Mechanisms and Rehabilitation of Cerebellar Ataxia

小脑性共济失调的机制与康复

• 批准号: 7423889
• 负责人: Amy J. Bastian
• 金额: $ 26.07万
• 依托单位: HUGO W. MOSER RES INST KENNEDY KRIEGER
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-02-18 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7423889
• 关键词: Address; Affect; Brain Part; Case Study; Cerebellar Ataxia; Cerebellum; Clinical; Complex; Condition; Data; Effectiveness; Environment; Equilibrium; Exercise; Feedback; Freedom; Goals; Hand; Home environment; Intervention; Joints; Kinetics; Lead; Learning; Limb structure; Measures; Mechanics; Motion; Motor; Movement; Outcome; Patients; Pattern; Performance; Personal Satisfaction; Population; Preparation; Process; Randomized Clinical Trials; Range; Rehabilitation Outcome; Rehabilitation therapy; Relative (related person); Research; Research Design; Research Personnel; Residual state; Resistance; Standards of Weights and Measures; Techniques; Testing; Thinking; Time; Training; Translating; Upper arm; Walking; Work; base; cerebellar lesion; design; improved; kinematics; motor control; motor learning; programs; rehabilitation strategy; research study; size; theories

DESCRIPTION (provided by applicant): One major function of the cerebellum is to dynamically adjust the relative motion of multiple joints and limbs, making movement smooth and accurate. To do this, cerebellar circuits must process complex temporal and kinetic relationships between body segments predictively, avoiding inaccuracies caused by long feedback delays. Cerebellar control processes must also be continually calibrated via adaptive mechanisms in order be useful in a constantly changing environment. It is clear that cerebellar damage disrupts practice-dependent adaptation of many movements. The implication of these studies is that standard practice of affected movements will provide minimal benefit for people with cerebellar damage. Yet, rehabilitation training is the main, if not only treatment for most cerebellar conditions. Little evidence exists on the effectiveness of rehabilitation training, though it may improve some aspects of movement control; the mechanisms for this are unclear. Therefore, we think that an increased understanding of the adaptation capacity in people with cerebellar damage may facilitate the optimization of rehabilitation techniques. We will test: 1) if there are maneuvers that can improve movement performance of people with cerebellar damage, 2) if adaptive capacity can be enhanced in people with cerebellar damage, and 3) if adaptive capacity predicts rehabilitation outcome (i.e. learning). We hypothesize that we may be able to enhance residual cerebellar function and/or tap into extra-cerebellar mechanisms to improve movement performance and adaptation capacity. We also hypothesize that adaptive ability will correlate with learning capacity in this population, allowing us to predict who will best respond to rehabilitation. As we perform these studies, we will evaluate different theories of cerebellar function (e.g. dynamics control, timing), by determining which aspects of movement performance and adaptation are most compromised in cerebellar patients. Thus, this work will test motor control theories while at the same time evaluating new strategies for rehabilitation. Lay summary: The cerebellum is a part of the brain important for coordination and learning of new movements through practice. In these experiments, we will work to understand how to improve movement coordination and motor learning abilities of people with cerebellar damage. We will also study the effects of a rehabilitation program designed to improve balance and walking.

描述（申请人提供）：小脑的一大功能是动态调节多个关节和肢体的相对运动，使运动平稳、准确。为此，小脑回路必须预测性地处理身体各部分之间复杂的时间和动力学关系，避免长时间反馈延迟造成的不准确。小脑控制过程还必须通过自适应机制不断校准，以便在不断变化的环境中发挥作用。很明显，小脑损伤会扰乱许多动作依赖于练习的适应。这些研究的意义在于，受影响运动的标准做法对小脑损伤患者的益处微乎其微。然而，对于大多数小脑疾病来说，康复训练即使不是唯一的治疗方法，也是主要的治疗方法。尽管康复训练可以改善运动控制的某些方面，但几乎没有证据表明它的有效性；其机制尚不清楚。因此，我们认为，加深对小脑损伤患者适应能力的了解可能有助于康复技术的优化。我们将测试：1）是否有一些动作可以改善小脑损伤患者的运动表现，2）是否可以增强小脑损伤患者的适应能力，以及3）适应能力是否可以预测康复结果（即学习）。我们假设我们也许能够增强残余小脑功能和/或利用小脑外机制来提高运动表现和适应能力。我们还假设该人群的适应能力与学习能力相关，从而使我们能够预测谁对康复反应最好。当我们进行这些研究时，我们将通过确定小脑患者运动表现和适应的哪些方面最受影响来评估小脑功能的不同理论（例如动态控制、计时）。因此，这项工作将测试运动控制理论，同时评估新的康复策略。简单总结：小脑是大脑的一部分，对于通过练习协调和学习新动作非常重要。在这些实验中，我们将努力了解如何提高小脑损伤患者的运动协调和运动学习能力。我们还将研究旨在改善平衡和行走的康复计划的效果。