Treatment of Motor Function and Balance- A New Tool

运动功能和平衡治疗——一种新工具

• 批准号: 6962022
• 负责人: LARS I E ODDSSON
• 金额: $ 24.31万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-01 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6962022
• 关键词: Parkinson' s disease; assistive device /technology; balance; biomedical equipment development; body weight; clinical research; gait; human subject; musculoskeletal disorder therapy; nervous system disorder therapy; neuromuscular system; performance; posture; psychomotor function; rehabilitation

DESCRIPTION (provided by applicant): This is an R21 proposal in direct response to the announcement PA-04-006, "Neurotechnology, Research, Development, and Enhancement". This proposal addresses the request in the PA related to "development of novel tools and approaches for the study of the development, structure and function of the brain" including "those used for clinical assessment, diagnosis and treatment of brain disorders". As stated under "SPECIAL REQUIREMENTS" in the announcement, applications "may be design-, problem-, need-, or hypothesis-driven ". The current proposal is driven by the need for tools that can provide early effective and functional treatment of several categories of patients e.g. those with spinal cord and brain injuries including stroke as well as neurological diseases such as Parkinsonism. Furthermore, hip fractures, a common consequence of falls, seriously affect mobility and often leads to early death, especially in the elderly population. Current research has demonstrated in these populations of patients that gait training using partial body weight support (BWS) on a treadmill improves walking better than training with full weight bearing. One problem with the BWS technique that is not commonly acknowledged is that the harness supporting the subject decreases the need for a natural postural control. The harness provides an external support partly eliminating associated postural adjustments that are required during independent gait. We propose to build a tool that can further refine the concept of BWS training by allowing natural associated postural adjustments directly in the BWS training. We have demonstrated that upright balance function improves after training in a 90 deg tilted visual environment with the subject in a supine position strapped to a device (freely moving on air-bearings, cf. puck on an air hockey table) with a G-like load provided by a weight stack. For movements in the frontal plane, the tilted room environment allows associated postural adjustments, required in an upright environment, to occur. A video of a subject exercising in this environment appears to a blinded viewer as being upright with normal frontal plane postural adjustments and balancing against gravity. We propose to design, build and test a portable version of the tilted room concept that can be used in a hospital/clinical setting. Instead of a physical room subjects will view two 3-D automultiscopic displays representing windows to a virtual environment that may be captured from sites decided by the patient. In addition to treatment, the device can be used as a research tool to study postural control mechanisms The investigators represent a multidisciplinary team of experts from biomedical, computer engineering and the rehabilitation and exercise sciences.

描述（由申请人提供）：这是对公告PA-04-006的直接响应的R21提案，“神经技术，研究，开发和增强”。该提案涉及与“开发新工具和方法来研究大脑的发展，结构和功能”，包括“用于临床评估，诊断和治疗脑部疾病的新工具和方法”。如公告中的“特殊要求”所述，应用程序“可能是设计，问题，需求或假设驱动的”。当前的建议是由对可以提供几种类别患者（例如患有脊髓和脑损伤的人，包括中风以及帕金森病等神经系统疾病。此外，髋部骨折是跌倒的常见后果，严重影响流动性，并且经常导致早期死亡，尤其是在老年人中。当前的研究表明，在跑步机上使用部分体重支持（BWS）步态训练的患者人群中，比全重轴承的训练更好地改善了步行。 BWS技术的一个问题通常不承认，支持受试者的线束会减少对自然姿势控制的需求。该线束提供了外部支撑部分，部分消除了独立步态期间所需的相关姿势调整。我们建议构建一种工具，可以通过直接在BWS培训中进行自然相关的姿势调整来进一步完善BWS培训的概念。我们已经证明，在90度倾斜的视觉环境中训练后，直立平衡功能在仰卧位置训练后提高，并绑在设备上（在空气轴上自由移动，在空气曲棍球桌上自由移动），并带有由重量堆放的G样负载。对于额平面中的运动，倾斜的房间环境允许在直立环境中需要进行相关的姿势调整。在这种环境下进行锻炼的主题的视频似乎是盲目的观众，是正常的额叶平面姿势调整并与重力平衡。我们建议设计，构建和测试可在医院/临床环境中使用的倾斜房间概念的便携式版本。代替物理房间的主题将查看两个3-D自动化显示器，这些显示代表窗户到虚拟环境中，这可能是由患者决定的站点捕获的。除治疗外，该设备还可以用作研究姿势控制机制的研究工具，研究人员代表了来自生物医学，计算机工程以及康复和运动科学的多学科专家团队。