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

• 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
• 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

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.

项目摘要/摘要 脑瘫（CP）的个体开始逐渐下降的门诊能力下降 青春期到成年初。我们建议肌肉发电受损是关键的限制 影响步行活动的因素和身体参与日常生活的能力。优化卧床 功能，练习步行任务（称为特定于任务的培训）也是至关重要的，以了解如何 在步行过程中产生肌肉力量。但是，应对CP儿童进行跑步机培训 关于通常发展的（TD）青年的活动模式，该模式由高强度活动的间隔组成。 因此，该提案的目的是确定下肢电力训练的效果 通过间隔跑步机培训（PT3）关于功能性步行能力和基于社区的活动以及 参加CP儿童。为了通过这种训练来确定关键的肌肉机制，我们将 检查股四头肌的肌肉性能和建筑。我们假设最适合的 具有功率训练的明显肌肉性能障碍（即肌肉力量）以及一项任务 - 在发展上适当的特定行走方法将对步行产生重大影响 能力和性能。该假设将通过以下特定目的进行检验。目标1：确定 电力训练的直接和保留效应以及间隔跑步机训练（PT3）对功能 CP的门诊儿童的步行能力。有CP（10至17岁）的四十八名门诊参与者将 随机分配以接收PT3或同等剂量的传统方法（力量训练） 结合传统的跑步机训练）进行24次课程，每周3次，持续8周。步行成果 将在基线，治疗后立即收集，并在后2和6个月内收集。目标＃2：量化 治疗对超声成像测量的体内肌肉结构和肌肉性能的影响 和动力学。我们假设肌肉发电受损，并造成局限性 在步行活动中，PT3将导致肌肉力量的显着改善，这将被解释 部分是由横截面区域和束长的增加。 AIM＃3：使用全局的坐标数据 位置系统（GPS）结合加速度计，我们将直接测量治疗对 基于社区的步行活动和参与在现实世界中捕获。这个项目是创新的 因为它代表了当前临床康复实践中的范式转移，因为PT3针对肌肉力量 专门用于驱动诊所和基于社区步行活动的变化的缺陷 日常生活中的新技术。拟议的研究很重要，因为它将是第一步 一系列研究有望改善步行能力中有记录的恶化，从而开始 CP的青春期和成年早期。该提案产生的知识与整体相关 在整个寿命中，患有CP的人的健康，流动性和体育活动。