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: 10681303
• 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/10681303
• 关键词: Absenteeism at work; 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; Recreation; Rehabilitation therapy; Research; Research Activity; Research Personnel; Risk; Risk Reduction; Scientist; Services; Site; Skeleton; Space Flight; Specialist; Spinal cord injury; Stress; Therapeutic Intervention; Time; 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 stimulation; powered exoskeleton; prevent; skeletal; skeletal unloading; 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.

项目摘要/摘要 Christopher M.Cirnigliaro博士一直以研究健康科学的身份与研究人员合作 国家脊髓损伤医疗后果中心专家/研究协调员 差不多20年了。在这段时间里，他表现出了改善健康和 脊髓损伤退伍军人的一般福利。作为高级研究协调员，Cirnigliaro博士 帮助撰写了一份令人印象深刻的出版物清单，用于他的职业发展阶段，刚刚 获得博士学位；他的名字出现在50多篇原创文章(9篇第一作者)和2篇评论中 文章(两篇文章的第一作者)。在威廉·鲍曼博士的指导下，他完成了两个项目 博士论文工作对推进我们对骨骼的方法和理解具有重要意义 脊髓损伤患者的疾病。目前成功实施康复的研究还很少。 和/或运动训练干预，以减轻急性脊髓损伤(SCI)后的骨丢失，或者可能 逆转已经在慢性脊髓损伤中发生的骨丢失。先进的移动策略，可以恢复 脊髓损伤患者的皮下骨质将减少发病率和工作损失的天数 骨折，一种已知的深而长时间制动的继发性并发症。更重要的是， 皮下骨骼的改善也将提高患者从事娱乐活动的信心 努力提高他们在进行日常生活活动时的独立性和自主性。该协议 在我的CDA-1应用程序中提出，它比较了外骨骼辅助步行(EAW)单独的效果 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，代表了先前工作的继续，旨在减少 改善脊髓损伤患者骨骼健康的骨折风险。一个成功的结果将与 增加骨骼强度，预计将对扩大治疗方案产生直接影响 康复。除了完成提出的CDA-1方案外，Cirnigliaro博士还将完成 其他实践研究活动、特定的学术课程和研讨会，以及来自 一支SCI研究领域的专家团队。CDA-1将为Cirnigliaro博士提供机会 完成这项与临床相关的研究计划，改善他的知识基础，发展新的技能，并成长 这样他就可以成熟为一名独立的VA RR&D服务临床科学家。