Eccentric Motor-Control Training to Improve Human SCI

描述（由申请人提供）：脊髓损伤（SCI）后行走的最佳恢复取决于针对不同缺陷的特定任务训练。偏心运动控制在SCI患者和动物中均受损，并在跑步机训练后持续存在，这表明需要更大的训练特异性。偏心集中的跑步机训练计划尚未在人类SCI中进行过研究，但在啮齿动物SCI中显示出良好的疗效。在一个强有力的原理验证设计中，该提案将为至少6个月前完成传统运动训练的不完全SCI患者提供下坡跑步机训练。在偏心控制、功能表现和社区参与方面的任何进一步收获都将确立偏心任务特定训练的重要性。由于偏心肌肉激活在人类SCI中研究不足，因此该提案旨在表征运动期间的偏心运动控制（目标1）和下坡训练的有效性（目标2和3）。在目标2中，我们将确定下坡训练对地面运动的影响，通过测量生物力学在运动的重量接受阶段时，偏心膝关节控制在矢状面占上风。下坡训练是否会促进功能和社区参与的收益将在目标3中进行测试。初步证据表明，过度的膝关节屈曲或过伸在体重接受提供了支持，我们的理论，长期存在偏心运动缺陷，并减少功能恢复。因此，我们假设，偏心缺陷的存在和严重程度，如这些将产生负面影响本地运动恢复;将通过下坡偏心训练减少，并将转化为改善地面运动和功能。

DESCRIPTION (provided by applicant): Optimal recovery of walking after spinal cord injury (SCI) depends on task-specific training tailored to distinct deficits. Eccentric motor control is impaired in both humans and animals with SCI and persists after treadmill training, suggesting that greater training specificity is needed. An eccentrically-focused treadmill training program has not been studied in human SCI but has shown good efficacy in rodent SCI. In a strong proof-of- principle design, this proposal will deliver downhill treadmill training in individuals wth incomplete SCI who completed traditional loco motor training at least 6 months earlier. Any further gains in eccentric control, functional performance and community participation will establish the importance of eccentric task-specific training. Because eccentric muscle activation is understudied in human SCI, the proposal aims to characterize eccentric motor control during locomotion (Aim 1) and efficacy of downhill training (Aims 2 and 3). In Aim 2, we will determine downhill training effects on over ground locomotion by measuring biomechanics during the weight acceptance phase of locomotion when eccentric knee control in the sagittal plane prevails. Whether downhill training will promote gains in function and community participation will be tested in Aim 3. Preliminary evidence shows that excessive knee flexion or hyperextension during weight acceptance provides support for our theory that long-lasting eccentric motor deficits exist and reduce functional recovery. Therefore, we hypothesize that the presence and severity of eccentric deficits such as these will negatively impact loco motor recovery; will be reduced by downhill eccentric training and will translate into improved over ground locomotion and function.