Sensory contributions to typical and atypical development of trunk control

感官对躯干控制的典型和非典型发展的贡献

• 批准号: 8688400
• 负责人: SANDRA L SAAVEDRA
• 金额: $ 13.53万
• 依托单位: UNIVERSITY OF HARTFORD
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8688400
• 关键词: 4 year old; Activities of Daily Living; Address; Adult; Affect; Age; Age-Months; Benchmarking; Biomechanics; Cerebral Palsy; Child; Childhood; Chronic; Chronic Disease; Complement; Complex; Conflict (Psychology); Cross-Sectional Studies; Cutaneous; Data; Data Set; Databases; Deglutition; Development; Devices; Disease; Eating; Equilibrium; Evaluation; Family; Feedback; Force of Gravity; Foundations; Freedom; Future; Goals; Grant; Growth; Head; Infant; Intervention; Knowledge; Lead; Life; Literature; Longitudinal Studies; Measures; Methods; Modeling; Motor; Motor Skills; Musculoskeletal; Musculoskeletal Equilibrium; Nature; Neuraxis; Neurologic; Noise; Participant; Postural response; Posture; Reliance; Research; Research Personnel; Sensory; Speech; Staging; Stimulus; Surface; System; Testing; Time; Visual; Walking; Weight-Bearing state; base; care systems; critical period; disability; improved; innovation; insight; kinematics; model development; motor control; motor deficit; novel; outcome forecast; public health relevance; relating to nervous system; research study; response; sensory feedback; sensory system; skill acquisition; skills; somatosensory; visual feedback; visual-vestibular

DESCRIPTION (provided by applicant): One of the major challenges of motor control is to understand how the central nervous system controls the degrees of freedom of the body. This is particularly evident in cerebral palsy (CP), which is the most prevalent chronic childhood motor disability and is one of the most disabling and costly chronic disorders of children and adults. Deficits in postural control and sensorimotor integration are hallmarks of CP. Thirty-three percent of children with CP never achieve stable sitting balance in spite of current treatments. Although postural control of the trunk for independent sitting creates the foundation for all other motor tasks, surprisingly little is known about how infants use sensory input to guide their development of upright control (which typically occurs by 8 months of age). This lack of knowledge limits our ability to effectively assess and treat children with neuromotor deficits in trunk control. AIM 1 will identify sensory reliance and sensory reweighting in a longitudinal study of typically developing (TD) infants prior to, and during, development of stable sitting (1-8 months of age). AIM 2 will identify sensory reliance and sensory reweighting in a cross sectional study of children with moderate-to-severe CP (4-12 yrs of age). A novel trunk support device will enable testing of participants who lack (or are still developing) stable sitting. In experiments, kinematics of the head and trunk will be measured. Sensory reliance and reweighting will be identified from postural trunk responses to sensory conflict stimuli consisting of tilts of a visua surround and/or tilts of a surface which participants sit upon. Generally, participants with a high reliance on vestibular feedback will remain upright with respect to gravity during all tests; whereas a high reliance on cutaneous or visual feedback will produce trunk sway away from upright and toward the surface or visual surround tilt, respectively. To tease apart biomechanical, physical, and neurological contributions to trunk sway, sensorimotor integration modeling will be used to complement data interpretation. Knowledge obtained from this study will allow clinicians to develop new methods of assessment and intervention and may lead to creation of novel support devices for children with moderate-to-severe CP. The identification of sensorimotor integration during typical development will provide benchmarks for comparison with a variety of other neural or musculoskeletal deficits that affect trunk control, including CP.It is anticipated that, in addition to identification of sensory reliance, the rich data set collectedand quantitative model development will give insight into questions about sensorimotor noise, variability, system linearity, and internal models, generating pilot data and refining hypotheses for future R01 grants.

描述（由申请人提供）：运动控制的主要挑战之一是了解中枢神经系统如何控制身体的自由度。这在脑瘫（CP）中尤其明显，脑瘫是最普遍的慢性儿童运动障碍，并且是儿童和成人中最致残和最昂贵的慢性疾病之一。姿势控制和感觉运动整合的缺陷是CP的标志。33%的脑瘫儿童从未达到稳定的坐姿平衡，尽管目前的治疗。虽然躯干的姿势控制为独立坐创造了基础， 运动任务，令人惊讶的是，很少有人知道婴儿如何使用感觉输入来指导他们的直立控制（通常发生在8个月大）的发展。这种知识的缺乏限制了我们有效评估和治疗躯干控制神经运动缺陷儿童的能力。AIM 1将在一项纵向研究中确定感觉依赖和感觉重新加权 典型发育（TD）婴儿在发展稳定坐姿之前和期间（1-8个月大）的年龄。AIM 2将在一项中重度CP儿童（4-12岁）的横断面研究中确定感觉依赖和感觉重新加权。一种新型的躯干支撑装置将能够测试缺乏（或仍在发展）稳定坐姿的参与者。在实验中，将测量头部和躯干的运动学。感觉依赖和重新加权将从躯干对感觉冲突刺激的姿势反应中识别，所述感觉冲突刺激包括视觉环境的倾斜和/或参与者坐在其上的表面的倾斜。一般来说，参与者高 在所有测试期间，对前庭反馈的依赖将相对于重力保持直立;而对皮肤或视觉反馈的高度依赖将分别产生躯干远离直立方向和朝向表面或视觉环绕倾斜的摇摆。梳理除了生物力学，物理和神经系统的贡献躯干摇摆，感觉运动整合建模将用于补充数据解释。从这项研究中获得的知识将使临床医生能够开发新的评估和干预方法，并可能为中重度CP儿童创造新的支持设备。在典型发育过程中识别感觉运动整合将为与影响躯干控制的各种其他神经或肌肉骨骼缺陷（包括CP）进行比较提供基准。预计，除了识别感觉依赖外，收集的丰富数据集和定量模型开发将深入了解感觉运动噪声、变异性、系统线性和内部模型等问题，生成试验数据并为将来的R 01赠款改进假设。