Quantifying proprioceptive acuity in individuals with motor disability

量化运动障碍患者的本体感觉敏锐度

• 批准号: 8392036
• 负责人: Paul Cordo
• 金额: $ 25.63万
• 依托单位: AMES TECHNOLOGY, INC.
• 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 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8392036
• 关键词: Address; Affect; Articular Range of Motion; Biofeedback; Body part; Brain; Chronic; Clinic; Clinical; Clinical Assessment Tool; Clinical Research; Computer software; Data; Devices; Diagnosis; Diagnostic; Disease; Effectiveness; Esthesia; Goals; Hand; Impairment; Individual; Injury; Intervention; Investigation; Joints; Laboratories; Lead; Limb structure; Location; Lower Extremity; Measurement; Measures; Medical; Monitor; Motion; Motor; Movement; Movement Disorders; Multicenter Studies; Nervous System Trauma; Outcome; Paralysed; Participant; Patients; Persons; Phase; Positioning Attribute; Proprioception; Recovery; Rehabilitation device; Research; Robotics; Sensory; Spinal Cord; Spinal cord injury; Stroke; Test Result; Testing; Therapeutic; Traumatic Brain Injury; Treatment Protocols; Upper Extremity; acronyms; arm; disability; functional restoration; improved; motor deficit; motor impairment; nervous system disorder; novel strategies; novel therapeutic intervention; response; robotic device; software development; somatosensory; tool

DESCRIPTION (provided by applicant): Volitional, coordinated movement depends on proprioception to the extent that a loss of proprioception can lead to a lifetime of dyscoordinated movement. Proprioception can be adversely affected by spinal cord injury (SCI), stroke, and traumatic brain injury (TBI). Given the influence of proprioception on normal movement and on movement disorders, the PI's laboratory has developed a novel approach to treat sensory and motor impairments in the limbs of persons with SCI, stroke, and TBI. This approach involves a robotic rehabilitation device that helps a patient move the affected limb while providing somatosensory stimulation. This approach is called AMES: Assisted Movement with Enhanced Sensation. Clinical studies have shown that AMES treatment reduces impairments, which can lead to a restoration of functional movement. The objective of the proposed research is to develop a proprioception assessment tool for the AMES robotic device, which will be used, in conjunction with existing tests of motor impairment, to track the level of sensory impairment while a patient is treated with AMES. The hypothesis underlying this proposed study is that, in persons with somatosensory, as well as motor, impairments, recovery of somatosensation is a prerequisite to the recovery of motor function. The proposed research has 2 specific aims. The first aim is to develop software to implement a proprioception assessment tool on an existing AMES robotic device, to modify the hardware of the device so that the proprioceptive acuity of patients with severe motor disability can be quantified, and to bench-test the new software and hardware. The second aim is to evaluate, preliminarily, this clinical assessment tool on a small number of persons with chronic incomplete SCI and to compare the results from the proprioception assessment tool to other existing somatosensory tests currently in use, in the clinic. Test results from this proposed research will then form the preliminary data for a Phase 2 application to validate the proprioception assessment tool in a multicenter study involving a larger group of SCI participants. PUBLIC HEALTH RELEVANCE: This research addresses the need for an objective, quantitative assessment of proprioception that can be used, to evaluate the extent and type of proprioceptive loss in patients with motor deficits. With this proprioception assessment tool, clinicians using the AMES robotic device therapeutically may be better able to monitor the progressive loss or recovery of proprioceptive acuity in response to disease or to medical interventions, thereby guiding decisions about the treatment regimen to be used.

描述（由申请人提供）：意志，协调的运动取决于本体感觉，本体感觉的丧失可能导致终身不协调 运动本体感觉可受到脊髓损伤（SCI）、中风和创伤性脑损伤（TBI）的不利影响。鉴于本体感觉对正常运动和运动障碍的影响，PI的实验室开发了一种新的方法来治疗SCI，中风和TBI患者肢体的感觉和运动障碍。这种方法涉及一种机器人康复设备，可以帮助患者移动受影响的肢体，同时提供体感刺激。这种方法被称为艾姆斯：具有增强感觉的辅助运动。临床研究表明，艾姆斯治疗可以减少损伤，从而恢复功能性运动。拟议研究的目的是为艾姆斯机器人设备开发一种本体感觉评估工具，该工具将与现有的运动障碍测试结合使用，以跟踪患者接受艾姆斯治疗时的感觉障碍水平。这项研究的假设是，在有躯体感觉和运动障碍的人中，躯体感觉的恢复是运动功能恢复的先决条件。本研究有两个具体目标。第一个目标是开发软件，以实现现有的艾姆斯机器人设备上的本体感觉评估工具，修改设备的硬件，使严重运动障碍患者的本体感觉敏锐度可以量化，并对新的软件和硬件进行台架测试。第二个目的是初步评估，这种临床评估工具对少数慢性不完全性SCI患者，并比较本体感觉评估工具的结果，目前在临床上使用的其他现有的体感测试。然后，这项拟议研究的测试结果将形成第2阶段应用的初步数据，以在涉及更多SCI参与者的多中心研究中验证本体感觉评估工具。 公共卫生相关性：这项研究解决了需要一个客观的，定量的评估本体感觉，可以用来评估运动障碍患者的本体感觉丧失的程度和类型。利用该本体感受评估工具，在治疗上使用艾姆斯机器人设备的临床医生可以更好地监测本体感受敏锐度响应于疾病或医疗干预的逐渐丧失或恢复，从而指导关于待使用的治疗方案的决定。