Underwater Treadmill Training in Spastic Diplegia

痉挛性截瘫的水下跑步机训练

基本信息

批准号：
7006991
负责人：
DON W MORGAN
金额：
$ 11.57万
依托单位：
MIDDLE TENNESSEE STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-01-15 至 2008-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7006991
关键词：
aerobic exercise behavioral /social science research tag bioenergetics cerebral palsy chordate locomotion clinical research functional ability gait human subject human therapy evaluation medical rehabilitation related tag middle childhood (6-11)muscle strength musculoskeletal disorder therapy patient oriented research physical therapy rehabilitation water

项目摘要

DESCRIPTION (provided by applicant): Clinicians and researchers are often hampered in developing sound and practical remedies when working with any population that is understudied. This is especially true when there is little valid and reliable information upon which to build a reasoned approach to treat basic physical impairments. Efficient locomotion, which is foundational to the ease of life, has been well-documented in able-bodied children, but remains poorly understood in cerebral palsy (CP). Research has shown that a large percentage of adults with CP who stop walking do so because of physical fatigue and an inability to ambulate without tiring. Hence, a clinical need exists to develop and test rehabilitation strategies aimed at reducing the cardiopulmonary strain that accompanies walking before the child with CP enters adulthood. Against this backdrop, the primary goal of this project is to determine the impact of an aquatics-based, treadmill walking program on locomotor energetics and functional mobility in youth with spastic diplegia. Our first specific aim is to document changes in the aerobic function of spastic diplegic children following a 10-week program of underwater treadmill training (UTT). To accomplish this aim, 30 children with spastic diplegia will undergo UTT while another 30 spastic diplegic children serve as age- and sex-matched controls. We hypothesize that children undergoing UTT will demonstrate an increase in maximal aerobic power, a decrease in submaximal energy use, and an improvement in treadmill walking performance. We also predict that an increase in the ratio of lower-extremity muscle strength to total body mass will underlie anticipated improvements in locomotor economy resulting from UTT. Our second specific aim is to determine the clinical significance of enhanced aerobic function and relative leg strength as they relate to community mobility in the child with spastic diplegia. This aim will be addressed by quantifying training-related changes in daily step activity, preferred and maximal walking speeds, and distance covered in a timed walking test. Achieving our two specific aims will enable us to establish the aerobic and strengthening benefits of UTT and evaluate the synergistic effects of these adaptations on functional mobility. Our ultimate objective in this work is to develop and implement the most effective methods of reducing energy-wasteful movement in youth with CP. By accomplishing this goal, we hope to increase the likelihood that optimal function can be maintained as the child with spastic cerebral palsy transitions into adolescence and adulthood.

描述（由申请人提供）：临床医生和研究人员在研究任何未充分研究的人群时，往往难以制定合理且实用的补救措施。当几乎没有有效和可靠的信息来建立合理的方法来治疗基本的身体损伤时，尤其如此。高效运动是舒适生活的基础，在身体健全的儿童中已得到充分证明，但对脑瘫 (CP) 患者的了解仍知之甚少。研究表明，很大一部分患有脑瘫的成年人停止行走是因为身体疲劳和无法在不累的情况下行走。因此，临床需要制定和测试旨在减少脑瘫儿童进入成年之前行走时伴随的心肺压力的康复策略。在此背景下，该项目的主要目标是确定基于水上运动的跑步机步行计划对痉挛性瘫痪青少年的运动能量和功能活动能力的影响。我们的第一个具体目标是记录痉挛性截瘫儿童在进行为期 10 周的水下跑步机训练 (UTT) 计划后有氧功能的变化。为了实现这一目标，30 名痉挛性截瘫儿童将接受 UTT，同时另外 30 名痉挛性截瘫儿童作为年龄和性别匹配的对照。我们假设接受 UTT 的儿童将表现出最大有氧能力的增加、次最大能量消耗的减少以及跑步机步行表现的改善。我们还预测，下肢肌肉力量与总体质量之比的增加将是 UTT 带来的运动经济性预期改善的基础。我们的第二个具体目标是确定增强有氧功能和相对腿部力量的临床意义，因为它们与痉挛性瘫痪儿童的社区活动能力相关。这一目标将通过量化日常步数活动、首选和最大步行速度以及定时步行测试中的距离等与训练相关的变化来实现。实现我们的两个具体目标将使我们能够确定 UTT 的有氧和强化益处，并评估这些适应对功能活动性的协同效应。我们这项工作的最终目标是开发和实施最有效的方法来减少脑瘫青少年的能量浪费运动。通过实现这一目标，我们希望增加痉挛性脑瘫儿童在进入青春期和成年期时保持最佳功能的可能性。