Understanding How Children with Hemiparetic Cerebral Palsy Anticipate Gait

了解偏瘫脑瘫儿童如何预测步态

• 批准号: 10533306
• 负责人: Hassan-Galaydh Farah
• 金额: $ 2.03万
• 依托单位: VIRGINIA POLYTECHNIC INST AND ST UNIV
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-10 至 2023-04-09
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10533306
• 关键词: Adverse event; Age; Anterior; Attenuated; Awareness; Bilateral; Biomechanics; Biometry; Cerebral Palsy; Child; Childhood; Collaborations; Data; Development; Diagnosis; Equilibrium; Face; Family; Foundations; Future; Gait; Gender; Goals; Health; Human; Knowledge; Lead; Left; Leg; Length; Life; Lifting; Light; Lighting; Limb structure; Lower Extremity; Measures; Motion; Motor; Musculoskeletal Equilibrium; Operative Surgical Procedures; Outcome; Outcome Study; Participant; Patients; Pattern; Posture; Prospective Studies; Reaction Time; Rehabilitation therapy; Research Personnel; Retrospective Studies; Shoulder; Side; Techniques; Testing; Therapeutic Intervention; Time; Toes; Visit; Walking; Weight; Weight-Bearing state; Width; Work; career; comparative; disability; expectation; foot; gait examination; hemiparesis; improved; innovation; novel; novel strategies; peer; pressure; prospective; therapeutic target

PROJECT SUMMARY/ABSTRACT Of all children in the US born with Cerebral Palsy (CP), 30-40% of them will be diagnosed with Hemiparetic CP (HCP), presenting with one side of the body being weaker than the other. The resulting asymmetries impede the ability of children with HCP to distribute weight evenly between their lower limbs. This, often, contributes to poor postural control and `favoring' of their uninvolved side (increased load on the uninvolved leg) during balance and gait. While many studies have examined gait and balance, our project serves as a foundational first step toward understanding how gait and balance influence one another. We're proposing a prospective, 40 participant (20 children with HCP and 20 typically developing (TD) children) one-visit study to locate and track the center of pressure (COP) during standing and walking tasks. This work seeks to determine the impact of gait anticipation (GA, i.e., expectation of initiating a step) on balance and load symmetry during quiet standing for children with HCP in comparison to TD peers. This aim allows us to fill the gap in knowledge concerning the relationship between GA and quiet standing balance. Completion of this will define for the first time the impact of load symmetry on balance for children with HCP. This work will also determine the impact of changing stance limb (dominant/non-dominant) on COP displacement and reaction time during gait initiation (GI) in children with HCP when compared with TD peers. While there is a clear difference in ability between limbs (especially for children with HCP), no one has attempted to quantify or comparatively analyze these differences. Assessing the ability of each limb to be the leading limb during GI provides a framework for evaluating how each limb performs when completing other daily activities, such as climbing stairs or stepping over obstacles. We can apply our findings toward revealing rehabilitation targets that not only focus on strengthening the more involved side, but also improve bilateral ability.

项目总结/摘要 在美国出生的所有脑瘫儿童中，有30-40%的儿童被诊断为偏侧脑瘫。 (HCP)表现为身体的一侧比另一侧弱。由此产生的不对称阻碍了 HCP儿童在下肢之间均匀分配体重的能力。这往往会导致贫困。 在平衡过程中，姿势控制和“有利于”他们的未受累侧（增加未受累腿上的负荷）， 步态虽然许多研究已经检查了步态和平衡，但我们的项目是迈向 了解步态和平衡如何相互影响。 我们提出了一个前瞻性的，40名参与者（20名儿童与HCP和20名典型发展（TD） 儿童）的一次访问研究，以定位和跟踪压力中心（COP）在站立和行走任务。这 工作寻求确定步态预测（GA，即，启动步骤的预期）， 与TD同龄人相比，HCP儿童安静站立时的负荷对称性。这一目标使我们能够填补 关于GA和安静站立平衡之间关系的知识上的差距。完成本 将首次定义负荷对称性对HCP儿童平衡的影响。 这项工作还将确定改变站立肢体（优势/非优势）对COP的影响 与TD同龄人相比，HCP儿童在步态起始（GI）期间的位移和反应时间。 虽然肢体之间的能力有明显的差异（特别是对于患有HCP的儿童），但没有人 试图量化或比较分析这些差异。评估每个肢体的能力， GI期间的主要肢体提供了一个框架，用于评估每个肢体在完成其他肢体时的表现。 日常活动，如爬楼梯或跨越障碍物。我们可以用我们的发现来揭示 康复目标，不仅注重加强更多参与的一方，而且还改善双边 能力