Robotic Interventions to Enhance Locomotor Stability Following Spinal Cord Injury

描述（由申请人提供） 项目概述：该提案的主要目标是开发和测试一种能够为脊髓损伤（SCI）退伍军人提供有针对性的运动平衡训练的机器人设备。 工作假设是，这种新型的机器人工具将传统的体重支持跑步机训练（BWSTT）转化为一个动态的环境，在这个环境中，测量和适应性地挑战行走的平衡特定组件，从而提高运动训练的效果。 候选人：戈登博士的目标是在退伍军人管理局系统内建立一个新颖的、富有成效的、独立的研究路线，这将有利于受SCI影响的退伍军人的生活质量。 Gordon博士在SCI步态康复方面有着丰富的研究经验。 他观察到，在这一领域缺乏有效的运动平衡训练和评估工具。 在这个项目中，戈登博士将开发一种能够满足这一需求的新机器人设备。 结合戈登博士过去的经验与训练目的在目前的项目将定位戈登博士在这个未充分探索的领域SCI步态康复的前沿。 研发计划：Gordon博士组建了一个由Zev Rymer博士领导的多元化指导团队，在四个关键项目领域提供培训和指导;康复机器人，SCI后运动的神经生理学，运动平衡和SCI的临床护理。 戈登将通过课程作业，定向阅读和临床阴影的结合来推进他对这些领域的正式知识。 戈登博士还将通过定期的小组辅导会议，积极的手稿/赠款写作和参与赠款写作和领导力研讨会，在建立，资助和发展一个富有成效的独立研究计划方面获得职业发展指导。 工作环境：拟议的研究项目将在美国排名第一的康复医院芝加哥康复研究所（RIC）的感觉运动性能项目内的VA指定空间进行。 RIC提供的资源包括专用研究空间和设备、临床检查区域、办公空间和机械车间。 临床培训和脊髓损伤退伍军人的主要招募将通过小爱德华海因斯的脊髓损伤服务进行。退伍军人医院 拟议的研究：目标1）创建一个能够提供具有挑战性的，平衡特定运动训练的机器人环境库。 申请人提出开发一种智能机器人康复工具，其能够：A）施加一系列动态平衡环境，包括在步态期间施加到骨盆的稳定和/或不稳定的横向力，B）实时测量运动稳定性，以及C）自动调整平衡环境的难度以最佳地挑战参与者的能力。 该器械将由一个刚性连接到骨盆安全带后部的动圈式施力器（线性电机）组成。 软件将控制线圈推进器沿着与跑步机垂直对齐的轨道的行进。 因此，线圈推进器的移动将对用户施加内外向力。 他将开发软件来创建几个平衡特定的训练环境，可以安全，轻松地提供给SCI患者在跑步机上行走。目的2）探讨定向运动平衡训练对不完全性脊髓损伤患者步态稳定性、步行速度和能量效率的影响。 他将比较BWSTT在三种特定平衡训练环境中的效果。 步行不完全SCI受试者将接受BWSTT，其中1）要求动态平衡环境，自动并逐步适应，以在步态期间持续挑战受试者; 2）无平衡辅助（类似于在跑步机上无辅助行走）;或3）固定平衡辅助（类似于BWSTT的当前方法）。 他假设，动态平衡环境将导致步行速度、充满活力的步态效率和对步态扰动的反应能力的最大改善。

DESCRIPTION (provided by applicant) Project Overview: The major goals of this proposal are to develop and test a robotic device capable of providing targeted locomotor balance training for veterans with spinal cord injury (SCI). The working hypothesis is that this novel robotic tool will transform traditional body weight supported treadmill training (BWSTT) into a dynamic environment where balance-specific components of walking are measured and adaptively challenged, thereby enhancing locomotor training outcomes. Candidate: Dr. Gordon's objective is to establish a novel and productive, independent line of research within the VA system that will benefit the quality of life of veterans affected by SCI. Dr. Gordon has significant research experience in gait rehabilitation of SCI. He has observed that effective locomotor balance training and assessment tools are lacking within this field. For the purposed project, Dr. Gordon will develop a new robotic device capable of addressing this need. Combining Dr. Gordon's past experience with the training purposed in the current project will position Dr. Gordon at the forefront of this under-explored area of SCI gait rehabilitation. Research Development Plan: Dr. Gordon has assembled a diverse mentoring team, lead by Dr. Zev Rymer, to provide training and guidance in four critical project areas; rehabilitation robotics, neurophysiology of movement following SCI, locomotor balance and clinical care of SCI. Dr. Gordon will advance his formal knowledge of these areas through a combination of course work, directed readings and clinical shadowing. Dr. Gordon will also receive career development guidance in terms of establishing, funding and growing a productive independent research program through regular group mentoring sessions, active manuscript/grant writing and participation in grant writing and leadership seminars. Environment: The proposed research project will be conducted in VA designated space within the Sensory Motor Performance Program at the Rehabilitation Institute of Chicago (RIC), the top ranked rehabilitation hospital in the country. The resources provided by RIC include dedicated research space and equipment, clinical examination areas, offices space and machine shop. Clinical training and the primary recruitment of veterans with SCI will be performed through the Spinal Cord Injury Service at Edward Hines Jr. VA Hospital. Proposed Research: Aim 1) To create a library of robotic environments capable of providing challenging, balance-specific locomotor training. Applicant proposes to develop an intelligent robotic rehabilitation tool capable of A) applying a range of dynamic balance environments, including stabilizing and/or destabilizing lateral forces applied to the pelvis during gait, B) measuring locomotor stability in real-time and C) automatically adjusting the difficulty of the balance environments to optimally challenge the abilities of the participant. The device will consist of a moving coil forcer (linear motor) rigidly attached to the posterior of a pelvic harness. Software will control travel of the coil forcer along a track aligned perpendicular to the treadmill. Thus, movement of the coil forcer will exert a medial-lateral force on the user. He will develop software to create several balance-specific training environments that can be safely and easily delivered to people with SCI during treadmill walking. Aim 2) To test the effects of targeted locomotor balance training on gait stability, walking speed and energetic efficiency in incomplete SCI subjects. He will compare the effects of BWSTT performed in one of three balance-specific training environments. Ambulatory incomplete SCI subjects will receive BWSTT with either 1) a demanding dynamic balance environment that automatically and progressively adapts to continuously challenge the subject during gait; 2) no balance assistance (similar to unassisted walking on a treadmill); or 3) fixed balance assistance (similar to current approaches to BWSTT). He hypothesizes that the dynamic balance environment will result in the greatest improvements in walking speed, energetic gait efficiency and the ability to respond to gait perturbations.