Locomotor learning in infants at high risk for cerebral palsy

脑瘫高危婴儿的运动学习

• 批准号: 9887789
• 负责人: Hlapang A. Kolobe
• 金额: $ 80.72万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-18 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9887789
• 关键词: Adult; Age-Months; Behavior; Biomechanics; Brain; Caring; Cerebral Palsy; Characteristics; Child; Cognition; Complex; Data; Dependence; Development; Disease; Enrollment; Ensure; Environment; Equilibrium; Evolution; Failure; Funding; Future; Goals; Health; Human; Impairment; Individual; Infant; Lead; Learning; Leg; Life; Link; Locomotion; Locomotor training; Longevity; Longitudinal Studies; Measures; Mediating; Mediator of activation protein; Mission; Modeling; Motivation; Motor; Motor Skills; Movement; Multi-Institutional Clinical Trial; Musculoskeletal Equilibrium; National Institute of Child Health and Human Development; Neonatology; Neuronal Plasticity; Pattern; Personal Satisfaction; Pilot Projects; Population; Productivity; Protocols documentation; Psychological Transfer; Psychological reinforcement; Public Health; Rehabilitation therapy; Research; Rewards; Risk; Robotics; Role; Shapes; Site; Societies; Technology; Time; Toddler; Training; Travel; Walkers; Walking; Work; base; behavior observation; comparative efficacy; computer science; critical period; design; disability; efficacy study; evidence base; experience; high risk; improved; infancy; learning strategy; longitudinal design; motor control; motor learning; nervous system disorder; neurobehavioral; novel; peer; physically handicapped; predictive modeling; sensor technology; skill acquisition; skills; time use; wearable sensor technology

PROJECT SUMMARY Physical disability in individuals with cerebral palsy (CP) is caused by a failure to learn and/or refine motor control during the first two years of life, during a critical period for neuroplasticity in motor control centers. Despite this, very little is known about how infants at high risk for CP learn (or fail to learn) to move and acquire early locomotor skills that are building blocks for later functional mobility. The long-term goal of our work is to reduce physical disability in individuals with CP by promoting the development of evidence-based motor training strategies to train and shape motor learning during infancy and toddlerhood. The objective of this project is to characterize the evolution of locomotor learning over the first 18 months of life in infants at high risk for CP. To characterize how locomotor skill is learned (or not learned) during this critical period, we will combine our established protocols using robust, unbiased robotic and sensor technology to longitudinally study infant movement across three consecutive stages during the development of impaired human motor control – early spontaneous movement, prone locomotion (crawling), and upright locomotion (walking). The spontaneous leg movements of sixty infants will be captured in real time using wearable sensors in their natural environment over the first 4 months of life. Infants who remain at high risk for CP at 4 months of age, which we expect to be approximately 50% of those enrolled, will progress to novel locomotor training protocols using robotic technology for crawling (5-9 months of age) and walking (9-18 months of age). The locomotor training protocols are introduced before the infants’ locomotor milestones emerge or fail to emerge, and are reward- and error-based, allowing ample opportunities for error learning while providing assistance to move when even small effort is made (reinforcement). Repeated measures of training characteristics and locomotor skill will quantify locomotor learning over time in infants at high risk for CP. Key training characteristics, combined with neurobehavioral moderators such as cognition and motivation to move, will be identified and used to develop a predictive model of locomotor learning. We hypothesize that experiencing and responding to error is a key mechanism for locomotor learning in CP, that learning is mediated by neurobehavioral factors outside of training, and that critical thresholds of error and other training characteristics predict the transfer of locomotor skill from prone to upright locomotion. Our team includes experts in motor control and development, computer science, robotics, biomechanics and neonatology. Characterizing and predicting locomotor learning in infants at high risk for CP will inform the design of future multi-site efficacy studies and the development of new treatments to shape motor learning during the critical years of the development of motor control, supporting the Eunice Kennedy Shriver National Institute of Child Health and Human Development mission that all children have the chance to achieve their full potential for healthy and productive lives, free from disease or disability, and to ensure the health, productivity, independence, and well-being of all people through optimal rehabilitation.

项目摘要 脑瘫（CP）患者的身体残疾是由于未能学习和/或完善运动控制而引起的 在生命的头两年中，在运动控制中心神经可塑性的关键时期。尽管如此， 关于CP高风险的婴儿如何移动和获取早期的运动，知之甚少 技能是以后功能流动性的基础。我们工作的长期目标是减少身体 通过促进基于证据的运动训练策略的发展，患有CP的人的残疾 在婴儿期和幼儿期间的训练和塑造运动学习。该项目的目的是表征 在患有CP高风险的婴儿的前18个月内，运动学习的演变。表征 在这个关键时期，如何学习（或未学到）运动技能，我们将结合我们既定的协议 使用强大的，公正的机器人和传感器技术来纵向研究三个的婴儿运动 人类运动控制受损 - 早期赞助商的发展期间连续阶段 运动，俯卧的运动（爬行）和直立的运动（步行）。赞助的腿 将在自然环境中使用可穿戴传感器实时捕获60名婴儿的运动 生命的头四个月。在4个月大时仍处于CP高风险的婴儿，我们希望这是 大约50％的入学者将使用机器人技术发展到新颖的运动训练方案 爬行（5-9个月大）和步行（9-18个月大）。运动训练方案是 在婴儿的运动里程碑出现或未能出现之前引入，并且是奖励和错误的， 在努力甚至小努力时提供帮助的同时，提供了足够的错误学习机会 制造（加固）。重复的训练特征和运动能力的度量将量化运动 随着时间的流逝，在患有CP高风险的婴儿中学习。关键训练特征，结合神经行为 将确定并使用诸如认知和移动动机之类的主持人来开发预测模型 运动学习。我们假设经历和应对错误是一个关键机制 CP的运动学习，该学习是由培训以外的神经行为因素介导的， 错误的阈值和其他训练特征可以预测运动技能从俯卧向直立的转移 运动。我们的团队包括运动控制和开发，计算机科学，机器人技术专家， 生物力学和新生儿学。表征和预测CP高风险的婴儿的运动学习 将告知未来多站点效率研究的设计以及开发新的治疗方法以塑造电动机 在运动控制发展的关键时期内学习，支持Eunice Kennedy Shriver 国家儿童健康与人类发展研究所，所有儿童都有机会 它们具有健康和产品生命的全部潜力，没有疾病或残疾，并确保健康 通过最佳康复，所有人的生产力，独立性和福祉。