Combined Aphasia and Robot-Assisted Arm Treatment for Chronic Stroke Survivors

失语症和机器人辅助手臂联合治疗慢性中风幸存者

• 批准号: 10640826
• 负责人: Adam Buchwald
• 金额: $ 21.62万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10640826
• 关键词: Anomia; Aphasia; Area; Combined Modality Therapy; Control Groups; Exhibits; Family; Future; Goals; Grant; Impairment; Individual; Inferior; Intervention; Language; Language Disorders; Leg; Life; Measures; Methods; Mission; Modality; Motor; Motor Cortex; Names; Participant; Patients; Phase II Clinical Trials; Public Health; Reading; Recovery; Rehabilitation therapy; Research; Retrieval; Robot; Severities; Standardization; Stroke; System; Testing; Therapeutic; Time; Training; United States; United States National Institutes of Health; Upper Extremity; Upper arm; Winking; Work; aphasia recovery; arm; arm movement; chronic stroke; computerized; cost; design; disability; effectiveness testing; experimental group; improved; innovation; language impairment; language outcome; lexical retrieval; limb movement; motor deficit; motor impairment; motor learning; motor recovery; novel strategies; phase II trial; preservation; response; robot assistance; social; standardize measure; stroke recovery; stroke rehabilitation; stroke survivor; stroke-induced aphasia; targeted treatment; treatment arm; treatment comparison; treatment trial

PROJECT SUMMARY/ABSTRACT Stroke is a leading cause of disability in the United States, frequently leading to both language and motor impairment that creates barriers to participation in professional, social, and family settings. The modal approach to rehabilitation separates treatment in language and motor domains, which contributes to the time and expense of stroke recovery. Co-treatment approaches are desirable to both enhance treatment efficiency and potentially lower costs, but the extent to which we can promote (and not dampen) recovery by combining treatment across domains has not been systematically explored. In this project, we integrate a computerized aphasia therapy targeting anomia into robot-assisted upper-extremity treatment while preserving the critical aspects of each treatment. This work will provide a foundational test of whether we can reduce impairment in both language and motor domains with a single combined treatment. Our long-term goal is to create effective and efficient approaches to aphasia recovery in chronic stroke survivors with both language and motor deficits by combining treatment across these traditionally-distinct rehabilitation domains. The central hypothesis of this proposal is that we can reduce impairment in each domain by combining treatments in a manner that retains the critical aspects of each. This central hypothesis will be tested by pursuing three specific aims: 1) determine the whether combining aphasia treatment with robot-assisted arm treatment can improve language outcomes in chronic stroke; 2) determine whether combining aphasia treatment with robot-assisted arm treatment supports motor recovery in chronic stroke; 3) explore whether combining aphasia treatment with robot- assisted arm treatment specifically enhances retrieval of lexical items associated with arm movement. Under the first two aims, we will directly test whether the combined treatment can reduce impairment in each domain, a critical step towards developing a larger Phase II clinical trial. The third exploratory aim tests whether the combining arm-based rehabilitation with aphasia treatment specifically enhances recall of arm-related words that activate motor cortex in unimpaired individuals. The proposed research represents an innovative approach to aphasia treatment within the larger context of stroke rehabilitation, combining therapeutic methods across language and motor domains to promote recovery in chronic stroke. The proposed research is significant because it tests the extent to which a combined language-motor treatment can enhance word retrieval and simultaneously whether it supports motor treatment. This combined treatment will form the basis of a Phase II trial as part of a future R01 powered to test the effectiveness of combined treatment compared to traditional approaches. This line of research based on combining treatment across domains has the potential to lead to a paradigm shift in stroke rehabilitation.

项目概要/摘要 中风是美国导致残疾的主要原因，经常导致语言和运动功能障碍 损害对参与专业、社会和家庭环境造成障碍。模态 康复方法将语言和运动领域的治疗分开，这有助于 中风康复的时间和费用。联合治疗方法对于增强治疗效果是可取的 效率和潜在的降低成本，但我们可以在多大程度上促进（而不是抑制）复苏 通过跨领域结合治疗尚未得到系统探索。在这个项目中，我们 将针对失语症的计算机化失语症治疗融入机器人辅助上肢治疗中 同时保留每种治疗的关键方面。这项工作将为 我们是否可以通过单一组合来减少语言和运动领域的损伤 治疗。我们的长期目标是创造有效且高效的失语症康复方法 通过综合治疗，治疗患有语言和运动缺陷的慢性中风幸存者 传统上独特的康复领域。该提案的中心假设是我们可以减少 通过以保留每个领域的关键方面的方式组合治疗，来消除每个领域的损害。 这个中心假设将通过追求三个具体目标来检验：1）确定是否 将失语症治疗与机器人辅助手臂治疗相结合可以改善失语症患者的语言结果 慢性中风； 2）确定是否将失语症治疗与机器人辅助手臂治疗相结合 支持慢性中风的运动恢复； 3）探索失语症治疗是否与机器人相结合 辅助手臂治疗专门增强了与手臂运动相关的词汇项目的检索。 在前两个目标下，我们将直接测试联合治疗是否可以减少损伤 每个领域都是开发更大规模的 II 期临床试验的关键一步。第三个探索目标 测试基于手臂的康复与失语症治疗相结合是否能特异性增强记忆能力 与手臂相关的单词可以激活未受损个体的运动皮层。拟议的研究 代表了中风康复大背景下失语症治疗的创新方法， 结合语言和运动领域的治疗方法，促进慢性中风的康复。 拟议的研究意义重大，因为它测试了语言运动相结合的程度 治疗可以增强单词检索，同时是否支持运动治疗。这结合了 治疗将构成 II 期试验的基础，作为未来 R01 的一部分，旨在测试治疗的有效性 与传统方法相比，联合治疗。这一系列研究以联合治疗为基础 跨领域有可能导致中风康复的范式转变。