Locomotor Adaptations Following Stroke

描述(申请人提供)：拟议研究的目标是了解中风后偏瘫患者适应运动肢体间协调的能力以及这种能力对步态对称性的影响。利用这些知识，申请人的长期研究目标是开发以科学为基础的疗法，以促进中风后患者的身体康复和运动恢复。为实现这些目标，已经制定了一项五年研究和培训计划。该计划包括运动神经机制的培训、神经损伤者的运动适应、步态测量和分析，以及康复随机临床试验的设计和实施。这项计划将在初级导师和共同发起人的指导下实施，初级导师是神经损伤者的运动适应专家，共同赞助者是步态障碍者行走分析以及康复临床试验的设计和实施方面的专家。培训将包括有组织的阅读、出席课程讲座和研讨会、有组织的实验室经验和在学术会议上的陈述。在候选人系主任的全力支持下，候选人将获得两个设备齐全的实验室，这些实验室能够测量三维人体运动和力量生产。这项拟议的研究将检验一个普遍的假设，即中风后偏瘫患者能够在分体带式跑步机上行走后适应他们的运动模式，在分体式跑步机上，每条腿以不同的速度移动。本研究假设，分体式跑步机运动后肢体间协调的适应模式可用于改善卒中后患者的步态对称性和功能。具体目标将测试：1)中风后偏瘫患者适应肢体间协调的能力，2)适应地面运动的模式的泛化，3)使用分裂带跑步机训练来改善中风后患者步态对称性的可行性。相关性：在每年受中风影响的70万人中，50%的人将继续表现出长期的步行功能障碍，其中一些是由于腿之间的协调不良造成的。这项研究调查了一种新型的跑步机行走对中风患者双腿之间协调性的影响。

DESCRIPTION (provided by applicant): The goal of the proposed research is to understand the capacity of persons with post-stroke hemiparesis to adapt locomotor interlimb coordination and the influence of this on gait symmetry. Utilizing this knowledge, the applicant's long-term research goal is to develop scientifically-based therapies to advance the physical rehabilitation and recovery of locomotion in persons following a stroke. A five-year research and training plan has been developed to meet these goals. This plan consists of training in the neural mechanisms of locomotion, motor adaptations in persons with neurological damage, gait measurement and analysis and the design and implementation of randomized clinical trials in rehabilitation. This plan will be implemented under the mentorship of the primary mentor, an expert in motor adaptation in persons with neurological damage and the cosponsor, an expert in the analysis of walking in persons with gait dysfunction and in the design and implementation of clinical trials in rehabilitation. Training will consist of structured readings, attendance at course lectures and seminars, structured laboratory experiences and presentation at academic meetings. With complete support from the candidate's department chair, the candidate will have access to two fully equipped laboratories capable of measuring 3-dimensional human movement and force production. The proposed research will test the general hypothesis that persons with post-stroke hemiparesis are able to adapt their locomotor patterns following walking on a split-belt treadmill, where each leg is moved at a different speed. It is hypothesized that the adapted pattern of interlimb coordination following split-belt treadmill locomotion may be used to improve gait symmetry and function in persons post-stroke. Specific aims will test: 1) the capacity of persons with post-stroke hemiparesis to adapt interlimb coordination, 2) the generalization of adapted patterns to overground locomotion and, 3) the feasibility of using split-belt treadmill training to improve gait symmetry in persons post-stroke. Relevance: Of the 700,000 persons affected by stroke each year, 50% will continue to demonstrate long term walking dysfunction, some caused by poor coordination between the legs. This research investigates the potential of a novel type of treadmill walking to influence coordination between the legs in persons who have sustained a stroke.