PALLIATIVE STRATEGIES IN SPINAL CORD INJURY

脊髓损伤的姑息策略

• 批准号: 6972186
• 负责人: Thomas S Kiser
• 金额: $ 34.58万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-16 至 2005-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6972186
• 关键词: behavioral /social science research tag; behavioral habituation /sensitization; biomechanics; body composition; body movement; chordate locomotion; clinical research; combination therapy; electromyography; electrostimulus; exercise; functional ability; human subject; human therapy evaluation; laboratory rat; levodopa; muscle strength; nonhuman therapy evaluation; rehabilitation; shear stress; spinal cord injury; spinal reflex; therapy design /development

Recent human clinical application of our epidural spinal cord stimulation (ESCS) technology was found to promote locomotion without fatigue for as long as 300 m with the aid of only a walker in a SCI patient. Our previous studies had shown that ESCS in acutely transected animals induced treadmill stepping. More recently, we found that passive exercise training in adult spinal cord transected rats led to maintenance of muscle mass (i.e. prevented muscle atrophy) and restored habituation of the H-reflex (i.e. decreased hyperreflexia). The proposed research is designed to develop a SCI Mobilization Program for humans, at first testing partial weight bearing training (PWBT) and motorized bicycle exercise training (MBET) for their effects, singly and in combination, on locomotor activity and H-reflex habituation in SCI patients. We will measure and compare increases in muscle mass, improvements in step cycle parameters, changes in motor and sensory indices, and changes in H-reflex habituation and spasticity. Future studies will include ESCS and other potential therapies. We will also test in animals additional potential palliative strategies for SCI. Recently, we tested successfully the possibility of combining 1) MBET, 2) ESCS and 3) oral L-dopa therapy to promote locomotion in transected adult rats. Preliminary data indicate that this combination of therapies may prove efficacious in the restoration of stepping following complete spinal transection in the rat. The variable to be measured is electromyographic (EMG) activity in the hindlimbs, with analysis of muscle burst timing and amplitude, and step cycle frequency and duration, induced following each form of treatment or combined therapy. Data will be generated using an established model of SCI in the rat. These studies will provide essential information regarding the optimal combination of pharmacological intervention, exercise duration, and electrical stimulation parameters of the spinal cord necessary to maximize recovery of spinal locomotion following SCI. There is great potential for such information to translate into improved rehabilitation strategies for the human patient with SCI. An indirect benefit of these therapies may be the reduction of hyperreflexia, and presumably spasticity, in some patients with SCI (with concomitant reduction in baclofen therapy). The proposed research will generate pilot data in multiple important areas for securing future R01 support.

最近的人体临床应用发现，我们的硬膜外脊髓刺激 (ESCS) 技术可以促进 SCI 患者仅借助助行器即可无疲劳地移动长达 300 m。我们之前的研究表明，急性横断动物的 ESCS 会诱导跑步机行走。最近，我们发现成年脊髓横断大鼠的被动运动训练可以维持肌肉质量（即防止肌肉萎缩）并恢复 H 反射的习惯（即反射亢进减少）。拟议的研究旨在开发人类 SCI 动员计划，首先测试部分负重训练 (PWBT) 和机动自行车运动训练 (MBET) 单独或组合对运动活动和 H 反射习惯的影响。脊髓损伤患者。我们将测量和比较肌肉质量的增加、步进周期参数的改善、运动和感觉指数的变化以及 H 反射习惯和痉挛的变化。未来的研究将包括 ESCS 和其他潜在的疗法。我们还将在动物身上测试其他潜在的 SCI 姑息策略。最近，我们成功测试了结合 1) MBET、2) ESCS 和 3) 口服左旋多巴疗法促进横断成年大鼠运动的可能性。初步数据表明，这种疗法的组合可能对大鼠脊柱完全横断后的行走恢复有效。要测量的变量是后肢的肌电图 (EMG) 活动，分析每种治疗形式或联合治疗后诱发的肌肉爆发时间和幅度以及步进周期频率和持续时间。将使用已建立的大鼠 SCI 模型生成数据。这些研究将提供有关药物干预、运动持续时间和脊髓电刺激参数的最佳组合的重要信息，以最大限度地恢复 SCI 后脊髓运动的恢复。这些信息有很大潜力转化为改善 SCI 患者的康复策略。这些疗法的间接益处可能是减少一些 SCI 患者的反射亢进和痉挛（同时减少巴氯芬治疗）。拟议的研究将为多个重要领域生成试点数据 确保未来的 R01 支持。