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）：长期目标是制定一种康复策略，以防止遵循完全脊髓损伤（SCI）的有害神经，肌肉和骨骼继发并发症。每年多达2万美国人维持一个SCI，这使其成为主要重要性的公共健康问题。在SCI每年在SCI社会中，次要并发症（肌肉萎缩，骨质疏松症，骨折，痉挛，痉挛）每年使社会损失4至70亿美元。一种防止这些并发症的方法不仅可以节省大量节省，而且还可以深刻地改善SCI人的生活质量，并使他们成为未来治愈的可行候选人。最近，我们验证了SCI后2年，在下腿中有一定剂量的应力保留了骨和肌肉生理。这些发现表明，一种新的方法在瘫痪后早期将各种剂量的肌肉应激施加到整个下肢，这可能是塑造SCI失败后塑造脊柱回路，肌肉和骨重组的重要机制。三个特定的目标将使用创新的方法检验这些假设，以使用神经肌肉电刺激在立场期间诱导下肢各种应力。 AIM 1将在SCI后的第一年比较3剂肌肉胁迫（0、40、80％BW）在肌肉生理特性（疲劳，力，增强）上。 AIM 2将在SCI后的第一年比较4剂骨骼骨矿物质密度的4剂应力（0、40、80和120％BW）。 AIM 3将比较SCI后的第一年对痉挛性高血压和H反射抑制的各种肌肉胁迫。这项研究的一个新组成部分是它强调可行性和剂量特异性。这项研究基于科学原则，但也有可能快速转化为临床环境以影响健康质量。在接下来的几十年中，治愈脊髓损伤是现实的可能性。没有一种方法来保留瘫痪的下肢完整性，如今被SCI受伤的人将被视为“不适当的候选人”，以重新引入站立和步行，如果找到治疗。在此期间，SCI后神经，肌肉和骨骼特性的保存可能有助于更健康的个体。提出的方法不仅具有良好的功效潜力，而且很可能是经济的，并且很容易融入SCI人的日常生活中。