CLASSIFICATION OF CEREBRAL PALSY SUBTYPES TRAINING STUDY

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。脑瘫有许多不同的类型。传统上，我们通过运动受影响的方式来区分这些不同的类型。患有痉挛性偏瘫型CP的儿童有一侧身体活动困难；患有痉挛性双截瘫型CP的儿童双臂和双腿都有活动困难，但腿部比手臂更严重。这种区分不同类型CP的方法是不准确的。我们有很多测试用来测量运动功能。一些（“标准化问卷”）给出了孩子们如何移动的一个很好的整体图景；其他的（“运动控制测试”）给了我们更多关于运动问题的细节。第二种类型的测试可能在识别CP类型方面更好。例如，当一些偏瘫型儿童移动一只手时，另一只手会做出不想要的动作。这些被称为镜像运动。我们不知道为什么会发生这种情况，但我们认为这可能是一种很好的方法，可以告诉哪些孩子有更严重的CP。这项研究还将帮助我们了解运动问题的根源，以便我们找到更好的治疗方法。例如，虽然许多患有CP的儿童肌肉非常僵硬（“痉挛”），但肌肉也可能很弱。我们不知道运动问题是由于僵硬还是虚弱造成的。我们将招募患有CP和年龄匹配的健康对照的4至18岁的儿童。本研究的第一个目的是开发一种可靠的方法来区分不同类型的CP。为了做到这一点，我们将请三位专家检查患有CP的儿童，看看他们是否能就儿童患有哪种类型的CP达成一致。这项研究的第二个目的是测量患有CP的儿童的运动问题。具体来说，我们想看看哪些测试可以帮助我们识别两种不同类型的CP（痉挛性偏瘫和痉挛性双瘫）。我们将通过使用标准化问卷和运动控制测试来评估运动问题，并将它们进行比较。这项研究的第三个目的是测量运动问题根源的肌肉和神经问题。我们将通过测量肌肉僵硬，肌肉无力，肌肉和脑电波模式来做到这一点，我们将研究这些与运动问题的关系。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There are many different types of cerebral palsy. Traditionally, we separate these different types by the way movement is affected. Children with spastic hemiplegia type of CP have difficulty moving one side of their body; children with spastic diplegia type of CP have difficulty moving both arms and legs, but their legs are worse than their arms. This way of separating the different types of CP is not accurate. We have many tests which we use to measure motor function. Some ("standardized questionnaires") give an excellent overall picture of how the children move; others ("tests of motor control") give us more detail about the movement problems. These second type of tests might be better at identifying the type of CP. For instance, when some children with hemiplegia type move one hand, the other hand makes unwanted movements. These are called mirror movements. We don't know why this happens but we think it may be a good way of telling which children have more severe CP. This study will also help us learn about what is at the root of the movement problems so that we can find better treatments. For instance, although many children with CP have very stiff muscles ("spasticity"), the muscles can also be weak. We don't know if the movement problems are due to the stiffness or to the weakness. We will enroll children from 4 to 18 years of age who have CP and age-matched healthy controls. The first aim of this study will be to develop a reliable way of telling the different types of CP apart. To do this we will ask three experts to examine children with CP to see if they can agree on which type of CP the children have. The second aim of this study is to measure the movement problems in children with CP. Specifically, we want to see which tests can help us identify the two different types of CP (spastic hemiplegia and spastic diplegia). We will do this by assessing the movement problems using the standardized questionnaires and the motor control tests and comparing them together. The third aim of this study is to measure the muscle and nerve problems that are at the root of the movement problems. We will do this by measuring muscle stiffness, muscle weakness, and muscle and brain wave patterns and we will examine how these relate to the movement problems.