SENSORY/MOTOR INPUT EFFECTS ON GAIT IN SCI SUBJECTS

描述（改编自申请人的描述：在存在 由于不完全脊髓损伤（SCI）引起的痉挛性轻瘫， 脊髓上对下肢运动输出的贡献导致 一些运动异常 其中包括不受管制的脊髓 反射、运动恢复不足和延迟以及平衡缺陷。 如果个体是走动的，这些异常表现在 导致步态模式为肌肉之间的异常时间关系 组，缺乏负重能力和不适当的肌肉 活动，如延长的站立期、阵挛和“剪刀”。“感官 来自多个来源的信息有助于制作 因此，通过操纵感觉输入， 可以修改电机输出。 两项创新技术似乎 有效实现这一目标的是体重支持（BWS）， 功能性电刺激（FES）。 人类脊髓响应和受益于神经刺激的能力 创新的跑步机训练方案将进行评估。 FES将用于 结合BWS，以促进在跑步机上的运动表现， 不完全SCI患者。 初步研究表明， 结合这些干预措施，步态性能得到改善， 允许出现有效和实用的运动。 的影响 体重支持和适当的定时刺激， 将表征所得到的同侧和对侧运动输出。 FES强化BWS运动的训练效果 将审查多期培训方案。 步态参数修改 将通过培训确定这些变化的性质， 表征了 为了进一步研究BWS如何影响脊髓神经元， 第二组实验将研究对α运动神经元的影响， 在有以下症状的个体中， 不完全SCI和健全（AB）对照。 本实验旨在验证以下假设：（1）运动 不完全SCI患者的能力可以受到以下因素的积极影响： 由BWS和FES组成的训练方案，以及（2） 下肢去负荷影响运动神经元兴奋性， 人类 这项工作的结果被设想为提供基础， 为SCI患者制定康复方案， 运动能力

DESCRIPTION (Adapted from Applicant's Description: In the presence of spastic paresis due to incomplete spinal cord injury (SCI), inadequate supraspinal contributions to motor output of the lower extremities result in a number of abnormalities of movement. Among these are unregulated spinal reflexes, inadequate and delayed motor recruitment, and balance deficits. If the individual is ambulatory, these abnormalities are manifest in the resulting gait pattern as aberrant temporal relationships between muscle groups, deficits in weight bearing capacity and inappropriate muscle activity such as prolonged stance phase, clonus and "scissoring." Sensory information from multiple sources contributes to the production of vertebrate locomotion, therefore, by manipulating sensory input it is possible to modify motor output. Two innovative technologies that appear to be effective for achieving this end are body weight support (BWS) and functional electrical stimulation (FES). The capacity of the human spinal cord to respond to and benefit from an innovative treadmill training regimen will be assessed. FES will be used in conjunction with BWS to facilitate locomotor performance on a treadmill in individuals with incomplete SCI. Preliminary studies indicate that, by combining these interventions, gait performance is improved such that more efficient and functional movement is allowed to emerge. The influence of the body weight support and of appropriately timed stimulation on the resulting ipsilateral and contralateral motor outputs will be characterized. The training effects of BWS locomotion augmented by FES over the course of a multi-session training program will be examined. Gait parameters modified by training will be identified and the nature of these changes will be characterized. To further study how BWS may affect spinal neural elements, a second set of experiments will investigate the effects on alpha motoneuron excitability of unloading the lower extremities, in individuals with incomplete SCI and able-bodied (AB) controls. The proposed experiments are to test the hypothesis that (1) locomotor capacity in individuals with incomplete SCI can be positively influenced by a training regimen consisting of BWS in conjunction with FES, and (2) unloading of the lower extremities influences motoneuron excitability in humans. Results from this work are envisioned to provide the foundation on which to develop rehabilitation protocols for SCI individuals with residual locomotor capacity.