Robotic Interventions to Enhance Locomotor Stability Following Spinal Cord Injury

描述(由申请人提供) 项目概述：该提案的主要目标是开发和测试一种能够为患有脊髓损伤(SCI)的退伍军人提供有针对性的运动平衡训练的机器人设备。工作假设是，这种新型机器人工具将把传统的体重支撑跑步机训练(BWSTT)转变为一个动态环境，在这个环境中，特定于行走的平衡成分被测量并自适应地挑战，从而提高运动训练结果。 候选人：戈登博士的目标是在退伍军人管理局系统内建立一条新的、富有成效的、独立的研究路线，使受脊髓损伤影响的退伍军人的生活质量受益。戈登博士在脊髓损伤的步态康复方面有丰富的研究经验。他观察到，这一领域缺乏有效的运动平衡训练和评估工具。在这个有目的的项目中，戈登博士将开发一种新的机器人设备，能够满足这种需求。将戈登博士过去的经验与当前项目中的培训结合起来，将使戈登博士处于这一未被探索的SCI步态康复领域的前沿。 研究发展计划：Gordon博士组建了一个由Zev Rmer博士领导的多元化指导团队，在四个关键项目领域提供培训和指导：康复机器人、脊髓损伤后运动的神经生理学、运动平衡和脊髓损伤的临床护理。戈登博士将通过课程作业、定向阅读和临床跟踪相结合的方式来提高他对这些领域的正式知识。戈登博士还将通过定期小组辅导会议、积极撰写手稿/赠款以及参与赠款撰写和领导力研讨会，在建立、资助和发展富有成效的独立研究计划方面接受职业发展指导。 环境：拟议的研究项目将在芝加哥康复研究所(RIC)的感觉运动表现计划内的VA指定空间进行，芝加哥康复研究所是全国排名最高的康复医院。RIC提供的资源包括专门的研究空间和设备、临床检查区域、办公空间和机械车间。临床培训和脊髓损伤退伍军人的初步招募将通过小爱德华·海因斯的脊髓损伤服务进行。退伍军人医院。 拟议研究：目标1)创建能够提供具有挑战性的、特定于平衡的运动训练的机器人环境库。申请人建议开发一种智能机器人康复工具，该工具能够A)应用一系列动态平衡环境，包括稳定和/或破坏在步态期间施加于骨盆的侧向力，B)实时测量运动稳定性，以及C)自动调整平衡环境的难度，以最佳地挑战参与者的能力。该装置将由一个固定在骨盆背带后部的移动线圈强制装置(直线电机)组成。软件将控制线圈加力沿垂直于跑步机的轨道移动。因此，线圈夹持器的移动将对使用者施加内侧力。他将开发软件来创建几个特定于平衡的训练环境，这些环境可以在跑步机行走期间安全而轻松地提供给SCI患者。目的2)研究定向运动平衡训练对不完全性脊髓损伤患者步态稳定性、步行速度和能量效率的影响。他将比较在三种特定平衡训练环境中进行的BWSTT的效果。活动不完全性脊髓损伤患者将接受BWSTT，1)要求严格的动态平衡环境，在步态中自动和逐步地适应持续挑战受试者；2)无平衡辅助(类似于在跑步机上无人辅助行走)；或3)固定平衡辅助(类似于目前的BWSTT方法)。他假设，动态平衡环境将在行走速度、精力充沛的步态效率和对步态扰动的反应能力方面产生最大程度的改善。

DESCRIPTION (provided by applicant) Project Overview: The major goals of this proposal are to develop and test a robotic device capable of providing targeted locomotor balance training for veterans with spinal cord injury (SCI). The working hypothesis is that this novel robotic tool will transform traditional body weight supported treadmill training (BWSTT) into a dynamic environment where balance-specific components of walking are measured and adaptively challenged, thereby enhancing locomotor training outcomes. Candidate: Dr. Gordon's objective is to establish a novel and productive, independent line of research within the VA system that will benefit the quality of life of veterans affected by SCI. Dr. Gordon has significant research experience in gait rehabilitation of SCI. He has observed that effective locomotor balance training and assessment tools are lacking within this field. For the purposed project, Dr. Gordon will develop a new robotic device capable of addressing this need. Combining Dr. Gordon's past experience with the training purposed in the current project will position Dr. Gordon at the forefront of this under-explored area of SCI gait rehabilitation. Research Development Plan: Dr. Gordon has assembled a diverse mentoring team, lead by Dr. Zev Rymer, to provide training and guidance in four critical project areas; rehabilitation robotics, neurophysiology of movement following SCI, locomotor balance and clinical care of SCI. Dr. Gordon will advance his formal knowledge of these areas through a combination of course work, directed readings and clinical shadowing. Dr. Gordon will also receive career development guidance in terms of establishing, funding and growing a productive independent research program through regular group mentoring sessions, active manuscript/grant writing and participation in grant writing and leadership seminars. Environment: The proposed research project will be conducted in VA designated space within the Sensory Motor Performance Program at the Rehabilitation Institute of Chicago (RIC), the top ranked rehabilitation hospital in the country. The resources provided by RIC include dedicated research space and equipment, clinical examination areas, offices space and machine shop. Clinical training and the primary recruitment of veterans with SCI will be performed through the Spinal Cord Injury Service at Edward Hines Jr. VA Hospital. Proposed Research: Aim 1) To create a library of robotic environments capable of providing challenging, balance-specific locomotor training. Applicant proposes to develop an intelligent robotic rehabilitation tool capable of A) applying a range of dynamic balance environments, including stabilizing and/or destabilizing lateral forces applied to the pelvis during gait, B) measuring locomotor stability in real-time and C) automatically adjusting the difficulty of the balance environments to optimally challenge the abilities of the participant. The device will consist of a moving coil forcer (linear motor) rigidly attached to the posterior of a pelvic harness. Software will control travel of the coil forcer along a track aligned perpendicular to the treadmill. Thus, movement of the coil forcer will exert a medial-lateral force on the user. He will develop software to create several balance-specific training environments that can be safely and easily delivered to people with SCI during treadmill walking. Aim 2) To test the effects of targeted locomotor balance training on gait stability, walking speed and energetic efficiency in incomplete SCI subjects. He will compare the effects of BWSTT performed in one of three balance-specific training environments. Ambulatory incomplete SCI subjects will receive BWSTT with either 1) a demanding dynamic balance environment that automatically and progressively adapts to continuously challenge the subject during gait; 2) no balance assistance (similar to unassisted walking on a treadmill); or 3) fixed balance assistance (similar to current approaches to BWSTT). He hypothesizes that the dynamic balance environment will result in the greatest improvements in walking speed, energetic gait efficiency and the ability to respond to gait perturbations.