Dynamic balance in children with cerebral palsy

脑瘫儿童的动态平衡

• 批准号: 6837694
• 负责人: MARJORIE HINES WOOLLACOTT
• 金额: $ 30.64万
• 依托单位: UNIVERSITY OF OREGON
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-05-01 至 2007-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6837694
• 关键词: age difference; balance; cerebral palsy; child (0-11); clinical research; electromyography; environmental adaptation; gait; human subject; muscle function; patient oriented research; posture; proprioception /kinesthesia; psychomotor function; space perception; training; visual depth perception

DESCRIPTION (provided by applicant): The long-term goal of this research is to understand the development of balance control in children with cerebral palsy (CP), and to determine how impairments in visual, somatosensory, and balance control limit the development of functionally independent mobility and reaching skills. The primary focus of previous balance research in this population has been to understand the neuromuscular constraints that limit static balance. We propose to extend this research to examine the sensory and attentional constraints on balance control during the dynamic conditions of gait and reaching. The first specific aim of the grant is: To determine the limitations on response capabilities faced by the child with cerebral palsy when confronted with threats to balance during walking. Four alternative hypotheses have been proposed to account for balance deficits during recovery from slips: 1) reduced postural response magnitudes, specifically in the ankle muscles; 2) slowed muscle response onsets, 3) increased co-activation of agonist-antagonist muscles, leading to a reduced efficiency of the response 4) an inappropriate activation sequence, with proximal muscles or antagonist muscles activated before distal agonists. In specific aim 2, we will also study balance of children with CP under dual task conditions (balancing while performing a secondary task), another context with a high risk of falls. In this specific aim we will determine the attentional requirements of postural control in children with CP and whether the addition of a secondary attentional task causes deterioration in their postural control during locomotion. We hypothesize that children with visual spatial processing deficits will show reduced postural control when performing a secondary visual attention task, since the postural system also requires visual spatial processing. Finally, in specific aim 3 we will determine the extent to which a reduced ability to activate anticipatory postural adjustments before reaching contributes to reduced eye-hand coordination accuracy in children with cerebral palsy. Experiments will be performed to test the above hypotheses, using electromyographic, kinetic and kinematic analyses. In each specific aim we will examine the extent of the relationship between the motor dysfunction observed and the sensory capabilities of the children with CP.

描述（由申请人提供）：本研究的长期目标是了解脑瘫（CP）儿童平衡控制的发展情况，并确定视觉、体感和平衡控制方面的障碍如何限制功能发展。独立的行动能力和伸展能力。以前针对该人群的平衡研究的主要重点是了解限制静态平衡的神经肌肉约束。我们建议扩展这项研究，以检查步态和到达的动态条件下平衡控制的感觉和注意力限制。该赠款的第一个具体目标是：确定脑瘫儿童在行走过程中面临平衡威胁时所面临的反应能力的限制。已经提出了四种替代假设来解释滑倒恢复过程中的平衡缺陷：1）姿势反应幅度降低，特别是踝关节肌肉； 2) 肌肉反应开始减慢，3) 激动肌-拮抗肌的共同激活增加，导致反应效率降低4) 不适当的激活顺序，近端肌肉或拮抗肌在远端激动肌之前激活。在具体目标 2 中，我们还将研究 CP 儿童在双重任务条件下（在执行次要任务时保持平衡）的平衡能力，这是另一种跌倒风险较高的环境。在这个具体目标中，我们将确定 CP 儿童姿势控制的注意力要求，以及添加次要注意力任务是否会导致他们在运动过程中的姿势控制恶化。我们假设具有视觉空间处理缺陷的儿童在执行次要视觉注意任务时会表现出姿势控制能力下降，因为姿势系统也需要视觉空间处理。最后，在具体目标 3 中，我们将确定脑瘫儿童在到达之前激活预期姿势调整能力的降低在多大程度上导致了眼手协调准确性的降低。将使用肌电图、动力学和运动学分析进行实验来检验上述假设。在每个具体目标中，我们将检查观察到的运动功能障碍与脑瘫儿童的感觉能力之间的关系程度。