皮质启动优化中风后步态康复-猫眼课题宝

皮质启动优化中风后步态康复

批准号：

10676222

负责人：

Sangeetha Madhavan

金额：

$52.16万

依托单位：

UNIVERSITY OF ILLINOIS AT CHICAGO

依托单位国家：

美国

项目类别：

财政年份：

2014

资助国家：

美国

项目状态：

未结题

起止时间：

2014-01-10 至 2025-07-31

来源：

https://reporter.nih.gov/project-details/10676222

关键词：

Acute Adjuvant Adult Aerobic Affect Ankle Biomechanics Brain Brain-Derived Neurotrophic Factor Cardiovascular Diseases Clinical Clinical Data Communities Community Participation Custom Data Development Educational Intervention Effectiveness Equilibrium Exercise Exhibits Gait Gait speed Genetic Polymorphism Genetic Variation Genotype Goals Health Home Impairment Individual Interval training Intervention Learning Skill Lesion Long-Term Effects Lower Extremity Measures Methods Mission Motor Motor Cortex Motor Skills Movement Muscle Neuroanatomy Outcome Outcome Measure Output Participant Patients Persons Prediction of Response to Therapy Quality of life Recovery Rehabilitation therapy Reporting Research Research Personnel Risk Serum Speed Stroke Synapses Techniques Therapeutic Time Training Transcranial magnetic stimulation United States United States National Institutes of Health Upper Extremity Variant Walking cost effectiveness demographics design exercise intensity exercise program follow-up functional independence gait rehabilitation gait symmetry improved improved outcome innovation insight interest motor learning motor rehabilitation neural neurological rehabilitation neuromechanism neurophysiology neuroregulation patient response post stroke predicting response responders and non-responders skills skills training sound spatiotemporal stroke rehabilitation stroke survivor success therapy development tool transcranial direct current stimulation treadmill treadmill training walking program walking speed

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英文摘要

PROJECT SUMMARY Achieving functional ambulation post stroke continues to be a challenge for stroke survivors, clinicians and researchers. The proposed study builds on our earlier R01 where we successfully examined the feasibility of a clinically implementable walking program which involves high intensity speed-based treadmill training (HIISTT) in combination with cortical priming to improve walking speed of individuals with stroke. Cortical priming has emerged as a promising adjuvant to enhance the outcomes of motor training. Our research team has pioneered and successfully developed neuromodulation techniques for the lower limb motor cortex using non-invasive transcranial direct current stimulation (tDCS) and ankle motor skill training. In this renewal application, our goal is to quantify the effectiveness of 36 sessions of cortical priming plus HIISTT intervention in comparison to sham priming plus HIISTT. Outcome measures will include gait variables, balance, aerobic capacity, quality of life, neurophysiological measures of descending and interhemispheric corticomotor excitability measured with transcranial magnetic stimulation (TMS), and changes in serum BDNF before, immediately after and 3-months post training. There has been a growing interest in understanding responsiveness to training to personalize stroke rehabilitation. We aim to understand variability in responsiveness to training using patient-specific parameters such as participant demographics, neurophysiological measures and the presence of genetic variations such as brain derived neurotrophic factor (BDNF) polymorphism. With our innovative mechanistic approach to enhance walking recovery, we seek to optimize gait rehabilitation post stroke and characterize relationships between neural mechanisms, motor function and genetic variations. Improved gait will enable stroke survivors to be more independent in the community and advance their quality of life, which is highly relevant to the mission of the NIH.

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