High-Intensity, dynamic-stability gait training in people with multiple sclerosis

多发性硬化症患者的高强度、动态稳定性步态训练

基本信息

批准号：
10530019
负责人：
Thomas George Hornby
金额：
$ 60.29万
依托单位：
MARQUETTE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-15 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10530019
关键词：
Balance training Cardiopulmonary Clinic Clinical Clinical Trials Communities Development Elements Environment Equilibrium Exercise Exposure to Gait Gait speed Goals Impairment Incidence Individual Intervention Laboratories Locomotor training Measures Multi-Institutional Clinical Trial Multiple Sclerosis Musculoskeletal Equilibrium Outcome Outcome Measure Participant Patients Perception Persons Phase Physical activity Physiological Pilot Projects Posture Public Health Quality of life Rehabilitation therapy Research Research Personnel Secondary to Techniques Testing Training Translating Walking base clinically significant community setting design early phase clinical trial exercise intensity exercise training experience falls gait rehabilitation improved improved mobility kinematics locomotor control nervous system disorder neuromuscular novel primary outcome response treadmill treadmill training

项目摘要

Project Summary The goal of this phase I/II multicenter clinical trial is to improve walking function, dynamic stability, and community mobility in people with multiple sclerosis (MS) using a novel combination of high-intensity training and an environment that challenges dynamic balance. There are two critical elements of this proposal: 1) balance perturbations applied during treadmill walking will allow participants to develop neuromuscular strategies to maintain upright posture, which will be refined and enhanced with repeated practice, and 2) patients who engage in high-intensity training will improve their neuromuscular and cardiorespiratory capacity to facilitate the ability to walk faster and further. Indeed, patients with mild or moderate MS present with altered locomotor and postural control, and this 2X2 factorial design will delineate the individual and combined effects of repeated exposure to postural perturbations during walking and high-intensity exercise that may enhance locomotor and balance control in both laboratory conditions and in the real-world, where the locomotor and postural demands are substantial. This study is predicated on the previous experience of the investigators with high-intensity training in patients with other neurological disorders and promising results of a pilot study demonstrating feasibility of dynamic balance treadmill training in people with MS. The present project will attempt to delineate changes in clinical and laboratory measures of locomotor capacity following walking- specific exercise training at high vs low intensity and with or without postural perturbations during treadmill stepping (Aim 1). Aim 2 will demonstrate the relative efficacy of these strategies on dynamic postural control (i.e., balance) and relate improvements in the response to perturbations to secondary measures of community falls. Finally, Aim 3 will delineate changes in community mobility and participation following these various exercise paradigms. We suggest that high-intensity locomotor training with postural perturbations will elicit the largest changes in both locomotor and balance outcomes, and these combined gains will boost physical activity in the community setting leading to improved quality of life.

项目概要这项I/II期多中心临床试验的目标是改善步行功能、动态稳定性和使用高强度训练的新颖组合促进多发性硬化症 (MS) 患者的社区流动以及挑战动态平衡的环境。该提案有两个关键要素：1) 在跑步机行走过程中施加的平衡扰动将使参与者发展神经肌肉保持直立姿势的策略，将通过反复练习来完善和增强，以及2) 参加高强度训练的患者将提高他们的神经肌肉和心肺能力促进走得更快更远的能力。事实上，患有轻度或中度多发性硬化症的患者表现出改变运动和姿势控制，这种 2X2 因子设计将描述单独和组合的效果在步行和高强度运动期间反复暴露于姿势扰动，这可能会增强实验室条件和现实世界中的运动和平衡控制，其中运动和平衡控制姿势要求很高。这项研究是基于研究者之前的经验对患有其他神经系统疾病的患者进行高强度训练以及一项试点研究的有希望的结果证明多发性硬化症患者进行动态平衡跑步机训练的可行性。目前的项目将尝试描述步行后运动能力的临床和实验室测量的变化高强度与低强度的特定运动训练，以及在跑步机上有或没有姿势干扰的情况迈步（目标 1）。目标 2 将展示这些策略对动态姿势控制的相对功效（即平衡）并将扰动响应的改进与社区的次要措施联系起来瀑布。最后，目标 3 将描述社区流动性和参与性的变化练习范式。我们建议，带有姿势扰动的高强度运动训练将引发运动和平衡结果的最大变化，这些综合收益将增强身体素质社区环境中的活动可提高生活质量。