CUped: An Approach to Motor Recovery Post-Stroke, not Compensation

CUped：中风后运动恢复的方法，而不是补偿

• 批准号: 10667869
• 负责人: SHEILA M SCHINDLER-IVENS
• 金额: $ 23.14万
• 依托单位: MARQUETTE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-05 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10667869
• 关键词: Address; Adoption; Adverse event; Bilateral; Clinical; Communities; Coupled; Data; Development; Dose; Exercise; Funding Opportunities; Future; Goals; Home; Intervention; Laboratories; Left; Limb structure; Lower Extremity; Measures; Mechanics; Modeling; Motor; Movement; Muscle; Nature; Outcome; Output; Paresis; Participant; Performance; Phase; Physiological; Protocols documentation; Randomized, Controlled Trials; Recovery; Rehabilitation therapy; Research; Rewards; Risk; Robotics; Running; Safety; Specific qualifier value; Stroke; Target Populations; Technology; Testing; Therapeutic Effect; Therapeutic exercise; Training; United States National Institutes of Health; Walking; Work; design; effective intervention; effective therapy; exercise intervention; gait rehabilitation; improved; limb movement; motor impairment; motor recovery; novel; novel therapeutics; patient tolerability; post stroke; response; restoration; standard care; stroke rehabilitation; stroke survivor; therapy design; treatment response

Project Summary The goal of lower limb rehabilitation after stroke is recovery of independent walking at home and in the community. Few stroke survivors achieve this goal. Suboptimal outcomes are due to the serious and intransigent nature of movement impairments caused by stroke and the scarcity of feasible and effective therapies that restore movement lost to stroke. Our team has developed a novel exercise intervention called CUped (pronounced cupid, like the Roman god) to address barriers to recovery and improve walking after stroke. CUped is so called because it compels use of the paretic limb during a movement that resembles pedaling. This project will examine safety, acceptability, and tolerance to CUped, characterize its therapeutic effects, and identify dose-response relationships. Results will provide preliminary data for an R01 to support a randomized controlled trial (RCT). CUped is designed to help stroke survivors recover lower limb movement lost to stroke, thereby improving walking. It is intended to be used as an adjunct to gait training. CUped uses a robotic technology that eliminates compensatory movements that interfere with recovery, compels use of the paretic lower limb, and targets 3 key movement impairments caused by stroke: decreased muscle output from the paretic limb, inappropriate paretic muscle timing, and abnormal interlimb coordination. Exercise is done in sitting which enables high repetition practice. Like walking, CUped requires continuous, reciprocal use of both lower limbs; effects are likely to transfer to walking. The risk-reward profile of this proposal is ideal for an R21, which is an NIH funding opportunity intended to encourage exploratory/developmental research by providing support for the early and conceptual stages of project development. CUped is a novel therapy grounded in a physiologic premise and based on prior observations from our laboratory. We have pilot data suggesting that CUped fulfills its design specifications, and this study will be the first to test its therapeutic effects. In this Stage 1 rehabilitation trial, we will support or quickly refute the hypothesis that CUped is safe, acceptable, and capable of eliciting a therapeutic response in stroke survivors. We will also examine tolerance to CUped and dose-response effects. If our hypotheses are supported, we will be poised to run an RCT to isolate the effects of CUped and compare them to standard care. Future work will investigate physiologic mechanisms underlying the effects of CUped.

项目摘要 中风后下肢康复的目的是恢复在家中独立行走 社区。很少有中风幸存者实现这一目标。次优的结果是由于严重和 由中风造成的运动障碍的固定性质和可行有效的稀缺性 恢复运动的疗法失去了中风。 我们的团队开发了一种名为Cuped的新颖运动干预（像罗马神一样发音丘比特） 解决恢复障碍并改善中风后的步行障碍。之所以这样称呼，是因为它强迫使用 类似于踏板的运动过程中的圆肢。该项目将检查安全性，可接受性 耐受的耐受性，表征其治疗作用并识别剂量反应关系。结果 将为R01提供初步数据，以支持随机对照试验（RCT）。 CUPED旨在帮助中风幸存者恢复失去的下肢运动，从而改善 步行。它旨在用作步态训练的辅助手段。杯子使用一种机器人技术 消除了干扰恢复，强迫使用偏长的下肢使用的补偿性运动，并 目标3由中风造成的关键运动障碍：倾斜四肢的肌肉输出降低， 不适当的肌肉时机和异常的跨越协调。运动是在坐着完成的 实现高度重复练习。像步行一样，杯子需要连续的，相互的下肢使用。 影响可能会转移到步行。 该提案的风险回报概况是R21的理想选择，这是NIH的资金机会 通过为早期和概念阶段提供支持，鼓励探索/发展研究 项目开发。杯子是一种基于生理前提的新型疗法，并基于先验 我们实验室的观察。我们有飞行员数据表明​​，杯子符合其设计规格， 这项研究将是第一个测试其治疗作用的研究。在此阶段1康复试验中，我们将支持或 迅速反驳杯子的假设是安全的，可接受的，并且能够引起治疗反应 中风幸存者。我们还将检查对杯子和剂量反应效应的耐受性。如果我们的假设是 受支持，我们将准备运行RCT，以隔离杯子的效果，并将其与标准 关心。未来的工作将研究杯子作用的生理机制。