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.

项目总结/摘要 博士Christopher M. Cirnigliaro一直在与研究人员合作， 国家脊髓损伤医学后果中心的专家/研究协调员， 快20年了在这段时间里，他表现出了非凡的承诺，以改善健康， 脊髓损伤（spinal cord injury，SCI）的危害作为高级研究协调员，Cirnigliaro博士 在他的专业发展阶段，他帮助撰写了一系列令人印象深刻的出版物， 获得博士学位;他的名字出现在50多篇原创文章（第一作者9）和2篇评论中 第一作者（第一作者）。在William A.鲍曼，他完成了2个项目，为他的 博士这篇论文的工作对推进我们对骨的研究和理解具有重要意义。 SCI患者的疾病。很少有研究成功地实施了康复 和/或运动训练干预，以减轻急性脊髓损伤（SCI）后的骨丢失，或可能 逆转慢性SCI中已经发生的骨丢失。先进的门诊策略， SCI患者的病灶下骨可以减少与SCI相关的发病率和工作天数 骨折，这是深度和长期固定的已知继发性并发症。更重要的是， 病灶下骨的改善也会提高患者参与娱乐活动的信心。 努力，提高他们的独立性和轻松进行日常生活活动。议定书 在我的CDA-1申请中提出了一个建议，该申请比较了单独使用外激素辅助行走（EAW）的效果 与EAW+经皮脊髓刺激（TSCS）和有限元（FE）方法相比，沿着 与传统的放射学测量，代表了以前的工作，旨在减少 通过改善SCI患者的骨骼健康来降低骨折风险。一个成功的结果将与 骨强度增加，预计将对扩大治疗选择产生直接影响， 康复活动.除了完成拟议的CDA-1方案外，Cirnigliaro博士还将完成 额外的实践研究活动，具体的学术课程和研讨会，以及来自 SCI研究领域的专家团队。CDA-1将为Cirnigliaro博士提供机会， 完成这项临床相关的研究计划，提高他的知识基础，发展新的技能，并成长 专业，使他能够成熟为一个独立的VA RR&D服务临床科学家。