Advanced Spatiomotor Rehabilitation in Blindness & Visual Impairment

先进的失明空间运动康复

• 批准号: 9041594
• 负责人: Lora T. Likova
• 金额: $ 42.39万
• 依托单位: SMITH-KETTLEWELL EYE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9041594
• 关键词: Address; Adult; Affect; Age; Age of Onset; Area; Automobile Driving; Behavioral; Blindness; Brain; Clinical; Cognition; Cognitive; Conflict (Psychology); Data Set; Databases; Decision Making; Development; Effectiveness; Eye; Face; Financial compensation; Forms Controls; Functional Magnetic Resonance Imaging; Future; Gap Junctions; Generations; Goals; Hand; Health; Independent Living; Individual; Intervention; Knowledge; Learning; Life; Life Style; Maps; Measures; Memory; Motor; Nature; Neurology; Neuronal Plasticity; Occipital lobe; Ocular Prosthesis; Pattern; Performance; Persons; Population; Prosthesis; Protocols documentation; Psychiatry; Psychological Transfer; Quality of life; Questionnaires; Recruitment Activity; Regression Analysis; Rehabilitation therapy; Research; Residual state; Role; Running; Scientist; Self-Help Devices; Sensory; Short-Term Memory; Stroke; Structure; Tactile; Testing; Training; Vision; Visual; Visual Acuity; Visual impairment; Vocabulary; Work; blind; braille; design; disability; early onset; experience; eye hand coordination; handheld mobile device; improved; insight; interdisciplinary approach; learning strategy; life history; meetings; mental representation; multidisciplinary; neglect; neuroadaptation; novel; novel strategies; reconstitution; rehabilitation strategy; restoration; skills; spatial memory; standardize measure; tool; visual map; visual motor; web-accessible

DESCRIPTION (provided by applicant): We propose a multidisciplinary approach to effective spatiomotor rehabilitation in blindness and visual impairment. For those who have lost vision, the eye-hand coordination normally available for the manipulation of objects for everyday activities is unavailable and has to be replaced by information from other senses. It becomes crucial to activate cross-modal brain plasticity mechanisms for functional compensation of the visual loss in order to develop robust non-visual mental representations of space and objects. Such non- visual 'maps' are needed to guide spatiomotor coordination, reasoning and decision-making. Our multidisciplinary approach to this problem lies uniquely at the intersection of the fields of blindness assessment, spatiomotor rehabilitation, and brain function, each a focus of one Specific Aim. The novel approach overcomes the shortcomings of traditional rehabilitation training, which can never cover all tasks that a person faces in life (and can be both tedious and expensive). To bridge this gap, we have developed an effective rehabilitation tool, the Cognitive-Kinesthetic (C-K) training protocol to bridge the gap to wide- spectrum blind rehabilitation by employing an integral task (drawing) that can affect 'at one stroke' a wide vocabulary of core abilities that are building blocks for numerous everyday tasks. Our pilot testing shows C-K training to be a powerful instigator of multiple skills, such as generation of precise memory representations (mental maps), enhanced spatial cognition and improved spatiomotor coordination. In Aim 1, we will comprehensively characterize the differential impact of life-history factors through a set of complementary forms of objective assessment of performance. In Aim 2, we will run the C-K rehabilitation training of precise (non-visual) spatiomotor coordination guided by tactile memory. After training, we will re-run all the assessments from Aim 1 to quantify the effectiveness of spatiomotor rehabilitation, its transfer to standardized measures for blind capabilities, and the effect of the independent life-history variables from Aim 1 on the effectiveness of the rehabilitation. Aim 3 will compare whole-brain functional Magnetic Resonance Imaging (fMRI) before and after the C-K training to determine how the visual 'eye-hand' coordination is replaced by nonvisual spatial-memory/hand coordination. Understanding the behavioral and neural adaptation mechanisms underlying the rehabilitation of vision loss will meet the NEI strategic goal of providing for a well-informed scientific approach to future rehabilitation. The comprehensive studies planned will generate a large-scale dataset of parallel measures of life-factors, spatiomotor performance and brain activity measures, which will be made publicly available to basic and clinical scientists.

描述（由申请人提供）：我们提出了一种多学科方法，用于在失明和视觉障碍中有效的弱点康复。 对于那些失去视力的人来说，通常用于操纵日常活动的物体的眼手协调不可用，必须由其他感官的信息代替。 激活跨模式的大脑可塑性机制以进行视觉损失的功能补偿至关重要，以发展空间和物体的可靠的非视觉心理表示。 需要这种非视觉“地图”来指导水上运动的协调，推理和决策。 我们针对此问题的多学科方法在于盲目评估，水疗康复和大脑功能的交汇处，每个都是一个特定目标的重点。 这种小说的方法克服了传统康复训练的缺点，这些培训永远无法涵盖一个人在生活中面临的所有任务（而且既乏味又昂贵）。 为了弥合这一差距，我们已经开发了一种有效的康复工具，即认知基因觉（C-K）训练方案，通过采用一项不可或缺的任务（绘图）来弥合差距到广阔的盲目康复，从核心能力的词汇是许多日常任务的基础。 我们的试点测试表明，C-K培训是多种技能的强大煽动者，例如生成精确的记忆表示（心理图），增强的空间认知和改善的空中运动协调。 在AIM 1中，我们将通过一系列互补形式的客观评估绩效评估来全面地描述生活历史因素的差异影响。 在AIM 2中，我们将进行由触觉记忆指导的精确（非视觉）水上运动协调的C-K康复培训。 训练后，我们将重新运行AIM 1的所有评估，以量化Spatiomotor康复的有效性，转移到 盲目能力的标准化措施，以及AIM 1的独立生活历史变量对康复有效性的影响。 AIM 3将比较C-K训练之前和之后的全脑功能性磁共振成像（fMRI），以确定视觉“眼手”如何被非视觉空间 - 记忆/手部协调代替。 了解恢复视力丧失的行为和神经适应机制将实现NEI战略目标，即为未来的康复提供良好的科学方法。 计划的综合研究将产生大规模的生命因子，水疗绩效和大脑活动度量的平行度量，这将公开提供给基本和临床科学家。