Impact of Lingual Endurance Exercise on Rehabilitation of Swallowing Impairments after lschemic Stroke

项目总结/摘要 这个职业发展奖将是必不可少的博士布列塔尼Krekeler的成功，作为一个临床试验， 吞咽康复研究。克雷凯勒博士的研究使命是创造和提供新颖的， 脑卒中后吞咽困难患者的有效康复方法。为了实现这个职业目标，博士。 Krekeler必须能够设计和执行大型多中心临床试验。该职业发展计划是 提供必要的训练来提升她的水平。她的导师团队包括几个NIH资助的 中风和吞咽困难临床试验专家（Broderick、Vagal、Sucharew、Rogus-Pulia博士）。受其 在Krekeler博士的指导下，他将完成概述的职业发展计划以接受具体培训 必须成功。该培训计划和临床试验完美地建立在她现有的翻译技能集之上 和临床研究。她从K 01飞行员到R 01试验的轨迹是强大的。她的主要导师布罗德里克医生 指导NIH StrokeNet，并积极参与大学的许多正在进行的多地点中风恢复试验 辛辛那提热情欢迎Krekeler博士加入这个研究联盟。的机会 在这个机构进行的中风恢复试验是无与伦比的。这些具体的承诺， 培训计划中概述的课程将由临床试验和神经科学的正式课程补充。在 除了优秀的导师，研究环境，并在此奖项概述的培训机会，博士。 Krekeler还将收集有关舌耐力运动临床疗效的基本原始数据， 下一阶段的研究。这项初步试验将评估舌耐力运动的效果（与假运动相比） 对脑卒中后吞咽功能恢复的影响本研究的主要目的是评价舌向 耐力运动与假运动对卒中后吞咽困难患者吞咽功能的影响。我们 假设舌耐力训练将导致口腔吞咽生理学测量的更大改善 相比之下，sham。这项工作的探索性目的将使Krekeler博士获得MRI经验 测序和分析，并将收集有关白色物质束扩散变化的初步数据 和皮质厚度。我们假设，舌耐力运动将 与原发灶中白色物质扩散的完整性改善和皮质厚度增加相关 运动皮层，并与假手术相比。无论结果如何，该数据集将提供创新和高度 关于语言功能、吞咽障碍和皮质 卒中后人群中吞咽困难的表现。这些试点数据对于提供足够的 设计R 01 II期干预试验的把握度，以研究如何通过时间和 治疗强度，以更好地恢复卒中后吞咽功能。

Project Summary/Abstract This career development award will be essential to Dr. Brittany Krekeler’s success as a clinical-trialist in swallowing rehabilitation research. The mission of Dr. Krekeler’s research is to create and deliver novel, efficacious rehabilitation approaches for individuals with dysphagia after stroke. To achieve this career goal, Dr. Krekeler must be able to design and execute large, multi-site clinical trials. This career development plan was created to provide the training necessary elevate her to this level. Her mentor team includes several NIH funded stroke and dysphagia clinical trials experts (Drs. Broderick, Vagal, Sucharew, Rogus-Pulia). Under their guidance, Dr. Krekeler will complete the outlined career development plan to receive the specific training necessary to succeed. This training plan and clinical trial perfectly build on her existing skill set in translational and clinical research. Her trajectory from K01 pilot to R01 trial is strong. Her primary mentor, Dr. Broderick, directs NIH StrokeNet and is heavily involved in the many on-going, multi-site stroke recovery trials at University of Cincinnati and has enthusiastically welcomed Dr. Krekeler into this research consortium. The opportunities to engage in on-going stroke recovery trials at this institution are unparalleled. These specific engagements, outlined in the training plan, will be supplemented by formal coursework in clinical trials and neuroscience. In addition to the excellent mentorship, research environment, and training opportunities outlined in this award, Dr. Krekeler will also collect essential primary data regarding clinical efficacy of lingual endurance exercise to inform the next phase of study. This pilot trial will evaluate the effect of lingual endurance exercise (vs sham exercise) on recovery of swallow function after stroke. The Primary Aim of this study is to evaluate the effect of lingual endurance exercise vs sham on swallow function in individuals with post-stroke dysphagia. We hypothesize that lingual endurance training will result in greater improvement in measures of oral swallow physiology as compared to sham. The Exploratory Aim of this work will allow for Dr. Krekeler to gain experience in MRI sequencing and analysis and will collect preliminary data regarding changes in white matter tract diffusion and cortical thickness in endurance vs sham exercise. We hypothesize that lingual endurance exercise will be associated with improved integrity of white matter diffusion and increased cortical thickness in the primary motor cortex and as compared to sham. Regardless of outcome, this dataset will provide innovative and highly novel information regarding the relationship between lingual function, swallowing impairments, and cortical representation of dysphagia in a post-stroke population. These pilot data will be essential in providing sufficient power for designing an R01 Phase II intervention trial to investigate how to maximize gains with timing and intensity of therapy delivery to better recover swallow function after stroke.