间的关系，这是一项针对流动CP儿童的描述性横断面研究。为了使ICF成为临床研究和实践的有用框架，需要澄清不同水平ICF相关的程度结果。其次，ICF分量关系将在一项随机交叉临床试验中进行测试，该试验采用新型动态加速度计测量，对使用固体踝关节足矫形器（SAFO）的动态脑瘫儿童的日常动态/身体活动表现和社会参与进行测试。没有公开的数据定义SAFO对身体和移动活动表现以及日常生活参与的影响。这一信息将有助于开发一个生命周期矫形管理算法的流动人员与CP。

DESCRIPTION (provided by applicant): The candidate, Kristie Bjornson, PhD, PT, is a pediatric physical therapist and Assistant Professor of Pediatrics, University of Washington School of Medicine/Seattle Children's Research Institute. This award will establish her as an independent investigator in a patient-oriented clinical research program of interventions focused on improving the activity and social participation of persons with cerebral palsy (CP). This overarching goal will be accomplished through a five-year program of training, mentoring and research with the following specific objectives: 1) Develop knowledge and skill in the measurement of body composition, energy expenditure, ambulatory and physical activity performance and social participation within the context of daily life. 2) Employ skills in a cross-sectional descriptive study testing the relationship of the ICF components. 3) Enhance understanding of orthotic prescription and biomechanics. 4) Develop methodology and pilot within a cross-sectional orthotic intervention study. 5) Expand knowledge of clinical trials methods, study management/leadership, grant development and scholarly writing. The candidate's sponsor is an established pediatric researcher and career mentor, while her co-sponsor and advisory committee represent clinical and research expertise directly related to the study population and career development plan. The research plan focuses first on defining the relationships of activity, participation (ICF) and body composition in a descriptive cross-sectional study of ambulatory children with CP. The extent outcomes at various levels of the ICF relate requires clarification in order for the ICF to be a useful framework for clinical research and practice. Secondarily, the ICF component relationships will be tested within a randomized cross-over clinical trial of solid ankle foot orthoses (SAFO) on daily ambulatory/physical activity performance and social participation on ambulatory children with cerebral palsy with novel ambulatory accelerometry measures. There are no published data defining the impact of SAFO on physical and ambulatory activity performance and participation in day to day life. This information will facilitate the development of a life span orthotic management algorithm for ambulatory persons with CP. Public Health Relevance: The PIs will explore the connection between what a child with cerebral palsy does physically during motor testing to what they 'actually' do during their day to day lives. The project will also test whether ankle braces help children with cerebral palsy do what they want to do when they want to do it. This information will be used to develop ankle bracing guidelines for persons with, cerebral palsy across the life span.