Physical, Functional and Neurological Effects of Exercise in Children with CP

主要发现： 我们已经结束了招生，并提交了研究的主要结果。我们目前正在准备一份关于脑部成像结果的手稿，这些儿童能够完成核磁共振检查，数据质量对他们来说是可以接受的。主要发现是儿童能够进行相互腿部锻炼的速度发生了显着和显著的变化，其中约三分之一的儿童步态速度在临床上也有显着改善，其中椭圆形组的结果最积极。然而，该组步态速度的平均变化并不显著。干预的持续时间可能不够长，不足以显著地将更大的互惠腿速转移到改善步态功能。 另一项重要的资助是，这组患者在两个感觉运动半球显示出比正常更大的功能连接。运动后，我们发现了自愿速度的变化和连接性的变化之间的相关性，即那些速度变化更大的人，连接性的下降更大，这表明大脑路径得到了改善，变得更相互作用，而不是因为训练而同步。目前正在准备提交一份手稿。 项目影响说明书： 这是首次报道的运动辅助自行车和椭圆训练对脑瘫的疗效试验。由于训练改善了相互协调性，这些发现值得通过临床试验与现有的治疗方法(如BWSTT)进行进一步比较。这也是为数不多的对双侧脑性瘫痪儿童进行干预前后脑成像结果的研究之一。

Major Findings: We have closed enrollment and have submitted the main results of the study. We are preparing a manuscript at present on the brain imaging results in the subset of children who were able to complete the MRI and for whom the data quality was acceptable. The major findings were a significant and marked change in the speed with which children were able to perform the reciprocal leg exercise with approximately a third of those also having a clinically significant improvement in gait speed with the most positive results seen in the elliptical group. However, the mean change in gait speed for the group was not significant. The duration of the intervention may not have been long enough for significant transfer of greater reciprocal leg speed to improving gait function. Another important funding is that this group of patients showed greater than normal functional connectivity across the two sensorimotor hemispheres. After the exercise we found a correlation between the change in voluntary speed and the change in connectivity, such that those who had a greater change in speed, had a greater reduction of connectivity suggesting that the brain pathways improved and became more reciprocal instead of synchronized as a result of training. A manuscript is currently in preparation for submission. Project Impact Statement: This is the first reported efficacy trial of both motor-assisted cycling and elliptical training in CP. Since reciprocal coordination improved as a result of training,these findings warrant further comparison with existing treatments such as BWSTT through clinical trials. This is also one of the few studies with pre-post intervention brain imaging results in children with bilateral cerebral palsy.