Ankle strengthening using virtual reality and robotic dynamometer for CP patients

描述（由申请人提供）：我们假设强化肌肉可能是改善脑瘫儿童步态和功能的另一种选择。我们的长期目标是开发一种改进的强化疗法，与目前的方法相比。我们提出的治疗方法是基于罗格斯踝关节机器人原型的使用，该机器人集成了类似游戏的虚拟现实（VR）模拟。特定目标的首要目标是开发罗格斯脚踝CP用于加强脚踝的CP患儿。第二个目标是确定12周的密集的脚踝dorsi罗格斯脚踝CP / plantarflexors体能项目将改善踝关节力量,步态,功能,和CP患儿的生活质量。方法1)我们将构建罗格斯脚踝CP系统和修改机器人伺服控制允许积极协助/消极抵抗脚踝运动;2)我们将在Rutgers Ankle CP上为接受CP训练的儿童扩展虚拟康复软件。一种新的智能代理软件将任务消耗要求与患者过去的表现相关联，以确定机器人的行为（从100%协助到100%抵抗）；3)我们将开发一个可上网的数据库模块，用于报告和数据分析。罗格斯踝关节CP的数据将在临床现场实时透明采样。随后，这些数据将通过互联网转发到罗格斯大学现有的数据库服务器。现有的基于网络的临床数据库和绘图环境将得到加强，包括传统的CP临床评估措施、虚拟现实练习的计算机化变量和主观评估问卷；4) 6名患有痉挛性双瘫CP的受试者将参加为期12周的罗格斯踝关节CP的踝关节背/跖屈肌力量训练计划。受试者将在干预前、12周干预结束时和12周后进行踝关节力量、痉挛、步态分析、GMFM和Peds QL评估。我们假设受试者将通过机器人训练改善力量、步态、功能和生活质量，并将保持至少12周的收益。本项目将开发一种用于CP踝关节力量训练的装置。力量训练可用于改善步态和功能。一个简单的力量训练计划可以改善步态和功能，通过消除或推迟更昂贵的手术来降低医疗成本。

DESCRIPTION (provided by applicant): We hypothesize that strengthening muscles may be an alternative for improving gait and function in children with cerebral palsy. Our long-term objective is to develop an improved strengthening therapy compared to today's approaches. Our proposed therapy is based on the use of a prototype Rutgers Ankle robot integrated with game-like virtual reality (VR) simulations. SPECIFIC AIMS The first aim is to develop the Rutgers Ankle CP for use in strengthening the ankles of children with CP. The second aim is to determine if a 12-week intensive ankle dorsi/plantarflexors strength-training program on the Rutgers Ankle CP will improve ankle strength, gait, function, and quality of life of children with CP. METHODS 1) we will construct the Rutgers Ankle CP system and modify the robot servo control to allow active assistance/passive resistance to ankle motion; 2) we will expand virtual rehabilitation software for children with CP training on the Rutgers Ankle CP. A new intelligent agent software will correlate task exertion requirements with patient past performance in order to determine the robot behavior (from 100% assistance to 100% resistance); 3) we will develop a web-accessible database module for reporting and data analysis. Data from the Rutgers Ankle CP will be sampled transparently in real time at the clinical site. Subsequently the data will be forwarded over the Internet to an existing database server at Rutgers University. The existing web-based clinical database and graphing environment will be enhanced to include conventional CP clinical evaluation measures, computerized variables from the VR exercises, and subjective evaluation questionnaires; 4) Six subjects with spastic diplegia CP will participate in a 12-week strength-training program of the ankle dorsi/plantarflexors on the Rutgers Ankle CP. Subjects will be evaluated for ankle strength, spasticity, gait analysis, GMFM, and Peds QL prior to the intervention, at the end of the 12-week intervention, and after an additional 12 weeks. We hypothesize that the subjects will improve in strength, gait, function, and quality of life from training on the robot, and will maintain the gains for at least 12 weeks. NIH RELEVANCE This project will develop a device for ankle strength training in CP. The strength training can be used to improve gait and function. PUBLIC HEALTH RELEVANCE A simple strength training program that improves gait and function will reduce health care costs by eliminating or delaying more expensive procedures.