Short-Burst Interval Treadmill Training to Improve Community Walking Activity and Mobility in Cerebral Palsy

项目摘要/摘要： 脑性瘫痪(CP)儿童以低强度步行为主，步频较少 多变性，从而限制了他们的步行活动和参与日常生活的能力。相比之下，通常 发育中(TD)儿童从事短时间的高强度步行活动，其间穿插着不同的间隔 日常生活中的低强度步行。为了优化运动学习，积极参与，任务具体 学习新的运动技能需要训练和多次重复或大量练习。短时间内爆发 大强度运动平板运动训练(SBLTT)与低强度/中等强度交替进行，特别是 旨在以集体练习的形式模仿TD儿童的活动模式。试点数据表明，SBLTT 是可行的，并提高了CP儿童的步行能力和日常生活能力。的目标是 这项应用是为了检验SBLTT与同等剂量的传统运动的效果。 跑步机训练(TLTT)对脑性瘫痪儿童步行能力和运动能力的主要结果。 该方案还将检查SBLTT对步行能力和运动能力的影响是否 由肌肉发电能力的改善所调节。科学的前提是SBLTT，即 通过临床上可行的方法来近似典型发育中(TD)儿童的步行强度模式 集体练习方案，在提高步行能力和成绩方面将比TLTT更有效。我们 假设针对脑瘫儿童的SBLTT策略是以TD儿童的活动模式为模型的，将是 通过肌肉产生积极的调节作用，从而改善步行能力和社区 步行性能和机动性。我们将测试以下具体目标。目标#1.确定眼前的 短爆发间期潜伏期(SBLTT)对CP患儿步行能力的保留效应。 步行能力将通过自选步速和一分钟步行测试来测量。目标#2.检查 治疗对社区步行活动能力和活动能力的影响。步行活动 性能将通过加速度计获得。按家个性化的社区步行移动性与 社区位置将使用全球定位系统和加速度计的新组合进行测量。 目的#3.探索SBLTT对步行能力和运动能力的影响是否由肌肉介导 发电。该项目具有创新性，因为它侧重于针对特定任务的新颖方法 脑性瘫痪儿童的步行限制，并实施个性化的社区定位结果。这个 拟议的研究具有重要意义，因为它将是一系列研究的第一步，预计将 指导儿童残疾的运动训练方案和康复策略，并对 社区步行能力和脑性瘫痪儿童的行动能力。增加对肌肉的了解 慢性阻塞性肺病儿童对SBLTT的反应机制是可望的。这类知识与 一生中增强行动能力和体力活动的健康和功能益处。

Project Summary/Abstract: Ambulatory children with cerebral palsy (CP) walk predominately in low intensity stride rates with little variability, thus limiting their walking activity and ability to participate in daily life. In contrast, typically developing (TD) children engage in short bursts of intense walking activity interspersed with varying intervals of low intensity walking within daily life. In order to optimize motor learning, active participation, task-specific training and multiple repetitions or massed practice is required to learn new motor skills. Short bursts of vigorous intensity locomotor treadmill training (SBLTT) alternating with low/moderate intensity was specifically designed to mimic activity patterns of TD children in a massed practice format. Pilot data suggests that SBLTT is feasible and enhances walking capacity and performance in daily life for children with CP. The objective of this application is to examine the effect of SBLTT versus an equivalent dosage of traditional locomotor treadmill training (TLTT) on the primary outcomes of walking capacity and performance in children with CP. This protocol will also examine whether the effects of SBLTT on walking capacity and performance are mediated by improvements in in muscle power generation. The scientific premise is that SBLTT, that approximates the walking intensity patterns of typically developing (TD) children through a clinically feasible massed practice protocol, will be more effective than TLTT in improving walking capacity and performance. We hypothesize that SBLTT strategies for children with CP modeled on activity patterns in TD children, will be positively mediated by muscle power generation and subsequently improve walking capacity and community walking performance and mobility. We will test the following specific aims. Aim #1. Determine the immediate and retention effects of short-burst interval LTT (SBLTT) on walking capacity in ambulatory children with CP. Walking capacity will be measured by self-selected gait speed and the one minute walk test. Aim #2. Examine the effects of treatment on community-based walking activity performance and mobility. Walking activity performance will be captured by accelerometry. Community walking mobility individualized by home versus community locations will be measured with a novel combination of global position system and accelerometry. Aim #3. Explore whether the effects of SBLTT on walking capacity and performance are mediated by muscle power generation. This project is innovative because it focuses novel task-specific approach for addressing walking limitations in children with CP and implements an individualized community locations outcome. The proposed research is significant because it will be the first step in a continuum of research that is expected to direct locomotor training protocols and rehab strategies across pediatric disabilities and positively effecting the community walking performance and mobility for children with CP. Increased understanding of the muscular mechanisms by which children with CP respond to SBLTT are expected. Such knowledge has relevance to the health and functional benefits of enhanced mobility and physical activity across the life span.