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

项目概要/摘要： 患有脑瘫（CP）的非卧床儿童主要以低强度步幅率行走， 易变性，从而限制了他们的步行活动和参与日常生活的能力。相反，通常 发育中（TD）的儿童进行短时间的剧烈步行活动， 日常生活中的低强度行走。为了优化运动学习，积极参与，任务具体化 需要训练和多次重复或大量练习来学习新的运动技能。短时间的 高强度跑步机运动训练（SBLTT）与低/中等强度交替进行， 旨在模仿TD儿童的活动模式，在一个大规模的实践格式。试点数据表明，SBLTT 是可行的，并提高步行能力和日常生活中的表现与CP儿童。的目标 本申请旨在检查SBLTT与等效剂量的传统运动的效果 跑步机训练（TLTT）对CP儿童步行能力和表现的主要结局。 该方案还将检查SBLTT对步行能力和性能的影响是否 通过肌肉发电的改善来调节。科学前提是SBLTT， 通过临床上可行的方法， 大规模练习方案，将比TLTT更有效地提高步行能力和性能。我们 假设以TD儿童的活动模式为模型的CP儿童的SBLTT策略， 通过肌肉发电积极介导，随后提高步行能力和社区 行走性能和移动性。我们将测试以下具体目标。目标1。立即决定 短爆发间期LTT（SBLTT）对非卧床CP儿童步行能力的保持作用。 将通过自选步态速度和1分钟步行试验测量步行能力。目标2。审查 治疗对社区步行活动表现和活动能力的影响。行走活动 性能将通过加速度计捕获。社区步行移动性个性化的家庭与 将利用全球定位系统和加速度计的新组合来测量社区位置。 目标3。探索SBLTT对步行能力和性能的影响是否由肌肉介导 发电量这个项目是创新的，因为它侧重于解决新的特定任务的方法， CP儿童的步行限制，并实施个性化的社区位置结果。的 拟议中的研究意义重大，因为它将是一系列研究的第一步， 直接运动训练方案和康复策略，并积极影响儿童残疾， 社区步行表现和行动能力的儿童与CP。增加对肌肉的了解 CP儿童对SBLTT的反应机制是预期的。这些知识与 在整个生命周期中增强活动能力和身体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.