Slope walking and spinal plasticity in people with multiple sclerosis

多发性硬化症患者的斜坡行走和脊柱可塑性

• 批准号: 9036086
• 负责人: Manning Joseph Sabatier
• 金额: $ 7.8万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-30 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9036086
• 关键词: Address; Adult; Ankle; Biological Preservation; Clonus; Data; Development; Diagnosis; Disease Progression; Drops; Exercise; Flexor; Frequencies; Functional disorder; Future; Goals; Grant; H-Reflex; Health; Intervention; Knowledge; Laboratories; Leg; Lesion; Literature; Longitudinal Studies; Measurement; Measures; Mental Depression; Mission; Modeling; Movement; Multiple Sclerosis; Muscle Hypertonia; Nervous System Physiology; Neurologic; Neuronal Plasticity; Neurophysiology - biologic function; Outcome; Parkinson Disease; Participant; Physically Handicapped; Pilot Projects; Population; Productivity; Protocols documentation; Public Health; Quality of life; Reflex action; Rehabilitation therapy; Relapse; Research; Rest; Sensorimotor functions; Smooth Muscle; Speed; Spinal; Stroke; Survivors; Testing; Therapeutic; Training; Visit; Walking; Work; base; disability; experience; improved; improved functioning; innovation; nervous system disorder; presynaptic; programs; public health relevance; relating to nervous system; young adult

 DESCRIPTION (provided by applicant): There is a fundamental gap in understanding how best to use movement to minimize spasticity and maximize function and quality of life in people with MS. It is important to address this gap because spasticity is the most prevalent cause of neurological disability in young adults, and therapeutic options for people with MS are limited. Our long-term goal is to understand how neuroplasticity in people with MS can be exploited to improve function and quality of life. The objective of this application is to determine if downslop walking (DSW) as a functional movement changes spinal excitability as a measure of the underlying circuitry explaining neuroplasticity and sensorimotor function in MS. The central hypothesis is that DSW training will reduce spinal excitability and spasticity with a possible long term outcome of sustaining or improving walking ability in people with MS, in whom neural lesions negatively impact movement. This hypothesis has been formulated based on preliminary studies in the applicant's laboratory. The rationale for this research is that understanding how to tailor exercise training to target neuroplasticity is a necessary step in the development of strategies to stabilize or reverse disease progression and improve quality of life for people suffering from MS. Guided by preliminary data, this hypothesis will be testing by pursuing two specific aims: 1) Compare the effects of downslope, upslope and level treadmill walking on spinal excitability and ankle clonus in people with MS, and 2) Compare the effects of downslope, upslope and level treadmill walking on presynaptic inhibition in people with MS. A proven protocol established in the applicant's lab will be used to address these aims. H- reflexes and clonus will be measured while subjects are at rest, before and twice after 20 minutes of treadmill walking (at 10 min's and 45 min's post) during three visits. On one day the treadmill wil not be inclined, on another day the treadmill will be set at -7.5%, and on another day it will be set at +7.5%. The approach is innovative because it uses an inexpensive and accessible model of exercise based on promising evidence that it evokes spinal plasticity in a way that could benefit people with MS. The proposed pilot research is significant because it is expected to vertically advance and expand the understanding of how to tailor exercise to the specific needs of people with MS. Ultimately, this knowledge has the potential to inform the development of better exercise interventions that will help increase quality of life in people with MS.

 描述（由申请人提供）：在理解如何最好地使用运动来最大限度地减少MS患者的痉挛状态并最大限度地提高功能和生活质量方面存在根本性差距。解决这一差距很重要，因为痉挛状态是年轻人神经功能障碍的最常见原因，MS患者的治疗选择有限。我们的长期目标是了解如何利用MS患者的神经可塑性来改善功能和生活质量。本申请的目的是确定下坡行走（DSW）作为一种功能性运动是否改变脊髓兴奋性，作为解释MS中神经可塑性和感觉运动功能的潜在回路的测量。中心假设是DSW训练将降低脊髓兴奋性和痉挛，并可能长期存在。 维持或改善MS患者行走能力的长期结局，其中神经病变对运动产生负面影响。这一假设是根据申请人实验室的初步研究提出的。这项研究的基本原理是，了解如何 针对神经可塑性的运动训练是制定稳定或逆转疾病进展和改善MS患者生活质量的策略的必要步骤。在初步数据的指导下，将通过追求两个具体目标来测试这一假设：1）比较下坡、上坡和水平踏车行走对MS患者脊髓兴奋性和踝阵挛的影响，和2）比较下坡、上坡和水平踏车行走对患有MS的人的突触前抑制的影响。在申请人的实验室中建立的经证实的方案将用于解决这些目标。在三次访视期间，将在受试者休息时、在踏车行走20分钟之前和之后两次（在10分钟和45分钟之后）测量H反射和阵挛。一天跑步机不倾斜，另一天跑步机将设置为-7.5%，另一天将设置为+7.5%。该方法是创新的，因为它使用了一种廉价且易于使用的运动模型，该模型基于有希望的证据，即它以一种可能使MS患者受益的方式唤起脊柱可塑性。拟议的试点研究意义重大，因为它有望纵向推进并扩大对如何根据MS患者的特定需求量身定制运动的理解。这些知识有可能为开发更好的运动干预提供信息，这将有助于提高MS患者的生活质量。