Influence of neuromodulatory input on ankle control and spasticity in persons with spinal cord injury.

神经调节输入对脊髓损伤患者踝关节控制和痉挛的影响。

• 批准号: 10311060
• 负责人: Jasmine Hope
• 金额: $ 4.68万
• 依托单位: SHEPHERD CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-12-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10311060
• 关键词: 3-Dimensional; Address; Ankle; Biomechanics; Clonus; Corticospinal Tracts; Development; Disease; Drops; Electrophysiology (science); Equilibrium; Exhibits; Flexor; Foundations; Gait; Generations; Goals; Hyperreflexia; Impairment; Individual; Intervention; Isometric Exercise; Knowledge; Learning; Lifting; Lower Extremity; Measures; Motor; Motor Neurons; Motor output; Muscle; Muscle Contraction; Neurologic; Operant Conditioning; Outcome; Outcome Study; Paresis; Pattern; Performance; Persons; Phase; Productivity; Protocols documentation; Public Health; Quality of life; Reflex action; Reflex control; Rehabilitation therapy; Research; Role; Sample Size; Soleus Muscle; Spasm; Spastic Gait; Spinal; Spinal cord injury; Testing; Toes; Training; Training Activity; Transcranial magnetic stimulation; Upper Extremity; Volition; Walking; ankle joint dorsiflexor; biomechanical test; data acquisition; fall risk; foot; functional outcomes; improved; improved mobility; innovation; insight; kinematics; motor control; muscle stiffness; neuromechanism; neurophysiology; neuroregulation; rehabilitation strategy; relating to nervous system; sensor; spasticity; spinal reflex; therapy outcome; tibialis anterior muscle; vibration

People with spinal cord injury (SCI) may have some walking ability, however, they are often challenged with a spastic gait pattern, characterized by poor voluntary control of the muscles that lift the foot (dorsiflexors) and spasms of the muscles that control push-off (plantar flexors). Both deficits contribute to impaired ability to achieve foot-ground clearance, making walking laborious and unstable. Two major neural contributors to spastic gait include disrupted descending corticospinal tract (CST) drive to the ankle dorsiflexors and impaired modulation of the plantar flexor spinal reflex circuit (SRC). It is still unknown whether diminished descending volitional drive or impairment of reflex modulation contributes more to spastic gait. Afferent input has a strong neuromodulatory effect on the excitability of both the CST and SRC. Whole body vibration (WBV) is a robust form of afferent input that provides a probe to understand the neurophysiologic mechanisms underlying spastic gait. The long-term goal of this research is to develop rehabilitation strategies to enhance walking function and mobility in persons with SCI by improving ankle control. The overall objective of this proposal is to understand the roles of the CST and SRC in volitional and reflex control of the ankle. The rationale for this project is that understanding the neurophysiological contributions to increased volitional control and decreased spasticity in the ankles will be the first step to developing important non-invasive rehabilitation strategies to improve spastic gait in persons with SCI and other upper motor neuron disorders. The central hypothesis is that improvements in ankle function will have a greater association with changes in the CST than with changes in SRC modulation, as corticospinal drive influences both volitional control and reflex modulation. Using WBV to activate cortical and spinal circuits, the central hypothesis will be tested via two specific aims: 1) Determine the contribution of dorsiflexors CST and plantar flexor SRC excitability to ankle volitional control in individuals with SCI; and 2) Determine the contribution of dorsiflexors CST and plantar flexor SRC excitability to ankle spasticity in individuals with SCI. The proposed research is innovative, because there has yet to be a study examining how an intervention that targets the CST and SRC simultaneously, impacts the different components of spastic gait after SCI. Understanding the mechanisms underlying spastic gait is significant because it provides a foundation for the development of targeted non-invasive therapies to increase the functional outcomes of the people impacted by this impaired gait pattern. Overall, the knowledge gained in this proposal will provide more insight in the underlying mechanisms of ankle control and spasticity in persons with SCI.

脊髓损伤的人（SCI）可能具有一定的步行能力，但是，他们经常受到挑战 痉挛性步态模式，其特征是自愿控制肌肉的肌肉（背屈）和 控制推断的肌肉痉挛（足底屈肌）。两种赤字都导致能力受损 实现脚部的间隙，使步行不稳定和不稳定。两个主要神经贡献者 痉挛性步态包括干扰的降层皮质脊髓道（CST）驱动到脚踝背屈和受损 足底屈肌反射回路（SRC）的调节。尚不清楚下降是否减少 自愿驱动或反射调制的损害对痉挛步态有更多的影响。传入输入很强 神经调节对CST和SRC兴奋性的影响。全身振动（WBV）是一个强大的 传入输入的形式，提供了一种探针，以了解痉挛性的神经生理机制 步态。这项研究的长期目标是制定康复策略，以增强步行功能和 通过改善踝关节控制，具有SCI的人的流动性。该提议的总体目的是了解 CST和SRC在踝关节的自愿和反射控制中的作用。这个项目的理由是 了解神经生理学对增加的意志控制和痉挛减少的贡献 脚踝将是制定重要的非侵入性康复策略以改善痉挛的第一步 步态患有SCI和其他上运动神经元疾病。中心假设是改进 在踝关节功能中，与CST的变化相比，与SRC的变化相比，变化更大 调节，因为皮质脊髓驱动会影响自动控制和反射调制。使用WBV 激活皮质和脊柱回路，将通过两个特定目的测试中心假设：1）确定 背屈者CST和足底屈肌SRC兴奋性对患者的踝关节自愿控制的贡献 Sci; 2）确定背反射剂CST和Prantar Flexor SRC兴奋性对踝关节的贡献 SCI个体的痉挛。拟议的研究具有创新性，因为还没有研究 检查如何同时针对CST和SRC的干预措施影响不同的 SCI后痉挛性步态的组成部分。了解痉挛性步态的基础机制是重要的 因为它为开发有针对性的非侵入性疗法的发展提供了基础 受到这种步态模式影响的人们的功能结果。总体而言，在这方面获得的知识 提案将对患有踝关节控制的潜在机制和痉挛的人提供更多见解。 科学。