Parkinsonian Gait Disorders: Mechanisms and Treatment

描述(由申请者提供)：这个指导研究科学家发展奖将为申请者提供必要的培训，以实现在康复研究中独立职业的长期目标。申请者在运动神经控制研究方面的专业知识将与赞助商在评估、治疗和研究帕金森氏症患者方面的专业知识结合起来。所提供的培训将使申请者能够调查帕金森氏症患者步态困难的潜在机制，最终目标是制定康复策略，使这些患者的功能活动最大化。这项拟议的研究将重点放在走路时的转身上，因为许多帕金森氏症患者都有转身困难，而很少有研究关注这一关键的功能运动。拟议的研究将解决下列假设：1)选择和产生适当的运动模式存在问题，导致转向运动受损；2)传统的药物治疗部分改善了转向运动模式，但并不能完全解决问题；3)帕金森病患者在受到相关外部刺激时，保留了修改运动输出和产生适当的转向模式的能力；4)旋转跑步机刺激可能是提供这些外部刺激，从而增强转向能力的有效康复工具。所有这些假说都将通过全身3-D运动分析结合肌电记录进行研究。帕金森氏症患者将与年龄和性别匹配的对照组受试者进行比较。拟议的研究结果将为帕金森病对步态的影响提供重要的见解，评估当前治疗方法在解决步态困难方面的有效性，并指导未来改善帕金森病患者功能活动的康复策略。

DESCRIPTION (provided by applicant): This Mentored Research Scientist Development Award will provide the applicant, a doctorally and postdoctorally educated physical therapist, with the training necessary to achieve the long-term objective of an independent career in rehabilitation research. The applicant's expertise in the study of neural control of locomotion will be combined with the sponsor's expertise in the evaluation, treatment, and study of individuals with Parkinson's disease. The training provided will allow the applicant to investigate mechanisms underlying gait difficulties in individuals with Parkinson's disease, with the ultimate goal of developing rehabilitative strategies to maximize functional mobility in these individuals. The proposed studies will focus on turning during walking, as many subjects with Parkinson's disease have difficulty with turning and little research has focused on this functionally critical movement. The proposed studies will address the following hypotheses: 1) problems with the selection and production of appropriate motor patterns contribute to impaired turning movements, 2) conventional pharmacological treatments partially improve turning motor patterns but do not completely address the problem, 3) subjects with Parkinson's disease retain the ability to modify locomotor output and produce appropriate turning patterns when provided with relevant external stimuli, and 4) rotating treadmill stimulation may be an effective rehabilitative tool for providing these external stimuli, thereby enhancing turning ability. All of these hypotheses will be investigated using whole-body, 3-D movement analyses in conjunction with electromyographic recordings. Subjects with Parkinson's disease will be compared to age- and gender-matched control subjects. Results of the proposed studies will provide important insights regarding the effects of Parkinson's disease on gait, evaluate the effectiveness of current therapies in addressing gait difficulties, and guide future rehabilitation strategies for improving functional mobility in people with Parkinson's disease.