Prone Locomotion in Infants with or at Risk for Disabilities

患有残疾或有残疾风险的婴儿的俯卧运动

• 批准号: 7897130
• 负责人: Hlapang A. Kolobe
• 金额: $ 24.53万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-05 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7897130
• 关键词: Adult; Affect; Age-Months; Algorithms; Area; Back; Bicycling; Brain; Build-it; Cells; Cerebral Palsy; Child; Clinical Trials; Cognition; Complement; Computer software; Data; Detection; Development; Devices; Experimental Designs; Feedback; Frequencies; Future; Generations; Goals; Home environment; Human; Hypogravity; Infant; Infant Behavior; Infant Development; Intervention; Kinetics; Learning; Lesion; Life; Limb structure; Locomotion; Longevity; Measures; Mechanics; Motor Skills; Movement; Outcome; Pattern; Performance; Phase; Physically Handicapped; Protocols documentation; Recruitment Activity; Research; Rewards; Risk; Robotics; Sensory; Signal Transduction; Synapses; System; Technology; Testing; Therapeutic; Time; Trackball Device Component; Training; United States; User-Computer Interface; Videotape; Work; base; cost; design; disability; experience; improved; infancy; information gathering; innovation; kinematics; limb movement; motor learning; neuron loss; public health relevance; research study; response; sensor; skills; stroke rehabilitation; success; tool

DESCRIPTION (provided by applicant): The purpose of the proposed exploratory study is to develop and test an integrated robotics and sensor technology system designed to influence movement learning in infants with cerebral palsy (CP). CP is the most disabling condition for children in the United States with locomotion being the most affected functional skill. Of particular concern to the proposed project is that children with CP do not only show paucity of self-initiated movements critical for locomotion, but that these movements diminish as the children grow (learned disuse/non-use). Many of the mobility constraints that confront adults with CP can be traced back to infancy. Prone locomotion is the earliest and, in some cases the only form of locomotion available to infants during the first year of life, that infants with or at risk for CP rarely attain. Not only is prone locomotion integrated with other systems essential for functional independence and learning, its development in infants who are typically developing also coincides with a period of highly active synaptic formation in the brain, making it a critical gateway and target for intervention. No tested interventions exist to promote this skill in infants. The proposed study is the next step in our work on the use of a self-initiated prone progression crawler (SIPPC) to promote and help sustain limb and body movements by infants with CP during prone locomotion. It builds on promising results of our earlier trials that showed that the 1st generation SIPPC (SIPPC-1), which used device-based positional input sensors as control signals, tended to reward later rather than earlier efforts. The proposed 2nd generation SIPPC (SIPPC-2) will add infant-based sensors (limb-mounted accelerometers and load cells) that will not only serve as control signals, but will also generate kinematic and kinetic data about how infants with or at risk for CP learn to move during prone locomotion. Two (2) related studies will be used to test whether the SIPPC-2 controls will enhance motor learning and promote prone locomotion. In the first study we will gather information to create a menu of canonical limb and body movement patterns that predictably result in infant-driven movement of the SIPPC-2. The second study will test the device- and infant-driven control algorithms and compare the development of movement strategies of infants using active and inactive SIPPC-2 systems. Thirty (30) infants with and without CP will be recruited and tested at 3 - 4 months to determine risk for CP. Training will begin at 4.5 - 6.5 months of age. The design protocol will comprise 15-20 minutes of training on the SIPPC-2 for 12 weeks. The training sessions will be videotaped. The Bayley Scales of Infant Development III will be used to assess domains of development that are associated with prone locomotion. The SIPPC-2 design is unique and innovative in that it is not only an intervention device, but can also be used to gather comprehensive information about the infants' learning and mobility patterns. The results will generate information on how infants with brain lesions learn a new motor skill, provide information on the use of reinforced learning in infants, help determine the feasibility of the SIPPC-2 as a valid intervention system, and refine a self-contained portable battery powered SIPPC-2 to be used in homes and in future clinical trials. PUBLIC HEALTH RELEVANCE: The SIPPC-2 system is unique in that it is not only an intervention device that simultaneously generates performance outcomes, but it can also be used to gather comprehensive information about how infants (with and without CP) learn a movement-related task like crawling. The kinematic and kinetic data generated by the SIPPC-2 will allow us to begin to speculate about brain plasticity in infants with brain lesions. We expect that the use of a menu of patterns of limb movement will help deter learned non-use/disuse by challenging infants with a brain insult, such as cerebral palsy, to attain high levels of psychomotor abilities, and minimize the long term deleterious effects that immobility has on other domains of development and functional independence. Because early prone locomotion is associated with emergence of a wide variety of skills, assisting infants with or at risk for CP to attain this skill have far reaching effects.

描述（由申请人提供）：拟议的探索性研究的目的是开发和测试集成机器人和传感器技术系统，旨在影响脑瘫（CP）婴儿的运动学习。脑瘫是美国儿童最严重的残疾状况，其中运动能力是受影响最大的功能技能。拟议项目特别值得关注的是，患有脑瘫的儿童不仅缺乏对运动至关重要的自发运动，而且这些运动随着儿童的成长而减少（习得性废用/不使用）。患有脑瘫的成年人面临的许多行动限制可以追溯到婴儿期。俯卧运动是婴儿出生后第一年最早的运动方式，在某些情况下是唯一的运动方式，患有脑瘫或有脑瘫风险的婴儿很少能做到这一点。俯卧运动不仅与功能独立和学习所必需的其他系统相结合，而且它在通常发育的婴儿中的发育也与大脑中高度活跃的突触形成时期相一致，使其成为干预的关键门户和目标。目前还没有经过测试的干预措施可以促进婴儿的这项技能。拟议的研究是我们使用自发俯卧进展爬行器 (SIPPC) 来促进和帮助患有 CP 的婴儿在俯卧运动过程中维持肢体和身体运动的下一步工作。它建立在我们早期试验的有希望的结果的基础上，这些结果表明，使用基于设备的位置输入传感器作为控制信号的第一代 SIPPC (SIPPC-1) 往往会奖励后来的努力，而不是早期的努力。拟议的第二代 SIPPC (SIPPC-2) 将添加基于婴儿的传感器（安装在肢体上的加速度计和称重传感器），这些传感器不仅用作控制信号，还将生成有关患有脑瘫或有脑瘫风险的婴儿如何在俯卧运动期间学习移动的运动学和动力学数据。将使用两 (2) 项相关研究来测试 SIPPC-2 控制是否会增强运动学习并促进俯卧运动。在第一项研究中，我们将收集信息来创建规范的肢体和身体运动模式菜单，这些模式可预测地导致 SIPPC-2 的婴儿驱动运动。第二项研究将测试设备驱动和婴儿驱动的控制算法，并比较使用主动和非主动 SIPPC-2 系统的婴儿运动策略的发展。将招募三十 (30) 名患有和不患有 CP 的婴儿并在 3 - 4 个月大时进行测试，以确定患 CP 的风险。训练将于 4.5 - 6.5 个月大时开始。设计方案将包括在 SIPPC-2 上进行为期 12 周、15-20 分钟的培训。培训课程将被录像。婴儿发育贝利量表 III 将用于评估与俯卧运动相关的发育领域。 SIPPC-2的设计是独特和创新的，因为它不仅是一个干预设备，而且还可以用来收集有关婴儿学习和活动模式的全面信息。结果将生成有关脑损伤婴儿如何学习新运动技能的信息，提供有关在婴儿中使用强化学习的信息，帮助确定 SIPPC-2 作为有效干预系统的可行性，并改进独立便携式电池供电的 SIPPC-2，以便在家庭和未来的临床试验中使用。 公共健康相关性：SIPPC-2 系统的独特之处在于，它不仅是一种同时产生表现结果的干预设备，而且还可以用于收集有关婴儿（有或没有 CP）如何学习爬行等运动相关任务的全面信息。 SIPPC-2 生成的运动学和动力学数据将使我们能够开始推测患有脑损伤的婴儿的大脑可塑性。我们预计，使用一系列肢体运动模式将有助于阻止大脑损伤（如脑瘫）的婴儿获得高水平的精神运动能力，并最大限度地减少不动对其他发育和功能独立领域的长期有害影响。由于早期俯卧运动与多种技能的出现相关，因此帮助患有脑瘫或有脑瘫风险的婴儿获得这项技能具有深远的影响。