Mechanics of overground, dry, and aquatic treadmill walking in children & adolescents with cerebral palsy

儿童地上、干式和水中跑步机行走的力学原理

• 批准号: 10514226
• 负责人: David C Kingston
• 金额: $ 44.81万
• 依托单位: UNIVERSITY OF NEBRASKA OMAHA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10514226
• 关键词: Activities of Daily Living; Adolescent; Adult; Affect; Anterior; Articular Range of Motion; Biomechanics; Brain Injuries; Cerebral Palsy; Child; Child Care; Childhood; Clinical; Clinical Trials; Data; Deformity; Development; Disease; Distal; Ensure; Environment; Future; Gait; Hip Joint; Hip region structure; Immersion; Immobilization; Impairment; Intervention; Knee; Knee joint; Length; Link; Live Birth; Lower Extremity; Measures; Mechanics; Modality; Motor; Movement; Muscle; Muscle Weakness; Musculoskeletal; Nerve Degeneration; Operative Surgical Procedures; Osteotomy; Outcome; Patients; Population; Postoperative Care; Postoperative Period; Prevalence; Protocols documentation; Quality of life; Rehabilitation therapy; Research; Resistance; Speed; TimeLine; Underrepresented Minority; Walking; Weight-Bearing state; Work; base; case control; design; disability; evidence base; gait rehabilitation; improved; kinematics; motor control; motor impairment; nervous system disorder; pediatric patients; post-operative rehabilitation; response; spatiotemporal; surgery outcome; therapy outcome; treadmill; treatment response; walking rehabilitation; walking speed

Abstract This project will determine biomechanical mechanisms to optimize walking rehabilitation in overground, dry treadmill, and wet treadmill environments for children with cerebral palsy (CP). Cerebral palsy is a neurological disorder caused by brain damage in early development that impairs motor control and overall mobility. Common gait issues in children with CP are excessive knee flexion, excessive hip flexion/adduction, and high muscular demand. Additionally, children with CP have lower-limb muscle weakness and low joint ranges of motion (ROM). These are speculated as key mechanisms decreasing walking endurance, independence, and quality of life. Less understood is how lower limb kinematics and muscle activity are modified amongst different walking environments commonly used in rehabilitation. In addition, post-operative tolerance to various walking speeds has not been rigorously examined in children with CP. Through descriptive studies, we will perturb walking speed amongst diverse walking environments, characterize within-subject changes to spatiotemporal walking parameters, and establish a fulsome evidence base to design future clinical trials. We hypothesize that walking environment will impact lower limb kinematics and muscle activity due to hydrodynamic drag and altered walking strategies. Furthermore, we hypothesize that the impact of walking environment will vary base on speed. Aim 1: Determine the effects of walking speed and environment on lower body kinematics and muscular demand in children with CP. Aim 2: Link overground walking function with lower body kinematics and muscular demand in diverse walking rehabilitation conditions. Aim 3: Establish post-operative functional differences for walking rehabilitation in children with CP that receive Distal Femoral Extension Osteotomy (DFEO) or Anterior Distal Femoral Hemiepiphysiodesis (ADFH). Considering the ubiquity of post-operative rehabilitation, the clinical importance of data-driven interventions for children with CP is difficult to overstate.

抽象的 该项目将确定生物力学机制，以优化步行康复 脑瘫儿童（CP）的地面，干跑步机和湿跑车环境。 脑瘫是早期发育中脑损伤引起的一种神经系统疾病 损害电动机控制和整体活动性。 CP儿童的常见步态问题过多 膝盖屈曲，过度的臀部屈曲/内收和高肌肉需求。此外，孩子 CP具有较低的肌肉无力和低关节运动范围（ROM）。这些都是 推测关键机制降低了步行耐力，独立性和生活质量。 较少了解的是下肢运动学和肌肉活动如何在不同的不同 步行环境通常用于康复。另外，术后容忍度 CP儿童尚未严格检查各种步行速度。通过 描述性研究，我们将在各种步行环境中扰动步行速度， 表征对时空步行参数的受试者内部变化，并建立一个 为设计未来的临床试验设计的证据基础。我们假设步行环境 会影响下肢的运动学和肌肉活动，导致流体动力阻力和改变 步行策略。此外，我们假设步行环境的影响会有所不同 基于速度。目标1：确定步行速度和环境对下半身的影响 CP儿童的运动学和肌肉需求。目标2：链接地面步行功能 在各种步行康复条件下，下半身运动学和肌肉需求。目的 3：在患有CP儿童的步行康复中建立术后功能差异 接受股骨远端截骨术（DFEO）或股骨前远端 半二次静止（ADFH）。考虑到术后康复的无处不在，临床 数据驱动的干预措施对CP儿童的重要性很难夸大其词。