Multidirectional Treadmill Walking in Parkinson Disease

帕金森病的多向跑步机行走

• 批准号: 8278264
• 负责人: Monthaporn S Bryant
• 金额: --
• 依托单位: MICHAEL E DEBAKEY VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8278264
• 关键词: Address; Behavior; Biomechanics; Caring; Clinical; Clinical Research; Commit; Country; Dose; Education; Effectiveness; Equilibrium; Evaluation; Exercise; Fatigue; Freezing; Functional disorder; Gait; Gait abnormality; Goals; Health; Intervention; Left; Length; Life; Measurement; Measures; Mediating; Medical; Medical center; Medicine; Mental Depression; Mentors; Mission; Monitor; Motion; Motor; Musculoskeletal Equilibrium; Neurologist; Operative Surgical Procedures; Outcome; Pain; Parkinson Disease; Patient Care; Persons; Phase; Physical Medicine; Quality of life; Quantitative Evaluations; Randomized; Recruitment Activity; Rehabilitation therapy; Research; Research Project Grants; Safety; Sleep; Speed; Step Tests; Step training; Symptoms; System; Testing; Texas; Time; Training; Universities; Veterans; Waiting Lists; Walking; Work; career development; cognitive function; college; computerized; control trial; data acquisition; design; disability; equilibration disorder; executive function; experience; falls; follow-up; frontal lobe; gait examination; improved; indexing; interest; kinematics; member; professor; rehabilitation science; response; skills; spatiotemporal; tool

DESCRIPTION: Dr. Monthaporn S Bryant is a physical therapist and an assistant professor in the University of Texas Medical Branch, Division of Rehabilitation Sciences, Galveston and an adjunct assistant professor in the Baylor College of Medicine, Department of Physical Medicine and Rehabilitation in Houston. Her research work has focused on the rehabilitation of persons with Parkinson's disease (PD) at the Michael E. DeBakey VA Medical Center (MEDVAMC) in Houston. Dr. Bryant has experience in rehabilitation intervention for gait, gait analysis and exercise in persons with PD, as well as experience in conducting clinical studies within the VA system. The aim of the proposed research project is to study the effectiveness of multidirectional treadmill training (MDTT) in improving gait and balance in veterans with PD. Despite advances in both medical and surgical treatments, postural and gait instability are still significant problems, and necessitate rehabilitative interventions. The project will target veterans with PD who experience gait difficulty, impaired balance, freezing and/or fall. The first phase of the study will develop dose-response profile of MDTT to be used in the second phase. The second phase will study the effectiveness of MDTT in both clinical and biomechanical quantitative outcomes. Clinical outcomes will include PD symptoms, clinical gait and balance evaluations. Quantitative evaluations will include gait kinematics and computerized posturography. The design will be a randomized, wait-list controlled trial to evaluate the efficacy of MDTT to improve gait and balance. The intervention will consist of walking on a treadmill at a fastest tolerated speed in 4 directions (forward, backward, sideways) while supported in a harness for safety. The training will occur 3 times per week for 8 weeks. Follow-up assessments will be obtained at 4 months after the end of MDTT. Veterans with PD will be recruited from MEDVAMC in Houston. Dr. Eugene C Lai (Neurologists), Dr. William Paloski (Biomechanics), Dr. Kenneth Ottenbacher (Rehabilitation), and Dr. Michele York (Neuropsychologist) are members of a mentoring team for supporting Dr. Bryant's interests and training goals. The specific purposes of this career development proposal are to: 1) understand overall management for PD, and correct use of standardized PD clinical scales; 2) develop a dose-response profile of MDTT to gait and balance; 3) study the changes from MDTT in both clinical and quantitative outcomes; and 4) study the influence of MDTT on cognitive function and other non-motor symptoms of PD. Dr. Bryant will be trained in overall management and assessment of PD, biomechanical measurement (motion analysis), data acquisition and interpretation, non-motor symptom and cognitive function assessment. These tools will be used for the assessment of changes from MDTT. PUBLIC HEALTH RELEVANCE: Relevance to Veterans Health: An estimated 40,000 Veterans with Parkinson's disease (PD) receive care from VA facilities annually; many have difficulties with gait and balance leading to falls and subsequence disability. The VA is committed to improving care and finding a cure for PD as evidenced by creation six Parkinson's Disease Research, Education, and Clinical Centers in the country. The proposal is highly relevant to the VA patient care mission. The proposed research seeks to demonstrate the efficacy of a new rehabilitative intervention to address gait and balance deficits and to better understand the possible mechanism underlying the intervention. Veterans with PD will be recruited to participate in the proposed study and the results will be generalized to other Veterans with PD who receive care from VA facilities. In summary, care and quality of life in Veterans living with PD will be improved.

产品说明： 博士Monthaporn S Bryant是加尔维斯顿德克萨斯大学医学分支康复科学部的物理治疗师和助理教授，也是休斯顿贝勒医学院物理医学和康复系的兼职助理教授。她的研究工作主要集中在迈克尔E。DeBakey VA Medical Center（MEDVAMC），休斯敦Bryant博士在PD患者的步态康复干预、步态分析和运动方面具有丰富经验，并在VA系统内进行临床研究。该研究项目的目的是研究多向跑步机训练（MDTT）在改善PD退伍军人步态和平衡方面的有效性。尽管医学和手术治疗都取得了进展，但姿势和步态不稳定仍然是重要的问题，需要进行康复干预。该项目将针对患有PD的退伍军人，他们经历步态困难，平衡受损，冻结和/或跌倒。研究的第一阶段将建立MDTT的剂量-反应曲线，用于第二阶段。第二阶段将研究MDTT在临床和生物力学定量结果方面的有效性。临床结局将包括PD症状、临床步态和平衡评价。定量评估将包括步态运动学和计算机姿势描记术。该设计将是一项随机、等待列表对照试验，以评估MDTT改善步态和平衡的疗效。干预将包括在跑步机上以最快的耐受速度在4个方向（向前、向后、侧向）上行走，同时使用安全带进行支撑。培训将每周进行3次，持续8周。将在MDTT结束后4个月获得随访评估。患有PD的退伍军人将从休斯顿的MEDVAMC招募。尤金·C·赖博士（神经学家）、威廉·帕洛斯基博士（生物力学）、肯尼思·奥滕巴赫博士（康复）和米歇尔·约克博士（神经心理学家）是支持布莱恩特博士兴趣和培训目标的指导团队成员。本职业发展提案的具体目的是：1）了解PD的整体管理，并正确使用标准化PD临床量表; 2）建立MDTT对步态和平衡的剂量反应曲线; 3）研究MDTT在临床和定量结果方面的变化;和4）研究MDTT对认知功能和PD其他非运动症状的影响。Bryant博士将接受PD的整体管理和评估、生物力学测量（运动分析）、数据采集和解释、非运动症状和认知功能评估方面的培训。这些工具将用于评估千年发展目标技术转让的变化。 公共卫生相关性： 与退伍军人健康相关：据估计，每年有40，000名患有帕金森病（PD）的退伍军人接受VA设施的护理;许多人在步态和平衡方面有困难，导致福尔斯和随后的残疾。退伍军人事务部致力于改善护理和寻找治疗帕金森病的方法，在该国建立了六个帕金森病研究，教育和临床中心。该提案与VA患者护理使命高度相关。拟议的研究旨在证明一种新的康复干预措施对解决步态和平衡缺陷的有效性，并更好地了解干预的可能机制。将招募患有PD的退伍军人参与拟定的研究，并将结果推广到接受VA机构护理的其他患有PD的退伍军人。总之，PD患者的护理和生活质量将得到改善。