Improving Hand and Arm Function in Individuals with SCI

改善 SCI 患者的手和手臂功能

• 批准号: 7815128
• 负责人: EDELLE C. FIELD-FOTE
• 金额: $ 30.96万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2012-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7815128
• 关键词: Area; Brain; Cervical spinal cord injury; Chronic; Contralateral; Crossover Design; Data; Devices; Equipment; Etiology; Exhibits; Face; Frequencies; Functional disorder; Funding; Glean; Goals; Hand; Hand functions; Human Resources; Impairment; Individual; Intervention; Ipsilateral; Laboratories; Learning; Measures; Motor; Outcome Measure; Pathway interactions; Performance; Peripheral Nerve Stimulation; Peripheral Nerves; Postdoctoral Fellow; Production; Protocols documentation; Quadriplegia; Quality of life; Reporting; Safety; Self Care; Spinal Cord; Spinal cord injury; Stroke; Task Performances; Testing; Training; Work; arm; base; chronic stroke; disability burden; functional loss; functional outcomes; improved; innovation; neurophysiology; parent grant; public health relevance; rehabilitation science; rehabilitation strategy; repetitive task practice; repetitive transcranial magnetic stimulation; restoration; somatosensory; strength training; traditional therapy; trend

DESCRIPTION (provided by applicant): The studies proposed are intended to accelerate the pace of discovery related to interventions for individuals with cervical spinal cord injury (SCI) who face significant challenges in the performance of everyday activities that require functional use of the hands. Beyond the physical damage to the spinal cord, secondary neuroplastic reorganization in the brain exacerbates functional loss. In some reports, the changes in corticomotor excitability that occur after SCI are similar to those that occur following stroke. By increasing voluntary drive to the hands, function can be improved after SCI. The studies in the parent grant apply to individuals with SCI interventions similar to those gleaned from recent studies of stroke. Newer evidence indicates that high-frequency repetitive transcranial magnetic stimulation (rTMS) may be effective at improving hand function after stroke. The proposed studies will use rTMS with the goal of increasing corticomotor drive to improve hand function in individuals with SCI. These supplemental studies will assess the safety, neurophysiologic effects, and preliminary efficacy of rTMS using a two-week, single-blind, sham-controlled, crossover design in 20 subjects. The following aims will be accomplished: 1) Assess within-session changes in pinch force to quantify the immediate effects of rTMS on force production of the contralateral hand, compared to ipsilateral hand and to sham-rTMS condition, 2) Assess effects of a 3-day course of rTMS to quantify the short-term effects on force production, functional task performance, and cortimotor neurophysiology related to contralateral hand function, compared to ipsilateral hand function and to sham-rTMS, and 3) Assess endurance of effects by quantifying the persistence of effects of rTMS on hand function and force production. These studies expand the aims of the parent grant, support personnel, and invest in technological equipment. The supplement will maximize the information that can be learned about the relationship between corticospinal drive and hand function in individuals with SCI within the 2-year abbreviated funding period. PUBLIC HEALTH RELEVANCE: In individuals with cervical SCI, impairment of hand function severely restricts independence and quality of life by limiting performance of self care, work, and leisure tasks. These studies aim to advance the field of rehabilitation science and reduce the burden of disability by improving hand function in individuals with SCI. Few goals are more important for function, independence, and participation in these individuals.

描述（由申请人提供）：提出的研究旨在加快与颈脊髓损伤（SCI）干预措施相关的发现的速度，这些人在需要双手功能使用的日常活动中面临重大挑战。 除了对脊髓的物理损害之外，大脑中的继发性神经塑性重组加剧了功能损失。在某些报告中，SCI后发生的皮质运动兴奋性的变化与中风后发生的变化相似。通过增加自愿驱动到手，可以在SCI后提高功能。父母赠款的研究适用于具有SCI干预措施的人，类似于最近的中风研究中收集的研究。较新的证据表明，高频重复的经颅磁刺激（RTMS）可能有效地改善中风后的手部功能。拟议的研究将使用RTM，以增加皮质运动驱动力来改善SCI患者的手部功能。 这些补充研究将使用20个受试者中的两周，单盲，假对照的，分频器设计来评估RTMS的安全性，神经生理效应和初步疗效。 The following aims will be accomplished: 1) Assess within-session changes in pinch force to quantify the immediate effects of rTMS on force production of the contralateral hand, compared to ipsilateral hand and to sham-rTMS condition, 2) Assess effects of a 3-day course of rTMS to quantify the short-term effects on force production, functional task performance, and cortimotor neurophysiology related to contralateral hand function, compared to ipsilateral hand功能和sham-rtms，以及3）通过量化RTM对手功能和力产生的影响的持续性来评估影响的耐力。 这些研究扩大了父母赠款，支持人员的目标，并投资于技术设备。该补充剂将最大程度地提高有关在2年缩写的资金期内具有SCI的皮质脊髓驱动与手部功能之间关系的信息。 公共卫生相关性：在具有宫颈SCI的个体中，手部功能受损会严重限制独立性和生活质量，通过限制自我保健，工作和休闲任务的表现。这些研究旨在通过改善SCI患者的手部功能来提高康复科学领域，并减轻残疾负担。对于这些人的功能，独立性和参与，很少有目标更重要。