权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Mechanisms underlying impaired postural corrections following stroke

中风后姿势矫正受损的机制

基本信息

批准号：
9269590
负责人：
CLAIRE F. HONEYCUTT
金额：
$ 24.46万
依托单位：
ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-02-05 至 2019-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9269590
关键词：
Address Agonist Automobile Driving Bilateral Caring Complex Data Development Effectiveness Elderly Electromyography Equilibrium Fall prevention Family Flexor Future Goals Hospitals Impairment Incidence Individual Involuntary Movements Knowledge Lead Limb structure Link Measures Mediating Motor Movement Muscle Outcome Study Paresis Patients Pattern Performance Persons Population Posture Prevention program Public Health Quality of life Recovery Reflex action Rehabilitation therapy Reporting Risk Factors Role Shapes Stereotyping Stimulus Stroke Surface Time Toes Training Training Programs Translations United States Weight Work arm arm movement base cost effective therapy exercise intervention fall risk falls improved individualized medicine kinematics limb movement medical complication motor impairment post stroke programs relating to nervous system response stroke survivor treadmill

项目摘要

PROJECT ABSTRACT/SUMMARY Fall prevention programs have had mixed results highlighting the need for more effective therapies that tackle the most common medical complication in stroke survivors. Task-specific training, which directly targets improving an individual's response during a fall, offers potential. The long-term goal of this proposal is to develop task-specific training that accounts for the unique balance challenges of stroke survivors that is both effective and time efficient. The ability to implement a task-specific training program in stroke survivors is thwarted by a lack of empirical evidence about which factors and mechanisms lead to a failed recovery during a balance disturbance in this population. An essential component of a successful recovery (avoidance of a fall) is compensatory limb movement – taking a step to regain balance or reaching to a stable surface. We recently noted important similarities between compensatory movements and startle-evoked movements – the involuntary release of planned movement when exposed to startling stimuli. Specifically, startle-evoked and compensatory movements share similar deficits following stroke – delayed, diminished muscle activity, and inappropriate patterns of muscle activation. Thus our central hypothesis is that deficits in compensatory movements post-stroke are driven by deficits in startle-evoked movements. In Aim 1, our objective is to quantify stroke survivors' response during a balance disturbance identifying the key, trainable factors that lead to unsuccessful recovery (i.e. a fall). In brief, stroke survivors will be exposed to backward translations of a treadmill while quantifying stability measures, trunk and step kinematics, paretic limb parameters, and electromyography. Factors will be assessed for their ability to classify successful (fall avoidance) and failed (fall) recoveries. These factors can then be assessed for trainability in future task-specific training paradigms for stroke survivors. In Aim 2, we will pursue identification of the mechanism driving deficits in compensatory movements to arm perturbation in stroke survivors. Our objective is to evaluate the impact of deficits in startle- evoked movement on the ability of stroke survivors to effectively compensate during an arm perturbation. To precisely control perturbation parameters and allow bilateral assessment of paretic and non-paretic limbs, we will evaluate subjects while seated. In Aim 3, we will combine knowledge gained in Aims 1 & 2 and evaluate the link between factors that contribute to falls and the mechanisms proposed. Our objectives are to 1) evaluate the link between triggering a startle-evoked movement and successful compensatory movement during a balance challenge in unimpaired individuals and 2) evaluate the relationship between deficits in startle-evoked movement and deficits in compensatory limb movements post-stroke. The rationale for the proposal is to establish both the factors and mechanisms driving unsuccessful recovery during a fall post- stroke in order to generate an effective task-specific training paradigm in the next application.

项目摘要/总结跌倒预防计划的结果喜忧参半，强调需要更有效的治疗方法，中风幸存者最常见的并发症针对具体任务的培训，直接针对改善个人在跌倒时的反应，提供了潜力。该提案的长期目标是开发针对特定任务的训练，以应对中风幸存者独特的平衡挑战，有效和时间效率。在中风幸存者中实施特定任务训练计划的能力是由于缺乏关于哪些因素和机制导致复苏失败的经验证据，这个种群的平衡紊乱成功恢复的重要组成部分（避免跌倒）是肢体的补偿运动--迈出一步以恢复平衡或到达一个稳定的表面。我们最近注意到补偿运动和惊吓诱发运动之间的重要相似之处-- 当暴露在令人吃惊的刺激下时，无意识地释放计划的运动。具体来说，中风后的代偿性运动也有类似的缺陷-延迟，肌肉活动减少，肌肉活动的不适当模式。因此，我们的中心假设是，中风后的运动是由惊吓诱发的运动的缺陷驱动的。在目标1中，我们的目标是量化中风幸存者在平衡障碍期间的反应，确定导致不成功的恢复（即跌倒）。简而言之，中风幸存者将暴露于一个跑步机，同时量化稳定性指标、躯干和步伐运动学、麻痹肢体参数，以及肌电图将评估因素对成功（避免跌倒）和失败进行分类的能力（秋季）回收。这些因素可以在未来的特定任务培训模式中进行评估中风幸存者的治疗在目标2中，我们将继续识别代偿性损伤的驱动机制。中风幸存者的手臂运动。我们的目标是评估财政赤字的影响- 诱发运动对中风幸存者在手臂扰动期间有效补偿的能力的影响。到精确控制扰动参数，并允许双侧评估麻痹和非麻痹肢体，我们会在坐着的时候评估实验对象在目标3中，我们将联合收割机结合目标1和目标2中获得的知识，导致福尔斯的因素与提出的机制之间的联系。我们的目标是：（1）评估触发惊吓诱发运动和成功代偿运动之间的联系在未受损个体的平衡挑战期间，以及2）评估中风后的惊吓诱发运动和代偿性肢体运动缺陷。的理由建议是建立因素和机制，推动不成功的复苏，在秋季后，中风，以便在下一个应用中产生有效的任务特定的训练范例。