Systems approach to studying therapeutic horse riding and/P.Reeves/H.Clayton

研究治疗性骑马的系统方法和/P.Reeves/H.Clayton

• 批准号: 8093429
• 负责人: Jacek Cholewicki
• 金额: --
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-10-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8093429
• 关键词: Activities of Daily Living; Animals; Cerebral Palsy; Child; Chronic; Clinical; Clinical Research; Controlled Environment; Coupled; Data Set; Enrollment; Equus caballus; Experimental Designs; Face; Family; Feedback; Foundations; Future; Gatekeeping; Goals; Health Personnel; Impairment; Incidence; Individual; Insurance; Learning; Life; Live Birth; Measurable; Medical; Methods; Modeling; Monitor; Movement; Musculoskeletal Equilibrium; Nature; Outcome; Physical therapy; Population; Postural response; Prevalence; Primary Health Care; Process; Protocols documentation; Rehabilitation therapy; Research; Robotics; Role; Science; Severities; Simulate; Social support; Stimulus; System; Testing; Therapeutic; Therapeutic Studies; Therapeutic Uses; Treatment Efficacy; Uncertainty; Well in self; Work; alternative treatment; base; clinical application; cost; design; disability; experience; functional improvement; improved; innovation; insight; interest; motor control; osteopath; response; stem; theories; therapeutic effectiveness; tool; tool development; treatment program

Sudden, unexpected loading to the spine results in the most severe and costly back injuries. Fast and appropriate postural control responses during these sudden, unexpected events are important to spare the spine from harmful loading. Unfortunately, people with low back pain (LBP) have impaired postural control, which suggests that they are more likely to re-injure themselves and develop chronic back pain. Experimental and modeling work has demonstrated that poor postural control found in the LBP group, in part, can be explained by longer delays in postural responses. There are several studies documenting an increase in the postural response times associated with back pain. In addition, there are studies documenting increased variability in postural responses suggesting that postural control is less precise. We hypothesize that if osteopathic manipulative therapy (OMT) can effectively reduce somatic dysfunction and pain, then improvements in postural control, including faster and more accurate responses, should be realized. This improvement in postural control should then mitigate any adverse effects from a sudden, unexpected event. To test this hypothesis, we will develop objective performance measures of the postural control system, in particular assessment of the bandwidth of control (speed of the control system) and accuracy (error between desired and actual output). This will be accomplished with three specific aims: (1) to compare postural control in healthy and LBP individuals; (2) to compare postural control in LBP individuals before and after OMT; and (3) to classify subjects into homogeneous groups of measures of somatic dysfunction and postural control, and to evaluate group differences in terms of pain and disability. Both position and force control will be assessed during tracking and stabilization tasks. In addition, a simulated lifting task will be used to assess the response of the postural control system to sudden, unexpected perturbations from shifting the base of support. The proposed research will apply an innovative approach, based on Systems Science, to develop sensitive and objective clinical research tools that can assess performance changes in the postural control system.

突然的、意外的脊柱负荷会导致最严重和最昂贵的背部损伤。 在这些突发的、意外的事件中，快速和适当的姿势控制反应对于使脊柱免受有害负荷是重要的。不幸的是，患有腰痛（LBP）的人的姿势控制能力受损，这表明他们更有可能再次伤害自己并发展为慢性背痛。实验和建模工作表明，在LBP组中发现的姿势控制不良，部分原因是姿势反应延迟较长。 有几项研究记录了与背痛相关的姿势反应时间的增加。此外，有研究表明姿势反应的变异性增加，表明姿势控制不太精确。我们假设，如果整骨手法治疗（OMT）可以有效地减少躯体功能障碍和疼痛，那么改善姿势控制，包括更快，更准确的反应，应该实现。这种姿势控制的改善应该可以减轻突发意外事件的任何不良影响。 为了验证这一假设，我们将开发客观的性能措施的姿势控制系统，特别是评估的带宽控制（控制系统的速度）和精度（期望和实际输出之间的误差）。 这将通过三个具体目标来实现：（1）比较健康和LBP个体的姿势控制;（2）比较OMT前后LBP个体的姿势控制;（3）将受试者分为躯体功能障碍和姿势控制测量的同质组，并评估疼痛和残疾方面的组间差异。 在跟踪和稳定任务期间，将对位置和力控制进行评估。此外，将使用模拟提升任务来评估姿势控制系统对支撑底座移位引起的突发意外扰动的反应。 拟议的研究将采用基于系统科学的创新方法，开发敏感和客观的临床研究工具，以评估姿势控制系统的性能变化。