Robotic Interventions to Enhance Locomotor Stability Following Spinal Cord Injury

机器人干预增强脊髓损伤后的运动稳定性

• 批准号: 8466822
• 负责人: Keith Edward Gordon
• 金额: --
• 依托单位: EDWARD HINES JR VA HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8466822
• 关键词: Address; Affect; Area; Balance training; Body Weight; Chicago; Chronic; Clinical; Computer software; Country; Development Plans; Devices; Elements; Environment; Equilibrium; Equipment; Funding; Gait; Goals; Grant; Hospitals; Institutes; Intervention; Knowledge; Lateral; Lead; Leadership; Libraries; Locomotor training; Manuscripts; Measures; Medial; Mentors; Motor; Movement; Outcome; Participant; Patients; Pelvis; Positioning Attribute; Quality of life; Reading; Rehabilitation therapy; Research; Research Project Grants; Resources; Robotics; Sensory Motor Performances; Services; Shadowing (Histology); Speed; Spinal cord injury; System; Technology; Testing; Time; Training; Travel; Veterans; Walking; Work; Writing; career development; clinical care; cost; experience; improved; improved mobility; neurophysiology; novel; programs; research and development; robotic device; software development; tool; treadmill training

DESCRIPTION (provided by applicant) Project Overview: The major goals of this proposal are to develop and test a robotic device capable of providing targeted locomotor balance training for veterans with spinal cord injury (SCI). The working hypothesis is that this novel robotic tool will transform traditional body weight supported treadmill training (BWSTT) into a dynamic environment where balance-specific components of walking are measured and adaptively challenged, thereby enhancing locomotor training outcomes. Candidate: Dr. Gordon's objective is to establish a novel and productive, independent line of research within the VA system that will benefit the quality of life of veterans affected by SCI. Dr. Gordon has significant research experience in gait rehabilitation of SCI. He has observed that effective locomotor balance training and assessment tools are lacking within this field. For the purposed project, Dr. Gordon will develop a new robotic device capable of addressing this need. Combining Dr. Gordon's past experience with the training purposed in the current project will position Dr. Gordon at the forefront of this under-explored area of SCI gait rehabilitation. Research Development Plan: Dr. Gordon has assembled a diverse mentoring team, lead by Dr. Zev Rymer, to provide training and guidance in four critical project areas; rehabilitation robotics, neurophysiology of movement following SCI, locomotor balance and clinical care of SCI. Dr. Gordon will advance his formal knowledge of these areas through a combination of course work, directed readings and clinical shadowing. Dr. Gordon will also receive career development guidance in terms of establishing, funding and growing a productive independent research program through regular group mentoring sessions, active manuscript/grant writing and participation in grant writing and leadership seminars. Environment: The proposed research project will be conducted in VA designated space within the Sensory Motor Performance Program at the Rehabilitation Institute of Chicago (RIC), the top ranked rehabilitation hospital in the country. The resources provided by RIC include dedicated research space and equipment, clinical examination areas, offices space and machine shop. Clinical training and the primary recruitment of veterans with SCI will be performed through the Spinal Cord Injury Service at Edward Hines Jr. VA Hospital. Proposed Research: Aim 1) To create a library of robotic environments capable of providing challenging, balance-specific locomotor training. Applicant proposes to develop an intelligent robotic rehabilitation tool capable of A) applying a range of dynamic balance environments, including stabilizing and/or destabilizing lateral forces applied to the pelvis during gait, B) measuring locomotor stability in real-time and C) automatically adjusting the difficulty of the balance environments to optimally challenge the abilities of the participant. The device will consist of a moving coil forcer (linear motor) rigidly attached to the posterior of a pelvic harness. Software will control travel of the coil forcer along a track aligned perpendicular to the treadmill. Thus, movement of the coil forcer will exert a medial-lateral force on the user. He will develop software to create several balance-specific training environments that can be safely and easily delivered to people with SCI during treadmill walking. Aim 2) To test the effects of targeted locomotor balance training on gait stability, walking speed and energetic efficiency in incomplete SCI subjects. He will compare the effects of BWSTT performed in one of three balance-specific training environments. Ambulatory incomplete SCI subjects will receive BWSTT with either 1) a demanding dynamic balance environment that automatically and progressively adapts to continuously challenge the subject during gait; 2) no balance assistance (similar to unassisted walking on a treadmill); or 3) fixed balance assistance (similar to current approaches to BWSTT). He hypothesizes that the dynamic balance environment will result in the greatest improvements in walking speed, energetic gait efficiency and the ability to respond to gait perturbations.

描述（由申请人提供） 项目概述：该提案的主要目标是开发和测试一种机器人设备，能够为患有脊髓损伤（SCI）的退伍军人提供有针对性的运动平衡训练。 工作假设是，这种新颖的机器人工具将把传统的体重支撑跑步机训练（BWSTT）转变为动态环境，在该环境中测量步行的平衡特定组成部分并进行适应性挑战，从而提高运动训练效果。 候选人：戈登博士的目标是在 VA 系统内建立一个新颖且富有成效的独立研究路线，这将有利于受 SCI 影响的退伍军人的生活质量。 Gordon 博士在 SCI 步态康复方面拥有丰富的研究经验。 他观察到该领域缺乏有效的运动平衡训练和评估工具。 对于该项目，戈登博士将开发一种能够满足这一需求的新机器人设备。 将 Gordon 博士过去的经验与当前项目的培训相结合，将使 Gordon 博士处于 SCI 步态康复这一尚未探索的领域的前沿。 研究发展计划：Gordon 博士组建了一支多元化的指导团队，由 Zev Rymer 博士领导，在四个关键项目领域提供培训和指导；康复机器人学、SCI 后运动的神经生理学、运动平衡和 SCI 的临床护理。 戈登博士将通过课程作业、定向阅读和临床见习相结合来提高他对这些领域的正式知识。 戈登博士还将通过定期的小组指导会议、积极的手稿/资助写作以及参与资助写作和领导力研讨会，获得建立、资助和发展富有成效的独立研究项目方面的职业发展指导。 环境：拟议的研究项目将在美国排名第一的康复医院芝加哥康复研究所 (RIC) 感觉运动表现项目内的 VA 指定空间内进行。 RIC 提供的资源包括专用研究空间和设备、临床检查区域、办公空间和机械车间。 临床培训和脊髓损伤退伍军人的初步招募将通过爱德华·海因斯退伍军人医院 (Edward Hines Jr. VA Hospital) 的脊髓损伤服务中心进行。 拟议研究：目标 1) 创建一个能够提供具有挑战性、针对平衡的运动训练的机器人环境库。 申请人提出开发一种智能机器人康复工具，能够A)应用一系列动态平衡环境，包括在步态期间施加到骨盆的稳定和/或不稳定侧向力，B)实时测量运动稳定性，以及C)自动调节平衡环境的难度，以最佳方式挑战参与者的能力。 该设备将由一个刚性连接到骨盆安全带后部的动圈施力器（线性电机）组成。 软件将控制线圈施力器沿着垂直于跑步机的轨道行进。 因此，线圈力的运动将向使用者施加内侧-外侧力。 他将开发软件来创建几种特定于平衡的训练环境，这些环境可以安全、轻松地提供给 SCI 患者在跑步机上行走时使用。目标 2) 测试定向运动平衡训练对不完全 SCI 受试者的步态稳定性、步行速度和能量效率的影响。 他将比较在三种平衡特定训练环境之一中进行的 BWSTT 的效果。 动态不完全 SCI 受试者将接受 BWSTT，其中 1) 要求严格的动态平衡环境，自动逐步适应在步态过程中不断挑战受试者； 2）没有平衡辅助（类似于在跑步机上无辅助行走）； 3) 固定余额援助（类似于当前的 BWSTT 方法）。 他假设动态平衡环境将最大程度地提高步行速度、精力充沛的步态效率以及对步态扰动的反应能力。