Power Training Combined with Interval Treadmill Training to Improve Walking Activity in Cerebral Palsy

力量训练与间歇跑步机训练相结合，改善脑瘫患者的步行活动

基本信息

批准号：
10197982
负责人：
Noelle G Moreau
金额：
$ 48.78万
依托单位：
LSU HEALTH SCIENCES CENTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-05 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10197982
关键词：
Accelerometer Adolescence Adolescent Affect Aftercare Age Architecture Area Caring Cerebral Palsy Child Childhood Clinic Clinical Communities Data Deterioration Development Devices Educational Intervention Ensure Fascicle Gait speed Generations Global Positioning System Goals Health Impairment Individual Isotonic Exercise Knowledge Laboratories Learning Length Life Location Longevity Lower Extremity Measures Mission Modeling Muscle Muscle Weakness Musculoskeletal National Institute of Child Health and Human Development Outcome Participant Pattern Performance Personal Satisfaction Physical activity Productivity Protocols documentation Public Health Quality of life Randomized Randomized Clinical Trials Rehabilitation therapy Research Testing Time Training Training Programs Translational Research Translations Ultrasonography United States National Institutes of Health Walking Work Youth base clinical practice clinical translation comparison group cost cost effective dosage emerging adult evidence base experience improved improved mobility in vivo innovation muscle strength nervous system disorder new technology novel primary outcome quadriceps muscle rehabilitation research rehabilitation strategy secondary outcome strength training theories treadmill training treatment effect trial comparing

项目摘要

PROJECT SUMMARY/ABSTRACT Individuals with cerebral palsy (CP) experience a progressive decline in ambulatory ability, beginning in adolescence and into early adulthood. We propose that impaired muscle power generation is the key limiting factor affecting walking activity and the ability to physically participate in day to day life. To optimize ambulatory function, it is also essential to practice the task of walking, known as task-specific training, in order to learn how to generate muscle power during walking. However, treadmill training for children with CP should be modeled on the activity pattern of typically developing (TD) youth, which consists of intervals of high intensity activity. Therefore, the objective of this proposal is to determine the effect of lower extremity Power Training combined with Interval Treadmill Training (PT3) on functional walking capacity and community-based activity and participation in children with CP. To identify key muscular mechanisms with this type of training, we will examine quadriceps muscle performance and architecture. We hypothesize that remediating the most pronounced muscle performance impairment (i.e., muscle power) with power training combined with a task- specific approach to walking that is developmentally appropriate will have a significant effect on walking capacity and performance. This hypothesis will be tested by the following specific aims. Aim #1: determine the immediate and retention effects of power training combined with interval treadmill training (PT3) on functional walking capacity in ambulatory children with CP. Forty-eight ambulatory participants with CP (10 to 17yrs) will be randomized to receive either PT3 or an equivalent dosage of traditional approaches (strength training combined with traditional treadmill training) for 24 sessions, 3 times per week for 8 weeks. Walking outcomes will be collected at baseline, immediately post-treatment, and at 2 and 6 months post. Aim #2: quantify the effects of treatment on in vivo muscle architecture and muscle performance measured with ultrasound imaging and dynamometry. We hypothesize that muscle power generation is impaired and is responsible for limitations in walking activity, and that PT3 will result in significant improvements in muscle power that will be explained partly by increases in cross-sectional area and fascicle length. Aim #3: using coordinate data from global position system (GPS) combined with accelerometry, we will directly measure the effects of treatment on community-based walking activity and participation captured in real-world settings. This project is innovative because it represents a paradigm-shift in current clinical rehabilitation practice in that PT3 targets muscle power deficits specifically to drive changes in clinic and community-based walking activity that will be measured with novel technology during day to day life. The proposed research is significant because it will be the first step in a line of research that is expected to ameliorate the documented deterioration in walking ability that begins in adolescence and early adulthood in CP. Knowledge generated from this proposal has relevance for the overall health, mobility, and physical activity in individuals with CP across the life span.

项目概要/摘要脑瘫 (CP) 患者的行走能力逐渐下降，从青春期和成年早期。我们认为肌肉发电受损是关键限制影响步行活动和身体参与日常生活能力的因素。优化门诊除了功能之外，练习步行任务也很重要，称为特定任务训练，以便学习如何在行走时产生肌肉力量。然而，针对脑瘫儿童的跑步机训练应该建模典型发育（TD）青少年的活动模式，包括高强度活动的间歇期。因此，本提案的目的是确定下肢力量训练结合的效果进行功能性步行能力和社区活动的间歇跑步机训练 (PT3)，以及 CP 儿童的参与。为了确定此类训练的关键肌肉机制，我们将检查股四头肌的肌肉性能和结构。我们假设修复最多的是力量训练与任务相结合导致明显的肌肉性能受损（即肌肉力量）适合发育的特定步行方法将对步行产生重大影响容量和性能。这一假设将通过以下具体目标进行检验。目标#1：确定力量训练与间歇跑步机训练（PT3）相结合对功能性的即时和保留效果脑瘫儿童的步行能力。患有 CP（10 至 17 岁）的 48 名流动参与者将随机接受 PT3 或同等剂量的传统方法（力量训练结合传统跑步机训练）共 24 节，每周 3 次，持续 8 周。步行结果将在基线、治疗后立即以及治疗后 2 个月和 6 个月时收集。目标#2：量化通过超声成像测量治疗对体内肌肉结构和肌肉性能的影响和测力。我们假设肌肉发电受到损害并导致限制步行活动中，PT3 将导致肌肉力量的显着改善，这将得到解释部分是通过横截面积和束长度的增加。目标#3：使用来自全球的坐标数据定位系统（GPS）结合加速测量，我们将直接测量治疗效果在现实世界环境中捕获的基于社区的步行活动和参与。这个项目很创新因为它代表了当前临床康复实践的范式转变，PT3 以肌肉力量为目标专门用于推动诊所和社区步行活动变化的缺陷，这些变化将通过日常生活中的新技术。拟议的研究意义重大，因为它将是解决这一问题的第一步。一系列研究预计将改善已记录的步行能力下降的情况，该研究始于 CP 的青春期和成年早期。从该提案中产生的知识与整体相关脑瘫患者一生中的健康、活动能力和体力活动。