Assessment of Locomotor Potential Following Stroke

联系PD/PI：帕滕，卡罗林 中风是全世界成年人严重、慢性残疾的主要原因。超过750,000例新中风发生 在美国，每年入院的急性神经科患者占一半以上。而两个人- 中风患者中有三分之一恢复了行走功能，由此产生的步态模式缓慢， 不对称且新陈代谢效率低下。行走障碍代表着最大的生理障碍之一 限制中风后和改善步行是最经常被表达的目标之一 神经康复。到目前为止，中风后步行功能障碍的康复治疗产生了很大的变数 结果显示步行功能的最小真实变化，包括步行速度或步行模式。 我们的长期目标是改善中风后患者的行走功能。此应用程序的目标是 开发一种预测指标，以确定改善以下步行能力的生理潜力 卒中。我们提议的理由源于我们之前的工作，该工作确定了不同的模式 对偏瘫步行功能障碍的治疗干预的反应，“应答者”和“无应答者”。 应答者的特征是地面行走速度的显著变化和 时空协调。无响应者的地面行走速度变化很小， 时空协调方面的变化很少，如果有的话。当应答者和非应答者出现在 中风后的人口并不令人惊讶，在研究基线上，应答者和非应答者不可能是 用临床上的运动障碍、活动或行走速度的仪器来区分的。此外，临床上 慢性性和严重性的特征未能预测这些反应模式。把我们的 研究结果表明，存在内在的、迄今尚未确定的特定于受试者的特征，这些特征 行走功能恢复顺利。 在这里，我们建议开发一种预后指标来识别：a)神经生理学缺陷导致 步行功能障碍和b)中风后个人提高步行能力的潜力。通知人 在我们之前的工作中，我们认识到神经生理功能对步行过程中的神经机械输出有贡献。 达到神经生理功能的阈值将意味着神经生物学的存在 提高步行能力所必需的底物。因此，我们将能够区分具有 对那些可能需要更积极的方法来应对传统干预措施的人做出反应的能力 修复神经生理功能。 关键词：中风、运动、康复、康复、生物力学 项目摘要/摘要第6页

Contact PD/PI: Patten, Carolynn Stroke is the leading cause of serious, chronic disability in adults worldwide. Over 750,000 new strokes occur in the United States each year accounting for over half of all acute neurological hospital admissions. While two- thirds of persons who suffer a stroke regain ambulatory function, the resulting gait pattern is slow, asymmetrical and metabolically inefficient. Walking dysfunction represents one of the greatest physical limitations post-stroke and improved walking is among the most frequently articulated goals of neurorehabilitation. To date, rehabilitation for walking dysfunction post-stroke has produced highly variable outcomes revealing minimal genuine change in walking function including walking speed or walking pattern. Our long term goal is to improve walking function in persons post-stroke. The objective of this application is to develop a prognostic indicator to determine the physiological potential to improve walking capacity following stroke. The rationale for our proposal stems from our previous work, which has identified distinct patterns of response to therapeutic intervention for hemiparetic walking dysfunction, `responders' and `non-responders'. Responders are characterized by significant changes in overground walking speed and multiple changes in spatio-temporal coordination. Non-responders produced minimal changes in overground walking speed and few, if any, changes in spatio-temporal coordination. While the presence of responders and non-responders in the post-stroke population is not surprising, at study baseline responders and non-responders could not be differentiated using clinical instruments of motor impairment, activity, or walking speed. Moreover, clinical characteristics of chronicity and severity failed to predict these patterns of response. Taken together our findings suggest the presence of intrinsic, as-yet-unidentified subject-specific characteristics that mediate successful recovery of walking function. Here we propose development of a prognostic indicator to identify: a) neurophysiologic deficits contributing to walking dysfunction and b) an individual's potential to improve walking capacity following stroke. Informed by our prior work, we recognize neurophysiologic function contributes to neuromechanical output during walking. Attainment of a threshold of neurophysiologic functioning will suggest the presence of a neurobiological substrate requisite to improvement in walking capacity. Thus we will be able to differentiate individuals with the capacity to respond to traditional interventions from those who may need more aggressive approaches to remediate neurophysiologic function. Keywords: stroke, locomotion, recovery, rehabilitation, biomechanics Project Summary/Abstract Page 6