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Quantifying patient-specific changes in neuromuscular control in cerebral palsy

量化脑瘫患者神经肌肉控制的特定变化

基本信息

批准号：
10621781
负责人：
Michael Hart Schwartz
金额：
$ 33.54万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-30 至 2027-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10621781
关键词：
Aftercare Age Ankle Bilateral Birth Brain Injuries Caring Cerebral Palsy Characteristics Child Data Diagnosis Dorsal Electromyography Europe Exhibits Exposure to Feedback Flexor Impairment Individual Intervention Joints Knowledge Learning Leg Length Life Measures Methods Modality Motor Movement Muscle Nervous System Trauma Operative Surgical Procedures Orthopedic Surgery Orthotic Devices Outcome Participant Patients Pattern Performance Persons Process Quality of life Randomized Research Resistance Rhizotomy procedure Robot Soleus Muscle Speed Symptoms System Time Training Treatment outcome Visual Walking Work comparison control design experimental analysis experimental study gait examination gait rehabilitation improved light weight motor control motor impairment motor learning multimodality neuromuscular peer rate of change recruit response robotic device sex synergism treadmill treatment response walking speed

项目摘要

Project Summary Walking enables independence and exploration in daily life. For people with cerebral palsy (CP), a brain injury near the time of birth alters their ability to move and participate in daily activities. Treatments seek to improve walking function, but the processes by which people with CP adapt and learn new movement patterns are poorly understood. Our prior research demonstrated that patient-specific measures of motor control (i.e., how an individual recruits and coordinates their muscles) are important indicators of walking function and treatment outcomes. Children with more impaired motor control compared to nondisabled peers have worse function and worse outcomes after treatments like orthopedic surgery or selective dorsal rhizotomy. The premise of our proposed research is that patient-specific measures of adaptation are equally important to understand and inform care, but we lack methods to quantify adaptation or effectively induce motor learning. Whether adaptation is altered in CP and whether targeted training can amplify adaptation to improve walking function remains unknown. Multimodal feedback training is a promising approach to support adaptation and motor learning, but few studies have evaluated adaptation with real-time feedback training during walking or its impacts on walking function. The proposed research seeks to fill these gaps by completing the systematic experimental analyses necessary to quantify walking adaption rates (Aim-1) and determine whether repeated exposure to multimodal feedback training can alter adaptation rates (Aim-2) to induce motor learning and improve walking function (Aim-3). Specifically, we examine adaptation rates in response to multimodal feedback training that targets plantarflexor function, a key muscle group for walking that is nearly universally impaired in CP. We provide multimodal feedback using (1) sensorimotor feedback from adaptive ankle resistance delivered via a light-weight, wearable robot and (2) audiovisual feedback of plantar flexor activity from EMG recordings. By evaluating responses of children with CP to this feedback training – both individually and combined – this research will establish the scientific basis to quantify and understand adaptation and motor learning in CP.

项目总结