Neuro-Musculoskeletal Plasticity after SCI

SCI 后的神经肌肉骨骼可塑性

• 批准号: 7285704
• 负责人: RICHARD K. SHIELDS
• 金额: $ 31.98万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-28 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7285704
• 关键词: American; Biological Preservation; Bone Density; Chemosensitization; Clinical; Daily; Dose; Electric Stimulation; Fatigue; Fracture; Future; Goals; H-Reflex; Health; Individual; Left; Leg; Life; Lower Extremity; Methods; Muscle; Muscle Hypertonia; Muscular Atrophy; Musculoskeletal; Osteoporosis; Paralysed; Physiological; Physiology; Property; Public Health; Quality of life; Research; Savings; Shapes; Skeletal bone; Skeletal system; Societies; Spastic; Specificity; Spinal; Spinal cord injury; Stress; Testing; Today; Translating; Walking; bone; cost; improved; injured; innovation; muscle stress; novel; novel strategies; prevent; rehabilitation strategy; relating to nervous system

DESCRIPTION (provided by applicant): The long-term goal is to develop a rehabilitation strategy to prevent the deleterious neural, muscular, and skeletal secondary complications that follow complete spinal cord injury (SCI). As many as twenty thousand Americans sustain an SCI each year, making it a public health concern of primary importance. Secondary complications (muscle atrophy, osteoporosis, bone fractures, spasticity) in the decades after SCI cost society between 4 and 7 billion dollars annually. A method to prevent these complications would not only provide substantial savings, but could also profoundly improve the quality of life of people with SCI and keep them as viable candidates for the future cure. Recently, we verified that a certain dose of stress preserved bone and muscle physiology in the lower leg for 2 years following SCI. These findings suggest that a novel approach to apply various doses of muscle stress to the entire lower extremities early after paralysis may be an important mechanism to shape spinal circuitry, muscle, and bone reorganization following disuse from SCI. Three specific aims will test these hypotheses using an innovative method to induce various doses of stress to the lower extremities during stance using neuromuscular electrical stimulation. Aim 1 will compare 3 doses of muscle stress (0, 40, 80% BW) on muscle physiological properties (fatigue, force, potentiation) over the first year following SCI. Aim 2 will compare 4 doses of stress (0, 40, 80, and 120% BW) on skeletal bone mineral density over the first year following SCI. Aim 3 will compare various doses of muscle stress on spastic hypertonia and H-reflex suppression over the first year following SCI. A novel component of this study is its emphasis on feasibility and dose specificity. This research is grounded in scientific principles, but also has the potential to rapidly translate to the clinical milieu to influence health quality. In the next several decades, a cure for spinal cord injury is a realistic possibility. Without a method to preserve the integrity of paralyzed lower limbs, people injured today with SCI will be left as "inappropriate candidates" for reintroduction to standing and walking, should a cure be found. In the interim, preservation of neural, muscular, and skeletal properties after SCI may contribute to a healthier individual. The proposed method not only has excellent potential for efficacy, but is also likely to be economical and easily integrated into the daily lives of people with SCI.

描述（由申请人提供）：长期目标是制定康复策略，以预防完全脊髓损伤（SCI）后出现有害的神经、肌肉和骨骼继发性并发症。每年有多达两万名美国人患有 SCI，使其成为首要的公共卫生问题。 SCI 后的几十年里，继发并发症（肌肉萎缩、骨质疏松、骨折、痉挛）每年给社会造成 4 至 70 亿美元的损失。预防这些并发症的方法不仅可以节省大量费用，还可以深刻改善 SCI 患者的生活质量，并使他们成为未来治疗的可行候选者。最近，我们证实一定剂量的压力可以在 SCI 后 2 年内保持小腿的骨骼和肌肉生理机能。这些发现表明，在瘫痪后早期对整个下肢施加不同剂量的肌肉应力的新方法可能是在 SCI 废弃后塑造脊髓回路、肌肉和骨骼重组的重要机制。三个具体目标将使用一种创新方法来测试这些假设，在站立期间使用神经肌肉电刺激对下肢产生不同剂量的压力。目标 1 将比较 SCI 后第一年 3 种剂量的肌肉应激（0、40、80% BW）对肌肉生理特性（疲劳、力量、增强）的影响。目标 2 将比较 SCI 后第一年 4 种压力（0、40、80 和 120% BW）对骨骼骨矿物质密度的影响。目标 3 将比较 SCI 后第一年不同剂量的肌肉应激对痉挛性肌张力增高和 H 反射抑制的影响。这项研究的一个新颖之处是它强调可行性和剂量特异性。这项研究以科学原理为基础，但也有可能迅速转化为临床环境以影响健康质量。在接下来的几十年里，治愈脊髓损伤是一种现实的可能性。如果没有办法保持瘫痪下肢的完整性，如果找到治愈方法，今天受伤的 SCI 患者将被视为重新站立和行走的“不合适人选”。在此期间，脊髓损伤后保留神经、肌肉和骨骼特性可能有助于使个体变得更健康。所提出的方法不仅具有出色的疗效潜力，而且可能经济且易于融入 SCI 患者的日常生活中。