Human Locomotor Plasticity in Health and Disease

健康和疾病中的人类运动可塑性

• 批准号: 8912317
• 负责人: Amy J. Bastian
• 金额: $ 56.41万
• 依托单位: HUGO W. MOSER RES INST KENNEDY KRIEGER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8912317
• 关键词: Adult; Aging; Behavior; Behavioral Paradigm; Brain; Cerebellum; Complex; Disease; Environment; Exercise; Feedback; Gait; Goals; Health; Human; Impairment; Individual; Intervention; Knee; Learning; Length; Methods; Motor; Motor Cortex; Movement; Nervous System Trauma; Pathology; Patients; Pattern; Population; Psychological reinforcement; Regimen; Rehabilitation therapy; Rewards; Schedule; Speed; Staging; Stimulus; Stroke; Sum; Survivors; Testing; Time; Training; Translating; Visual; Walking; Work; base; chronic stroke; combinatorial; design; flexibility; follow-up; improved; motor learning; novel; response; virtual; visual motor; walking rehabilitation

DESCRIPTION (provided by applicant): Walking ability is an important predictor of health and survival in aging populations. This proposal will provide a scientific basis for designing walking rehabilitation regimens that take maximum advantage of 3 distinct forms of motor learning: instructive, adaptive and reinforcement learning. We will determine how these 3 motor learning mechanisms interact in people with and without neurological damage, and how they can be augmented with non-invasive brain stimulation. Our overarching goal is to understand how different learning circuits communicate, synergize, or interfere with each other. In Aim 1 we will determine the advantages of instructive, adaptive, and reinforcement learning of a new walking pattern. We will study each learning mechanism in isolation and in combinations, analyzing the (a) acquisition rates of new walking patterns, (b) immediate and long-term retention of patterns, and (c) transfer of new patterns to natural, over ground walking. We hypothesize that careful scheduling of instructive, adaptive, and reinforcement training is essential to optimize learning and avoid interference between mechanisms. In Aim 2 we will determine the advantages of learning multiple features of walking simultaneously. We will use dual adaptation (e.g. visuomotor adaptation and split-belt adaptation) to simultaneously train two features of the walking pattern in healthy adults and chronic stroke patients. In Aim 3, we will develop specific schedules of training, combining learning mechanisms and non-invasive brain stimulation to mitigate the walking deficits of stroke patients. We will study staged use of learning mechanisms with and without non-invasive brain stimulation in a 4-week training paradigm (with 1 and 3 month tests of retention). We hypothesize that cerebral stroke patients will benefit from specific combinations of the 3 learning mechanisms, and from non-invasive brain stimulation. In sum, this comprehensive study will provide fundamental information about how instructive, adaptive, and reinforcement motor learning mechanisms interact in training regimens for rehabilitation.

描述（由申请人提供）：行走能力是老年人群健康和生存的重要预测因素。该建议将为设计步行康复方案提供科学依据，这些方案将最大限度地利用3种不同形式的运动学习：指导性学习，自适应学习和强化学习。我们将确定这3种运动学习机制如何在有和没有神经损伤的人中相互作用，以及如何通过非侵入性脑刺激来增强它们。我们的首要目标是了解不同的学习回路如何相互沟通、协同或干扰。在目标1中，我们将确定新的步行模式的指导性，自适应和强化学习的优点。我们将研究每一种学习机制的孤立和组合，分析（a）收购率的新的步行模式，（B）立即和长期保留的模式，（c）转移的新模式，自然，在地面上行走。我们假设精心安排指导性，自适应和强化训练对于优化学习和避免机制之间的干扰至关重要。在目标2中，我们将确定同时学习行走的多个特征的优势。我们将使用双重适应（例如视觉适应和分裂带适应）来同时训练健康成人和慢性中风患者的行走模式的两个特征。在目标3中，我们将制定具体的训练计划，结合学习机制和非侵入性脑刺激，以减轻中风患者的行走缺陷。我们将在为期4周的训练范例中研究有无无无创脑刺激的学习机制的阶段性使用（1个月和3个月的保留测试）。我们假设脑卒中患者将受益于3种学习机制的特定组合，以及非侵入性脑刺激。总之，这项全面的研究将提供有关指导性，适应性和强化运动学习机制如何在康复训练方案中相互作用的基本信息。