Impact of Lingual Endurance Exercise on Rehabilitation of Swallowing Impairments after lschemic Stroke

项目摘要/摘要 这一职业发展奖将是Brittany Krekeler博士作为一名临床试验人员在 吞咽康复研究。Krekeler博士研究的使命是创造和交付小说， 卒中后吞咽困难患者的有效康复方法。为了实现这一职业目标，Dr。 Krekeler必须能够设计和执行大型、多地点的临床试验。这个职业发展计划是 为了提供必要的培训而创建的，将她提升到这个水平。她的导师团队包括几个由NIH资助的 中风和吞咽困难临床试验专家(Broderick博士、Magal博士、Sucharew博士、Rogus-Pulia博士)。在他们的 在指导下，Krekeler博士将完成概述的职业发展计划，接受具体的培训 是成功的必备条件。这项培训计划和临床试验完美地建立在她现有的翻译技能基础上 和临床研究。她从K01飞行员到R01试飞的轨迹是强劲的。她的主要导师布罗德里克博士， NIH StrokeNet主任，并积极参与大学许多正在进行的多部位中风恢复试验 并热情欢迎Krekeler博士加入这个研究联盟。有机会 该机构正在进行的中风康复试验是无与伦比的。这些具体的交战， 培训计划中概述的课程将得到临床试验和神经科学方面的正式课程的补充。在……里面 除了该奖项中列出的优秀的导师、研究环境和培训机会外，他还获得了该奖项。 Krekeler还将收集有关语言耐力练习临床疗效的基本基本数据，以告知 下一阶段的研究。这项先导试验将评估语言耐力练习(与假练习相比)的效果。 论中风后吞咽功能的恢复。这项研究的主要目的是评估语言的效果 耐力训练与假训练对卒中后吞咽困难患者吞咽功能的影响。我们 假设语言耐力训练将导致口腔吞咽生理指标的更大改善 与假的相比。这项工作的探索性目标将使Krekeler博士能够获得MRI方面的经验 测序和分析，并将收集关于白质束扩散变化的初步数据 耐力性运动与假运动的皮质厚度。我们假设语言耐力训练将 与改善脑白质扩散的完整性和增加初级大脑皮质厚度有关 运动皮质，与假手术相比。无论结果如何，此数据集都将提供创新和高度 关于语言功能、吞咽障碍和皮质之间关系的新信息 卒中后人群中吞咽困难的表现。这些试点数据对于提供足够的 设计R01阶段II干预试验的能力，以调查如何通过时间和时间最大化收益 加强治疗，以更好地恢复中风后的吞咽功能。

Project Summary/Abstract This career development award will be essential to Dr. Brittany Krekeler’s success as a clinical-trialist in swallowing rehabilitation research. The mission of Dr. Krekeler’s research is to create and deliver novel, efficacious rehabilitation approaches for individuals with dysphagia after stroke. To achieve this career goal, Dr. Krekeler must be able to design and execute large, multi-site clinical trials. This career development plan was created to provide the training necessary elevate her to this level. Her mentor team includes several NIH funded stroke and dysphagia clinical trials experts (Drs. Broderick, Vagal, Sucharew, Rogus-Pulia). Under their guidance, Dr. Krekeler will complete the outlined career development plan to receive the specific training necessary to succeed. This training plan and clinical trial perfectly build on her existing skill set in translational and clinical research. Her trajectory from K01 pilot to R01 trial is strong. Her primary mentor, Dr. Broderick, directs NIH StrokeNet and is heavily involved in the many on-going, multi-site stroke recovery trials at University of Cincinnati and has enthusiastically welcomed Dr. Krekeler into this research consortium. The opportunities to engage in on-going stroke recovery trials at this institution are unparalleled. These specific engagements, outlined in the training plan, will be supplemented by formal coursework in clinical trials and neuroscience. In addition to the excellent mentorship, research environment, and training opportunities outlined in this award, Dr. Krekeler will also collect essential primary data regarding clinical efficacy of lingual endurance exercise to inform the next phase of study. This pilot trial will evaluate the effect of lingual endurance exercise (vs sham exercise) on recovery of swallow function after stroke. The Primary Aim of this study is to evaluate the effect of lingual endurance exercise vs sham on swallow function in individuals with post-stroke dysphagia. We hypothesize that lingual endurance training will result in greater improvement in measures of oral swallow physiology as compared to sham. The Exploratory Aim of this work will allow for Dr. Krekeler to gain experience in MRI sequencing and analysis and will collect preliminary data regarding changes in white matter tract diffusion and cortical thickness in endurance vs sham exercise. We hypothesize that lingual endurance exercise will be associated with improved integrity of white matter diffusion and increased cortical thickness in the primary motor cortex and as compared to sham. Regardless of outcome, this dataset will provide innovative and highly novel information regarding the relationship between lingual function, swallowing impairments, and cortical representation of dysphagia in a post-stroke population. These pilot data will be essential in providing sufficient power for designing an R01 Phase II intervention trial to investigate how to maximize gains with timing and intensity of therapy delivery to better recover swallow function after stroke.