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）：这项研究的长期目标是了解脑瘫儿童（CP）的平衡控制的发展，并确定视觉，体感和平衡控制的损害如何限制了功能独立的移动性和达到技能的发展。先前在该人群中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，以检查步态动态条件期间平衡控制的感觉和注意力约束。该赠款的第一个具体目的是：确定脑瘫儿童面临的局限性在面对脑瘫时面临的威胁时要平衡的限制。已经提出了四个替代假设来说明从滑移恢复期间的平衡缺陷：1）姿势反应减少，特别是在踝肌中； 2）减慢肌肉反应的攻击，3）增加激动剂抗肌肉肌肉的共同激活增加，导致反应的效率降低4）不适当的激活序列，近端肌肉或拮抗肌肉在远端激动剂前激活。在特定目标2中，我们还将研究双重任务条件下CP的儿童的平衡（在执行次要任务时平衡），这是另一个具有高跌倒风险的情况。在这个具体目的中，我们将确定CP儿童姿势控制的注意力要求，以及次要注意任务是否会导致运动过程中其姿势控制的恶化。我们假设具有视觉空间处理缺陷的儿童在执行次级视觉注意任务时会显示姿势控制减少，因为姿势系统还需要视觉空间处理。最后，在特定的目标3中，我们将确定在达到预期姿势调整之前降低能力的程度，导致脑瘫儿童的眼手配位精度降低。将使用肌电图，动力学和运动学分析进行实验以检验上述假设。在每个特定目标中，我们将检查观察到的运动功能障碍与儿童CP的感觉能力之间的关系程度。