Movement Ability Changes with Balance-Based Torso-Weighting in Multiple Sclerosis

多发性硬化症患者的运动能力随基于平衡的躯干配重而变化

• 批准号: 7982033
• 负责人: Diane Dameron Allen
• 金额: $ 41.3万
• 依托单位: SAMUEL MERRITT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-20 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7982033
• 关键词: Affect; Age; Ankle; Articular Range of Motion; Body Weight; Characteristics; Clinical; Data; Data Collection; Disease; Effectiveness; Equilibrium; Esthesia; Exercise; Functional disorder; Future; Gait; Gait abnormality; Goals; Heterogeneity; Hip region structure; Impairment; Individual; Intervention; Joints; Kinetics; Knee; Knowledge; Light; Limb structure; Lower Extremity; Measures; Motion; Movement; Multiple Sclerosis; Multivariate Analysis; Muscle Tonus; Musculoskeletal Equilibrium; Neurodegenerative Disorders; Outcome; Participant; Patient Self-Report; Patients; Persons; Physical therapy exercises; Population; Process; Publishing; Qualifying; Quality of life; Recommendation; Rehabilitation therapy; Reporting; Research; Sampling; Sensory; Staging; Students; Techniques; Technology; Testing; Time; Walking; Weight; Work; base; clinical practice; disability; effective intervention; equilibration disorder; fall risk; health care delivery; improved; instrument; kinematics; light weight; motor control; motor impairment; novel; programs; public health relevance; relating to nervous system; response; sensorimotor system; young adult

DESCRIPTION (provided by applicant): Multiple sclerosis (MS) is a neurodegenerative disease affecting approximately 2.5 million people worldwide and is the most frequent cause of disability in young adults. Balance and gait impairments are common in MS, however, the manifestation of balance and mobility impairments is variable depending on the set of neural processing disruptions in the particular individual with MS. Most kinematic and kinetic analyses of gait and balance in MS have thus far focused on individuals with minimal clinical disability. Rehabilitation to improve gait and balance in this population have shown results in 6-8 weeks of exercise therapy. A novel intervention, balance-based torso-weighting (BBTW), a weighting technique tailored to individual directional balance loss, has shown immediate improvements in balance and gait in people with MS. The weight added to the torso is minimal (<1.5% body weight) and strategically placed according to the person's imbalance. However, the mechanisms behind its immediate effectiveness remain mysterious, and recommendations regarding people with MS or other disorders that will benefit remain vague. For Specific Aim 1 of this study, we will perform kinematic and kinetic analyses of standing and walking with and without BBTW in people with MS and healthy controls. For Specific Aim 2 of this study, we will examine which of several impairments of the sensory and motor systems best predicts immediate improvement in balance and mobility with BBTW in a new sample of participants with MS compared to healthy controls. The research goal is to refine hypotheses regarding the mechanism behind BBTW intervention, and clarify who will receive the most benefit. Future research could then test the hypotheses generated from this work. If we achieve our two specific aims, we will have evidence to add to the scientific knowledge regarding the mechanism of light weighting as a sensory supplement to change strategies for postural control. This study will help us understand the mechanisms for responsiveness to BBTW, and possibly to other interventions that supplement sensory input. With that knowledge, we can develop more effective interventions for people with MS or other neural disorders, improving clinical outcomes and quality of life. If we can determine which patients are most likely to benefit from this type of intervention, health care delivery can be more efficient as well as effective. PUBLIC HEALTH RELEVANCE: By beginning to unravel the mechanisms behind light torso-weighting we can develop more effective interventions for people with MS or other neural disorders that impair balance and gait. Such interventions will improve clinical outcomes and quality of life. When we determine the patients most likely to benefit from this type of intervention, health care delivery can be more efficient as well as effective.

描述（由申请人提供）：多发性硬化症（MS）是一种神经退行性疾病，影响了全球约250万人，是年轻人最常见的残疾原因。平衡和步态障碍在MS中很常见，但是，平衡和流动性障碍的表现是可变的，具体取决于特定个体中MS的神经处理中断的集合。迄今为止，大多数步态和平衡的运动学和动力学分析都集中在临床障碍最少的个体上。改善该人群的步态和平衡的康复表现出在运动治疗的6-8周内结果。一种新颖的干预，基于平衡的躯干加权（BBTW），这是一种针对个体方向平衡损失量身定制的加权技术，已显示出MS的人的平衡和步态立即改善。增加躯干的重量是最小的（体重<1.5％），并且根据人的失衡而战略性地放置。但是，其直接有效性背后的机制仍然是神秘的，关于MS或其他将受益的疾病的人的建议仍然模糊。对于本研究的特定目的1，我们将对具有MS和健康对照的人进行具有和没有BBTW的站立和行走的运动学和动力学分析。对于本研究的特定目的2，我们将研究感官和运动系统的几种损伤中的哪些最能预测，与健康对照组相比，在新的具有MS的参与者样本中，在新的MS参与者样本中可以立即改善BBTW的平衡和移动性。研究目标是完善有关BBTW干预背后机制的假设，并澄清谁将获得最大的好处。然后，未来的研究可以测试这项工作产生的假设。如果我们实现了两个特定的目标，我们将有证据可以增加有关轻量加权机理的科学知识，以此作为改变姿势控制策略的感觉补充。 这项研究将有助于我们了解对BBTW响应的机制，并可能对补充感觉输入的其他干预措施。有了这些知识，我们可以为患有MS或其他神经疾病的人开发更有效的干预措施，从而改善临床结果和生活质量。如果我们可以确定哪些患者最有可能从这种干预措施中受益，那么医疗保健提供的效率可能会更有效和有效。 公共卫生相关性：通过开始阐明轻躯干加权背后的机制，我们可以为MS或其他损害平衡和步态的神经疾病的人开发更有效的干预措施。这种干预措施将改善临床结果和生活质量。当我们确定最有可能从这种干预措施中受益的患者时，医疗保健提供的效率可能会更有效和有效。

项目成果

Patterns of balance loss with systematic perturbations in Parkinson's disease and multiple sclerosis.

• DOI: 10.3233/nre-210200
• 发表时间: 2021
• 期刊: NeuroRehabilitation
• 影响因子: 2
• 作者: Allen DD;Gadayan J;Hughes R;Magdalin C;Jang C;Schultz A;Scott K;Vivero L;Lazaro RL;Widener GL
• 通讯作者: Widener GL