The Effect of Exoskeleton-Assisted Walking and Transcutaneous Spinal Cord Stimulation on Measures of Bone Strength in Persons with Spinal Cord Injury

外骨骼辅助步行和经皮脊髓刺激对脊髓损伤患者骨强度测量的影响

• 批准号: 10536913
• 负责人: Christopher Cirnigliaro
• 金额: --
• 依托单位: JAMES J PETERS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-10-01 至 2024-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10536913
• 关键词: Activities of Daily Living; Acute; Amputation; Architecture; Bone Density; Bone Diseases; Chronic; Clinical; Clinical Trials; Complication; Contracture; Development; Devices; Distal; Doctor of Philosophy; Doctor' s Degree; Dual-Energy X-Ray Absorptiometry; Educational Intervention; Effectiveness; Elements; Enrollment; Event; Femur; Fracture; Gait; Gait abnormality; Geometry; Health; Healthcare; Hormonal; Hospitalization; Immobilization; Impairment; Infection; Injury; Intervention; Intervention Studies; Investigation; Joints; Knee; Knowledge; Lesion; Locomotion; Locomotor training; Lower Extremity; Measurement; Measures; Medical center; Mentors; Modality; Modeling; Morbidity - disease rate; Motor; Muscle; Names; Neurologic; Neuronal Plasticity; Neurostimulation procedures of spinal cord tissue; Osteoporosis; Outcome; Participant; Patients; Pattern; Persons; Postmenopause; Posture; Protocols documentation; Publications; Radiology Specialty; Rehabilitation therapy; Research; Research Activity; Research Personnel; Risk; Scientist; Services; Site; Skeleton; Space Flight; Specialist; Spinal cord injury; Stress; Therapeutic Intervention; Time; Torsion; Transcutaneous Electric Nerve Stimulation; Veterans; Walking; Woman; Work; bone; bone health; bone loss; bone strength; calcaneum; clinically relevant; cohort; cost; decubitus ulcer; design; efficacy evaluation; exercise training; exoskeleton; falls; fracture risk; fragility fracture; hands on research; health science research; improved; kinematics; knowledge base; medical complication; neural circuit; neuromuscular; powered exoskeleton; prevent; skeletal; skills; tibia; welfare

PROJECT SUMMARY/ABSTRACT Dr. Christopher M. Cirnigliaro has been working with researchers as a Research Health Science Specialist/Research Coordinator to the National Center for the Medical Consequences of Spinal Cord Injury for almost 20 years. Over this time, he has displayed an extraordinary commitment to improving the health and general welfare of Veterans with spinal cord injury (SCI). As the Senior Research Coordiantor, Dr. Cirnigliaro has helped author an impressive list of publications for his stage of professional development, having just received his doctoral degree; his name appears on over 50 original articles (first author on 9) and 2 review articles (first author on both). Under the tutelage of Dr. William A. Bauman, he completed 2 projects for his Ph.D. dissertation work that have been significant in advancing our approach and understanding of bone disease in persons with SCI. There is a paucity of research that have successfully implemented rehabilitation and/or exercise training interventions to mitigate the bone loss after acute spinal cord injury (SCI), or possibly reverse bone loss that has already occurred in chronic SCI. Advanced ambulatory strategies that can restore sublesional bone in persons with SCI would reduce the morbidity and days lost from work associated with fractures, a known secondary complication of profound and prolonged immobilization. More important, improvements in sublesional bone would also improve confidence of patients to engage in recreational endeavors and improve their independence and ease when performing activities of daily living. The protocol proposed in my CDA-1 application that compares the effects of exoskeleton-assisted walking (EAW) alone versus EAW plus transcutaneous spinal cord stimulation (TSCS) and the finite element (FE) approach, along with traditional radiologic measurements, represents a continuation of previous work aimed at reducing the risk of fracture by improving bone health in persons with SCI. A successful outcome would be associated with increased bone strength that would be anticipated to have a direct impact on expanding treatment options for rehabilitation. In addition to completing the CDA-1 protocol proposed, Dr. Cirnigliaro will complete additional hands-on research activities, specific academic courses and seminars, and extensive mentoring from a team of experts in the field of SCI research. The CDA-1 will provide Dr. Cirnigliaro the opportunity to complete this clinically relevant research plan and improve his knowledge base, develop new skills, and grow professionally so he can mature into an independent VA RR&D Service clinical scientist.

项目概要/摘要 Christopher M. Cirnigliaro 博士一直与研究人员合作，从事健康科学研究 国家脊髓损伤医疗后果中心专家/研究协调员 快20年了。在此期间，他表现出了对改善健康和健康的非凡承诺。 患有脊髓损伤 (SCI) 的退伍军人的一般福利。作为高级研究协调员，Cirnigliaro 博士 帮助撰写了一系列令人印象深刻的出版物，适合他的职业发展阶段，刚刚 获得博士学位；他的名字出现在 50 多篇原创文章中（9 篇为第一作者）和 2 篇评论 文章（两者的第一作者）。在William A. Bauman博士的指导下，他完成了2个项目 博士对推进我们对骨骼的方法和理解具有重要意义的论文工作 SCI 患者的疾病。成功实施康复的研究很少 和/或运动训练干预措施，以减轻急性脊髓损伤（SCI）后的骨质流失，或者可能 逆转慢性 SCI 中已经发生的骨质流失。可以恢复的高级门诊策略 脊髓损伤患者的病灶下骨治疗将减少与以下疾病相关的发病率和工作损失天数 骨折，一种已知的深度和长期制动的继发并发症。更重要的是， 病灶下骨骼的改善也将提高患者从事娱乐活动的信心 努力并提高他们在进行日常生活活动时的独立性和自如性。协议 在我的 CDA-1 申请中提出，该申请比较了单独外骨骼辅助行走 (EAW) 的效果 与 EAW 加经皮脊髓刺激 (TSCS) 和有限元 (FE) 方法相比， 与传统的放射学测量相比，代表了先前旨在减少辐射的工作的延续 通过改善 SCI 患者的骨骼健康来降低骨折风险。成功的结果将与 骨强度的增加预计将直接影响扩大治疗选择 康复。除了完成提议的 CDA-1 方案外，Cirnigliaro 博士还将完成 额外的实践研究活动、特定的学术课程和研讨会以及广泛的指导 SCI研究领域的专家团队。 CDA-1 将为 Cirnigliaro 博士提供机会 完成这个临床相关的研究计划，提高他的知识基础，发展新技能，并成长 专业，使他能够成长为一名独立的 VA RR&D 服务临床科学家。