Advanced Spatiomotor Rehabilitation in Blindness & Visual Impairment

先进的失明空间运动康复

• 批准号: 8720487
• 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/8720487
• 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; Independent Living; Individual; Intervention; Knowledge; Learning; Life; Life Style; Maps; Measures; Memory; Motor; Nature; Neurology; Neuronal Plasticity; Occipital lobe; 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; Solutions; 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; life history; meetings; mental representation; multidisciplinary; neglect; neuroadaptation; novel; novel strategies; public health relevance; reconstitution; rehabilitation strategy; restoration; skills; 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来有效治疗失明和视力障碍的空间运动康复。 对于那些失去视力的人来说，日常活动中通常可用于操纵物体的眼手协调能力不可用，必须由其他感官的信息代替。 激活跨模式大脑可塑性机制来补偿视觉损失的功能变得至关重要，以便发展出强大的空间和物体的非视觉心理表征。 需要这种非视觉“地图”来指导空间运动协调、推理和决策。 我们解决这个问题的多学科方法独特地位于失明评估、空间运动康复和大脑功能领域的交叉点，每个领域都有一个特定目标。 这种新颖的方法克服了传统康复训练的缺点，传统康复训练永远无法涵盖一个人在生活中面临的所有任务（并且可能既乏味又昂贵）。 为了弥补这一差距，我们开发了一种有效的康复工具，即认知动觉（C-K）训练方案，通过采用可“一次性”影响广泛范围的整体任务（绘画）来弥补与广泛盲人康复的差距。核心能力词汇是许多日常任务的基础。 我们的试点测试表明，C-K 训练是多种技能的强大推动者，例如生成精确的记忆表征（心理图）、增强空间认知和改善空间运动协调。 在目标 1 中，我们将通过一系列互补的客观绩效评估形式来全面描述生活史因素的差异影响。 在目标2中，我们将进行触觉记忆引导的精确（非视觉）空间运动协调的C-K康复训练。 训练结束后，我们将重新运行目标 1 的所有评估，以量化空间运动康复的有效性，将其转移到 盲人能力的标准化测量，以及目标 1 中的独立生活史变量对康复有效性的影响。 目标 3 将比较 C-K 训练前后的全脑功能磁共振成像 (fMRI)，以确定视觉“眼手”协调如何被非视觉空间记忆/手协调取代。 了解视力丧失康复背后的行为和神经适应机制将实现 NEI 的战略目标，即为未来的康复提供消息灵通的科学方法。 计划中的综合研究将生成一个大规模数据集，其中包含生命因素、空间运动表现和大脑活动测量的并行测量，这些数据将向基础和临床科学家公开。