National Pediatric Rehabilitation Resource Center: Techniques Development

项目总结(技术开发) 国家儿科康复资源中心(PedRehab Ctr)将从事技术开发 我们认为非常有希望，对该领域方法或技术的关键差距做出反应，并有可能 在它们的应用中具有多用途。具体地说，我们建议研究的领域适用于这两项研究 和临床实践。儿科康复研究将极大地受益于更加敏感、有效和 衡量新技能的出现及其在日常工作中的使用的可靠方法。中的许多工具 新的脑瘫通用数据元素(CDE)最初是为典型开发而开发的 儿童；其他儿童只适用于有限的年龄范围，但通常被用在“标签外”；还有一些被指定为 “探索性的”或“极有希望的”缺乏对其心理测量的确认(可能还会进一步完善)。 属性。儿科康复试验中的另一个主要问题是未能衡量 治疗(即，遵守预定的治疗方案)。我们的儿科康复中心的科学家们一直活跃在 开发和验证新的评估工具，从复杂的运动学到父报告工具；创建 儿童强迫诱导运动疗法和双指甲疗法治疗工具的首次保真度； 并探索结合各种神经成像方法来记录治疗引起的 神经可塑性。我们的技术开发的具体目标是： 1.获取功能、技能和行为评估方法的确认性文件 跨越实验室和现实世界环境。这包括运动学和视频的使用，游戏， 机器人和可穿戴设备，以补充传统的标准化测试和系统方法 建立具有临床意义的得失阈值； 2.将当前使用的工具的修改和汇总评分方法标准化，以实现更大的 适用于年龄、严重程度和神经运动病因差异很大的儿童 减值； 3.为推进保真发展提供急需的治疗措施 实际提供康复干预措施的文件记录；以及 4.探索新的神经成像策略，作为单独的生物标记物和有效、可靠的 治疗诱导的神经可塑性指标。

Project Summary (Techniques Development) The National Pediatric Rehabilitation Resource Center (PedRehab Ctr) will engage in development of techniques we consider highly promising, responsive to critical gaps in methods or technology in the field, and potentially multi-purpose in their application. Specifically, the areas we propose to pursue have application for both research and clinical practice. Pediatric rehabilitation research would benefit immensely from more sensitive, valid, and reliable approaches to measuring the emergence of new skills and their use in everyday function. Many tools in the new Common Data Elements (CDEs) for Cerebral Palsy were developed initially for typically developing children; others apply to only limited age ranges but often are used “off label;” and some designated as “exploratory” or “highly promising” lack confirmation (and likely further refinement) of their psychometric properties. Another major problem in pediatric rehabilitation trials has been the failure to measure Fidelity of Treatment (i.e., adherence to intended treatment protocols). Our PedRehab Ctr scientists have been active in developing and validating novel assessment tools from sophisticated kinematics to parent report tools; creating first ever Fidelity of Treatment tools for pediatric Constraint-Induced Movement Therapy and Bimanual treatment; and exploring the incorporation of various neuroimaging approaches to document treatment-induced neuroplasticity. Our specific aims for Techniques Development are: 1. To obtain confirmatory documentation of assessment methods for function, skill, and behaviors that go across laboratory and real-world environments. This includes use of kinematics and video-, game-, robotic-, and wearable-devices to supplement traditional standardized tests and systematic methods for establishing clinically meaningful thresholds for gain and losses; 2. To standardize modifications and summary scoring methods of currently used tools to allow for greater specificity and for use with children who vary widely in age, severity, and etiologies of neuromotor impairments; 3. To advance the development of Fidelity of Treatment measures to provide much-needed documentation of the actual delivery of rehabilitation interventions; and 4. To explore novel neuroimaging strategies for use as individual biomarkers and as valid, reliable indicators of treatment-induced neuroplasticity.