Locomotor Adaptations Following Stroke

描述（由申请人提供）：拟议研究的目的是了解中风后偏瘫患者适应运动肢体间协调的能力及其对步态对称的影响。利用这些知识，申请人的长期研究目标是开发基于科学的治疗方法，以促进中风后患者的身体康复和运动恢复。为实现这些目标，制定了一项五年研究和培训计划。该计划包括运动神经机制的训练，神经损伤患者的运动适应，步态测量和分析以及康复随机临床试验的设计和实施。该计划将在主要导师的指导下实施，主要导师是神经损伤患者运动适应方面的专家，共同发起人是步态功能障碍患者步行分析方面的专家，也是康复临床试验设计和实施方面的专家。培训将包括结构化阅读、出席课程讲座和研讨会、结构化实验室体验和学术会议报告。在系主任的全力支持下，候选人将可以使用两个设备齐全的实验室，能够测量三维人体运动和力的产生。拟议的研究将检验一个普遍的假设，即中风后偏瘫患者能够在分离式带跑步机上行走后适应他们的运动模式，在分离式带跑步机上，每条腿都以不同的速度移动。据推测，劈裂带跑步机运动后的肢间协调模式可用于改善中风后患者的步态对称性和功能。具体目标将测试：1)卒中后偏瘫患者适应肢间协调的能力；2)适应模式在地上运动的推广；3)使用分离式带跑步机训练改善卒中后患者步态对称性的可行性。相关性：在每年受中风影响的70万人中，50%的人将继续表现出长期的行走功能障碍，其中一些是由腿部协调性差引起的。这项研究调查了一种新型跑步机行走对中风患者腿部协调能力的影响。

DESCRIPTION (provided by applicant): The goal of the proposed research is to understand the capacity of persons with post-stroke hemiparesis to adapt locomotor interlimb coordination and the influence of this on gait symmetry. Utilizing this knowledge, the applicant's long-term research goal is to develop scientifically-based therapies to advance the physical rehabilitation and recovery of locomotion in persons following a stroke. A five-year research and training plan has been developed to meet these goals. This plan consists of training in the neural mechanisms of locomotion, motor adaptations in persons with neurological damage, gait measurement and analysis and the design and implementation of randomized clinical trials in rehabilitation. This plan will be implemented under the mentorship of the primary mentor, an expert in motor adaptation in persons with neurological damage and the cosponsor, an expert in the analysis of walking in persons with gait dysfunction and in the design and implementation of clinical trials in rehabilitation. Training will consist of structured readings, attendance at course lectures and seminars, structured laboratory experiences and presentation at academic meetings. With complete support from the candidate's department chair, the candidate will have access to two fully equipped laboratories capable of measuring 3-dimensional human movement and force production. The proposed research will test the general hypothesis that persons with post-stroke hemiparesis are able to adapt their locomotor patterns following walking on a split-belt treadmill, where each leg is moved at a different speed. It is hypothesized that the adapted pattern of interlimb coordination following split-belt treadmill locomotion may be used to improve gait symmetry and function in persons post-stroke. Specific aims will test: 1) the capacity of persons with post-stroke hemiparesis to adapt interlimb coordination, 2) the generalization of adapted patterns to overground locomotion and, 3) the feasibility of using split-belt treadmill training to improve gait symmetry in persons post-stroke. Relevance: Of the 700,000 persons affected by stroke each year, 50% will continue to demonstrate long term walking dysfunction, some caused by poor coordination between the legs. This research investigates the potential of a novel type of treadmill walking to influence coordination between the legs in persons who have sustained a stroke.