Strength Training Using NMES for Children with CP

使用 NMES 对 CP 儿童进行力量训练

• 批准号: 6732340
• 负责人: SAMUEL C.K. LEE
• 金额: $ 30.58万
• 依托单位: UNIVERSITY OF DELAWARE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6732340
• 关键词: biomechanics; cerebral palsy; clinical research; exercise; functional ability; gait; human subject; longitudinal human study; middle childhood (6-11); muscle strength; musculoskeletal disorder therapy; neuromuscular stimulator; patient oriented research; rehabilitation; striated muscles

DESCRIPTION (provided by applicant): Cerebral palsy (CP) has the highest lifetime economic cost and net cost of medical care compared to the most common birth defects. Reduced muscle strength affects functional abilities in children with CP. Volitional strength training in children with CP can produce substantial gains in force production with concomitant gains in function. Volitional strength training, however, may not be optimal for producing strength gains in this population due to reduced voluntary muscle activation. Neuromuscular electrical stimulation (NMES) activates a greater number of motor units and produces higher firing rates of the active motor units than can be obtained volitionally. Thus, NMES may offer advantages over volitional exercise programs for producing gains in force production. The proposed research is designed to develop improved rehabilitation techniques for children with CP. This study compares the effects of a 12-week NMES isometric strength-training program to 12 weeks of traditional isometric strength training in children with CP. A no-exercise control group with CP will also be studied. The specific aims are: 1) To compare the force generating, volitional activation, contractile and fatigue characteristics of the quadriceps femoris and triceps surae muscles in typically developing children and children with CP; 2) to assess the ability of NMES strength training to increase quadriceps femoris and triceps surae muscle force-generating ability as compared to volitional strength training and a no-exercise control group in children with CP; 3) to assess the mechanisms underlying improvements in force-generating ability of the quadriceps femoris and triceps surae after strength training in children with CP; and 4) to assess the ability of strength training to improve gross motor function and gait in children with CP. This work will help clinicians design rehabilitation strategies based on the physiologic differences in skeletal muscle and mechanisms for force production between children with CP and children of typical development. Increasing muscle force-generating ability of children with CP can improve a child's function during activities such as sitting, standing and walking.

描述（由申请人提供）：与最常见的出生缺陷相比，脑瘫 (CP) 的终生经济成本和医疗净成本最高。肌力下降会影响脑瘫儿童的功能能力。脑瘫儿童的意志力量训练可以在力量产生方面产生显着的效果，并伴随功能的增强。然而，由于随意肌肉激活减少，意志力量训练可能不是该人群产生力量增长的最佳选择。神经肌肉电刺激（NMES）可激活更多数量的运动单位，并产生比意志所能获得的更高的活动运动单位的放电率。因此，NMES 可能比意志锻炼计划更有优势，可以提高力量生产。 拟议的研究旨在开发改进的脑瘫儿童康复技术。本研究比较了 12 周 NMES 等长力量训练计划与 12 周传统等长力量训练对 CP 儿童的效果。还将研究 CP 不运动对照组。具体目的是： 1）比较典型发育儿童和脑瘫儿童股四头肌和小腿三头肌的发力、意志激活、收缩和疲劳特征； 2) 评估与意志力量训练和不运动对照组相比，NMES 力量训练增加 CP 儿童股四头肌和小腿三头肌发力能力的能力； 3）评估脑瘫儿童力量训练后股四头肌和小腿三头肌发力能力改善的机制； 4) 评估力量训练改善脑瘫儿童粗大运动功能和步态的能力。 这项工作将帮助临床医生根据脑瘫儿童和典型发育儿童之间骨骼肌的生理差异和力量产生机制来设计康复策略。提高脑瘫儿童的肌肉产生力量的能力可以改善儿童在坐、站、走等活动中的功能。