Parkinsonian Gait Disorders: Mechanisms and Treatment

描述（由申请人提供）：该导师研究科学家发展奖将为申请人提供博士和博士后教育的物理治疗师，为实现康复研究独立职业的长期目标所必需的培训。申请人在运动神经控制研究方面的专业知识将与申办者在帕金森病患者的评估、治疗和研究方面的专业知识相结合。所提供的培训将允许申请人调查帕金森病患者步态困难的机制，最终目标是制定康复策略，最大限度地提高这些患者的功能活动能力。拟议的研究将集中在行走时的转身，因为许多帕金森病患者在转身方面有困难，而且很少有研究关注这一功能关键的动作。拟议的研究将涉及以下假设：1)选择和产生适当的运动模式的问题导致了转向运动受损，2)传统的药物治疗部分改善了转向运动模式，但并不能完全解决问题，3)帕金森病患者在提供相关的外部刺激时保留了改变运动输出和产生适当的转向模式的能力。4)旋转跑步机刺激可能是提供这些外部刺激的有效康复工具，从而提高转身能力。所有这些假设都将通过结合肌电图记录的全身三维运动分析进行调查。患有帕金森病的受试者将与年龄和性别匹配的对照受试者进行比较。这些研究的结果将为帕金森病对步态的影响提供重要的见解，评估当前治疗方法在解决步态困难方面的有效性，并指导未来的康复策略，以改善帕金森病患者的功能活动能力。

DESCRIPTION (provided by applicant): This Mentored Research Scientist Development Award will provide the applicant, a doctorally and postdoctorally educated physical therapist, with the training necessary to achieve the long-term objective of an independent career in rehabilitation research. The applicant's expertise in the study of neural control of locomotion will be combined with the sponsor's expertise in the evaluation, treatment, and study of individuals with Parkinson's disease. The training provided will allow the applicant to investigate mechanisms underlying gait difficulties in individuals with Parkinson's disease, with the ultimate goal of developing rehabilitative strategies to maximize functional mobility in these individuals. The proposed studies will focus on turning during walking, as many subjects with Parkinson's disease have difficulty with turning and little research has focused on this functionally critical movement. The proposed studies will address the following hypotheses: 1) problems with the selection and production of appropriate motor patterns contribute to impaired turning movements, 2) conventional pharmacological treatments partially improve turning motor patterns but do not completely address the problem, 3) subjects with Parkinson's disease retain the ability to modify locomotor output and produce appropriate turning patterns when provided with relevant external stimuli, and 4) rotating treadmill stimulation may be an effective rehabilitative tool for providing these external stimuli, thereby enhancing turning ability. All of these hypotheses will be investigated using whole-body, 3-D movement analyses in conjunction with electromyographic recordings. Subjects with Parkinson's disease will be compared to age- and gender-matched control subjects. Results of the proposed studies will provide important insights regarding the effects of Parkinson's disease on gait, evaluate the effectiveness of current therapies in addressing gait difficulties, and guide future rehabilitation strategies for improving functional mobility in people with Parkinson's disease.