Characterizing Activity Patterns in Functional Mobility After Spinal Cord Injury

脊髓损伤后功能活动的特征活动模式

• 批准号: 10683734
• 负责人: Lynn A Worobey
• 金额: $ 10.14万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10683734
• 关键词: Address; Biomechanics; Caregiver support; Caring; Characteristics; Classification; Clinical; Clinical Research; Clinical assessments; Coin; Cross-Sectional Studies; Data; Data Analyses; Data Collection; Data Set; Dose; Environment; Esthesia; Exertion; Foundations; Future; Goals; Impairment; Individual; Injury; Inpatients; Intervention; Joints; Kinesiology; Length of Stay; Machine Learning; Measures; Mentors; Modeling; Monitor; Movement; Outcome; Outpatients; Pain; Pathology; Patient Care; Patient Self-Report; Patient-Focused Outcomes; Patients; Pattern; Personnel Management; Physical activity; Predictive Factor; Probability; Process; Quality of life; Rehabilitation therapy; Research; Resource Allocation; Resources; Secondary to; Self Efficacy; Self-Help Devices; Sensory; Spinal cord injury; Statistical Methods; Therapeutic Intervention; Time; Training; Upper Extremity; Walking; Wheelchairs; adverse outcome; biopsychosocial; biopsychosocial factor; career; clinical care; clinical implementation; clinical practice; community setting; cost; design; evidence base; expectation; experience; functional outcomes; gait rehabilitation; improved; improved mobility; injury prevention; innovation; inpatient service; insight; interest; meetings; muscle strength; neurological recovery; opportunity cost; patient mobility; person centered; predictive modeling; preservation; research study; resilience; sensor; translational study; wearable sensor technology

Abstract My career and research interests have centered on the science of movement and factors that maximize mobility. Whether this is through injury prevention, assistive technology, or biomechanical optimization, it is critical to clinical practice that these processes be well understood so that we can provide the most informed patient treatments. In order to carry out more effective clinically-based studies that inform patient care, it is my desire to continue my training through practical experiences with both formal coursework and a oversight by a strong mentoring team in the following domains: (1) activity-based data collection and analysis and (2) use of advanced statistical methods to investigate multiple factors. Through the K23, I will also gain experience specifically focused on my transition to independence; this will include grantsmanship and lab management, leading the design and implementation of clinical and translational studies, management of personnel and meetings, and pursuit of tenure and an R01. This continued training will be completed in the context of a research study that characterizes activity patterns in functional mobility after spinal cord injury (SCI). Aim 1 of this study is to predict mobility at discharge and at 1-year post-discharge, based upon patient characteristics and activity during IPR. Mobility outcomes can be challenging to predict, particularly for individuals with moderate strength and sensory impairments. Selecting appropriate training is increasingly important with shrinking lengths of stay and there are potential opportunity costs and adverse consequences on quality of life and participation for individuals who do not receive appropriate interventions. Additional activity measures that we can collect early in the IPR stay, by utilizing low-cost sensors, have the potential to provide rich data sets that we can examine to garner insight into outcomes with little administrative burden. Using a machine learning approach, we will investigate patient characteristics and activity-monitoring data to improve predictive models of patient mobility based on data acquired early in the rehab stay. Achieving these aims will improve patient and clinician understanding of anticipated changes in mobility in the year following SCI to appropriately target expectations and interventions to maximize functional outcomes. Aim 2 of this proposal is to quantitatively evaluate functional mobility changes (i.e., wheeling walking or changes in activity within mode) in the first year post injury and their impact on quality of life and participation. There are factors following discharge that challenge or enhance the sustainability of walking for functional mobility including energy costs, neurologic recovery and biopsychosocial factors such as resilience, self-efficacy, environment, and caregiver support. The association between these factors and post-discharge changes in mobility are not well understood. Using wearable sensors we will quantify time spent walking and wheeling to identify transitions between walking and wheeling, identify factors that contribute to these transitions and investigate their impact on participation.

摘要 我的职业生涯和研究兴趣集中在运动科学和最大化运动的因素。 迁移率无论是通过预防伤害、辅助技术还是生物力学优化， 对临床实践至关重要的是，这些过程必须得到很好的理解，以便我们能够提供最知情的 患者治疗。为了进行更有效的临床研究，为患者提供护理，我的 我希望通过正式课程和监督的实践经验继续我的培训， 在以下领域有强大的指导团队：（1）基于活动的数据收集和分析;（2）使用 先进的统计方法来调查多个因素。通过K23，我也将获得经验 特别侧重于我向独立的过渡;这将包括granitary和实验室管理， 领导临床和转化研究的设计和实施，人员管理， 会议，追求终身职位和R 01。这一继续培训将在一个 研究脊髓损伤（SCI）后功能活动的活动模式。 本研究的目的1是根据患者的情况预测出院时和出院后1年的活动能力。 IPR期间的特征和活动。移动性结果可能具有挑战性，特别是对于 具有中等强度和感觉障碍的个体。选择适当的培训越来越多地 重要的是，随着逗留时间的缩短，存在潜在的机会成本和不利后果 对没有接受适当干预的个人的生活质量和参与的影响。额外 我们可以利用低成本的传感器在知识产权停留的早期收集活动测量数据， 提供丰富的数据集，我们可以检查这些数据集，以获得对结果的深入了解，而无需承担多少管理负担。 使用机器学习方法，我们将研究患者特征和活动监测数据， 基于在康复期间早期获得的数据改进患者移动性的预测模型。实现这些 aims将提高患者和临床医生对未来一年移动性预期变化的理解 SCI以适当的期望和干预为目标，以最大限度地提高功能成果。 该提案的目的2是定量评估功能移动性变化（即，旋转行走 或模式内活动的变化）及其对生活质量的影响， 参与的出院后有一些因素会挑战或增强步行的可持续性， 功能移动性，包括能量消耗，神经恢复和生物心理社会因素，如弹性， 自我效能、环境和照顾者支持。这些因素与出院后 人们对流动性的变化并不十分了解。使用可穿戴传感器，我们将量化步行所花费的时间， 旋转确定行走和旋转之间的转换，确定导致这些转换的因素 过渡，并调查其对参与的影响。

项目成果

Effectiveness of a Web-Based Direct-to-User Transfer Training Program: A Randomized Controlled Trial.

• DOI: 10.1016/j.apmr.2021.05.007
• 发表时间: 2022-04
• 期刊: Archives of physical medicine and rehabilitation
• 影响因子: 4.3
• 作者: Rigot SK;DiGiovine KM;Boninger ML;Hibbs R;Smith I;Worobey LA
• 通讯作者: Worobey LA

Factors Influencing Incidence of Wheelchair Repairs and Consequences Among Individuals with Spinal Cord Injury.

影响脊髓损伤患者的轮椅修理发生率和后果的因素。

• DOI: 10.1016/j.apmr.2021.01.094
• 发表时间: 2022-04
• 期刊: Archives of physical medicine and rehabilitation
• 影响因子: 4.3
• 作者: Worobey LA;Heinemann AW;Anderson KD;Fyffe D;Dyson-Hudson TA;Berner T;Boninger ML
• 通讯作者: Boninger ML

Changes in Internet Use Over Time Among Individuals with Traumatic Spinal Cord Injury.

• DOI: 10.1016/j.apmr.2021.04.021
• 发表时间: 2022-04
• 期刊: Archives of physical medicine and rehabilitation
• 影响因子: 4.3
• 作者: Rigot SK;Worobey LA;Boninger ML;Robinson-Whelen S;Roach MJ;Heinemann AW;McKernan G
• 通讯作者: McKernan G

Intra- and Interrater Reliability of Remote Assessment of Transfers by Wheelchair Users Using the Transfer Assessment Instrument (Version 4.0).

• DOI: 10.1016/j.apmr.2020.12.032
• 发表时间: 2022-04
• 期刊: ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
• 影响因子: 4.3
• 作者: Worobey, Lynn A.;Hibbs, Rachel;Rigot, Stephanie K.;Boninger, Michael L.;Huzinec, Randall;Sung, Jong H.;Rice, Laura A.
• 通讯作者: Rice, Laura A.

Clinical utility during inpatient rehabilitation of a clinical prediction rule for ambulation prognosis following spinal cord injury.

脊髓损伤后步行预后的临床预测规则在住院康复期间的临床效用。

• DOI: 10.1080/10790268.2021.1888024
• 发表时间: 2023
• 期刊: The journal of spinal cord medicine
• 作者: Everhart,Joseph;Somers,Martha;Hibbs,Rachel;Worobey,LynnA
• 通讯作者: Worobey,LynnA