Ankle strengthening using virtual reality and robotic dynamometer for CP patients

描述（由申请人提供）：我们假设，加强肌肉可能是改善脑瘫儿童步态和功能的一种替代方法。我们的长期目标是开发一种改进的强化治疗相比，今天的方法。我们提出的治疗方法是基于使用罗格斯踝关节机器人原型与类似游戏的虚拟现实（VR）模拟集成。具体目标第一个目标是开发罗格斯踝关节CP，用于加强患有CP的儿童的踝关节。第二个目的是确定在Rutgers踝关节CP上进行12周强化踝背/跖屈肌力量训练计划是否会改善CP儿童的踝关节力量、步态、功能和生活质量。方法1）我们将构建Rutgers踝关节CP系统并修改机器人伺服控制以允许对踝关节运动的主动辅助/被动阻力; 2）我们将扩展用于在Rutgers踝关节CP上进行CP训练的儿童的虚拟康复软件。一种新的智能代理软件将任务执行要求与患者过去的表现相关联，以确定机器人的行为（从100%的援助到100%的阻力）; 3）我们将开发一个可访问的网络数据库模块，用于报告和数据分析。来自Rutgers Ankle CP的数据将在临床研究中心以真实的时间进行透明采样。随后，数据将通过互联网转发到罗格斯大学现有的数据库服务器。现有的基于网络的临床数据库和图形环境将得到增强，以包括传统的CP临床评价措施，来自VR练习的计算机化变量和主观评价问卷; 4）6名痉挛性双瘫CP受试者将参加Rutgers踝CP上踝背/跖屈肌的12周力量训练计划。将在干预前、12周干预结束时和额外12周后评价受试者的踝关节力量、痉挛、步态分析、GMFM和Peds QL。我们假设受试者将通过机器人训练改善力量，步态，功能和生活质量，并将保持至少12周的收益。NIH相关性本项目将开发一种用于CP踝关节力量训练的设备。力量训练可用于改善步态和功能。一个简单的力量训练计划，改善步态和功能，将减少医疗保健费用，消除或推迟更昂贵的程序。

DESCRIPTION (provided by applicant): We hypothesize that strengthening muscles may be an alternative for improving gait and function in children with cerebral palsy. Our long-term objective is to develop an improved strengthening therapy compared to today's approaches. Our proposed therapy is based on the use of a prototype Rutgers Ankle robot integrated with game-like virtual reality (VR) simulations. SPECIFIC AIMS The first aim is to develop the Rutgers Ankle CP for use in strengthening the ankles of children with CP. The second aim is to determine if a 12-week intensive ankle dorsi/plantarflexors strength-training program on the Rutgers Ankle CP will improve ankle strength, gait, function, and quality of life of children with CP. METHODS 1) we will construct the Rutgers Ankle CP system and modify the robot servo control to allow active assistance/passive resistance to ankle motion; 2) we will expand virtual rehabilitation software for children with CP training on the Rutgers Ankle CP. A new intelligent agent software will correlate task exertion requirements with patient past performance in order to determine the robot behavior (from 100% assistance to 100% resistance); 3) we will develop a web-accessible database module for reporting and data analysis. Data from the Rutgers Ankle CP will be sampled transparently in real time at the clinical site. Subsequently the data will be forwarded over the Internet to an existing database server at Rutgers University. The existing web-based clinical database and graphing environment will be enhanced to include conventional CP clinical evaluation measures, computerized variables from the VR exercises, and subjective evaluation questionnaires; 4) Six subjects with spastic diplegia CP will participate in a 12-week strength-training program of the ankle dorsi/plantarflexors on the Rutgers Ankle CP. Subjects will be evaluated for ankle strength, spasticity, gait analysis, GMFM, and Peds QL prior to the intervention, at the end of the 12-week intervention, and after an additional 12 weeks. We hypothesize that the subjects will improve in strength, gait, function, and quality of life from training on the robot, and will maintain the gains for at least 12 weeks. NIH RELEVANCE This project will develop a device for ankle strength training in CP. The strength training can be used to improve gait and function. PUBLIC HEALTH RELEVANCE A simple strength training program that improves gait and function will reduce health care costs by eliminating or delaying more expensive procedures.