Movement Ability Changes with Balance-Based Torso-Weighting in Multiple Sclerosis

描述(申请人提供)：多发性硬化症(MS)是一种影响全球约250万人的神经退行性疾病，是导致年轻人残疾的最常见原因。平衡和步态障碍在多发性硬化症中很常见，然而，平衡和行动能力障碍的表现取决于特定多发性硬化症患者的神经处理障碍集。到目前为止，多发性硬化症的步态和平衡的运动学和动力学分析主要集中在临床残疾程度最低的个体。在这一人群中，改善步态和平衡的康复治疗在6-8周的运动疗法中取得了成效。一种新的干预措施--基于平衡的躯干称重(BBTW)--一种针对个人定向平衡减重的称重技术--显示出患有多发性硬化症的人的平衡和步态立即得到改善。躯干增加的重量最小(1.5%体重)，并根据个人的不平衡进行战略性放置。然而，其即时疗效背后的机制仍然神秘，关于多发性硬化症或其他疾病患者将受益的建议仍然含糊其辞。为了达到本研究的特定目的1，我们将对MS患者和健康对照组的站立和行走进行运动学和运动学分析。对于这项研究的具体目标2，我们将检验与健康对照组相比，在一组新的多发性硬化症参与者中，感觉和运动系统的几种损伤中哪一种最能预测BBTW对平衡和灵活性的即时改善。研究目标是完善关于BBTW干预背后机制的假设，并澄清谁将获得最大好处。未来的研究可能会检验这项工作产生的假说。如果我们实现了我们的两个具体目标，我们将有证据增加关于轻体重机制的科学知识，作为改变姿势控制策略的感官补充。这项研究将帮助我们理解对BBTW的反应机制，以及可能对补充感觉输入的其他干预措施的反应。有了这些知识，我们可以为多发性硬化症或其他神经疾病患者开发更有效的干预措施，改善临床结果和生活质量。如果我们能确定哪些患者最有可能从这种类型的干预中受益，医疗保健的提供就会更有效率，也更有效。 与公共健康相关：通过开始解开躯干轻体重背后的机制，我们可以为多发性硬化症或其他损害平衡和步态的神经障碍患者开发更有效的干预措施。这些干预措施将改善临床结果和生活质量。当我们确定哪些患者最有可能从这种类型的干预中受益时，医疗保健的提供可能会更有效率，也更有效。

DESCRIPTION (provided by applicant): Multiple sclerosis (MS) is a neurodegenerative disease affecting approximately 2.5 million people worldwide and is the most frequent cause of disability in young adults. Balance and gait impairments are common in MS, however, the manifestation of balance and mobility impairments is variable depending on the set of neural processing disruptions in the particular individual with MS. Most kinematic and kinetic analyses of gait and balance in MS have thus far focused on individuals with minimal clinical disability. Rehabilitation to improve gait and balance in this population have shown results in 6-8 weeks of exercise therapy. A novel intervention, balance-based torso-weighting (BBTW), a weighting technique tailored to individual directional balance loss, has shown immediate improvements in balance and gait in people with MS. The weight added to the torso is minimal (<1.5% body weight) and strategically placed according to the person's imbalance. However, the mechanisms behind its immediate effectiveness remain mysterious, and recommendations regarding people with MS or other disorders that will benefit remain vague. For Specific Aim 1 of this study, we will perform kinematic and kinetic analyses of standing and walking with and without BBTW in people with MS and healthy controls. For Specific Aim 2 of this study, we will examine which of several impairments of the sensory and motor systems best predicts immediate improvement in balance and mobility with BBTW in a new sample of participants with MS compared to healthy controls. The research goal is to refine hypotheses regarding the mechanism behind BBTW intervention, and clarify who will receive the most benefit. Future research could then test the hypotheses generated from this work. If we achieve our two specific aims, we will have evidence to add to the scientific knowledge regarding the mechanism of light weighting as a sensory supplement to change strategies for postural control. This study will help us understand the mechanisms for responsiveness to BBTW, and possibly to other interventions that supplement sensory input. With that knowledge, we can develop more effective interventions for people with MS or other neural disorders, improving clinical outcomes and quality of life. If we can determine which patients are most likely to benefit from this type of intervention, health care delivery can be more efficient as well as effective. PUBLIC HEALTH RELEVANCE: By beginning to unravel the mechanisms behind light torso-weighting we can develop more effective interventions for people with MS or other neural disorders that impair balance and gait. Such interventions will improve clinical outcomes and quality of life. When we determine the patients most likely to benefit from this type of intervention, health care delivery can be more efficient as well as effective.