Quantifying the energetic cost of support and stabilization during walking in children with cerebral palsy

量化脑瘫儿童行走过程中支撑和稳定的能量消耗

基本信息

批准号：
10468872
负责人：
Max Donelan
金额：
$ 13.85万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-15 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10468872
关键词：
Activities of Daily Living Adult Balance training Biomechanics Body Weight Carbon Dioxide Cerebral Palsy Child Communities Development Device Designs Devices Eating Fatigue Food Energy Foundations Future Gait Goals Human Impairment Indirect Calorimetry Individual Intervention Jogging Knowledge Lateral Leg Life Limb structure Measures Metabolic Methods Monitor Movement Muscle Nervous System Trauma Operative Surgical Procedures Orthotic Devices Oxygen Participant Pattern Pelvis Performance Persons Population Prevalence Quality of life Recording of previous events Regimen Rehabilitation therapy Reporting Research Research Personnel Research Priority Running Self-Help Devices Speed System Testing Training Training Programs Walking Work biomechanical model cost cost comparison crouch gait design equilibration disorder evidence base exhaustion exoskeleton experience experimental study fitness improved innovative technologies insight muscle metabolism peer relative cost research and development respiratory gas spasticity strength training theories therapy design walker walking speed

项目摘要

Project Summary Walking promotes independence, participation, fitness, and exploration in daily life. Like other activities, walking requires metabolic energy from the food we eat, which is ultimately used by our muscles to power movement. Experimentally, we can measure this energy using indirect calorimetry, which monitors oxygen and carbon dioxide as the body converts stored energy into the form used by muscles during activities of daily living. Decades of energetics research has demonstrated that human walking is incredibly efficient. However, for people with cerebral palsy the energetic cost of walking is significantly increased, on average over two times higher than typically-developing individuals. This means that for people with cerebral palsy, walking is as tiring as jogging or climbing stairs. An energetic cost of this magnitude restricts activities of daily living and causes exhaustion. While our team and many others have sought to reduce these costs through surgical interventions, rehabilitation, orthotics, or other assistive devices, these strategies have failed to result in meaningful reductions in energy. To design strategies that successfully reduce walking costs, we must first understand the underlying mechanisms contributing to elevated cost in people with cerebral palsy. The proposed research seeks to fill this knowledge gap by examining biomechanical factors that contribute to elevated energy for people with cerebral palsy. Specifically, we will evaluate the energetic cost of supporting the body (Aim-1) and stabilizing the body (Aim-2) during walking for children with cerebral palsy, and compare these costs to typically-developing peers. These tasks require very little energy during unimpaired walking (e.g., <10% of total walking cost), but their costs remain unknown for people with cerebral palsy and have direct implications for treatment decisions and assistive device design. Building upon decades of energetics research of unimpaired walking, this research will use a mechatronic device to precisely provide support and stabilization assistance during walking and quantify the impact of this assistance on walking cost. In unimpaired adults, similar methods have led to the design of exoskeletons and training programs that effectively reduce walking and running energy. This research will provide the foundation to create evidence-based strategies to decrease energy costs, minimize fatigue, and increase quality of life for people with cerebral palsy and other neurologic injuries.

项目概要步行促进日常生活中的独立、参与、健身和探索。和其他活动一样，步行需要来自我们所吃食物的代谢能量，这些能量最终被我们的肌肉用来提供动力移动。在实验上，我们可以使用间接量热法来测量这种能量，该方法可以监测氧气和二氧化碳，因为身体将储存的能量转化为肌肉在日常活动中使用的形式活的。数十年的能量学研究表明，人类行走的效率非常高。然而，对于脑瘫患者来说，步行的能量消耗显着增加，平均增加两倍以上高于正常发育个体。这意味着对于脑瘫患者来说，走路同样累人如慢跑或爬楼梯。如此巨大的能量消耗限制了日常生活活动并导致精疲力尽。虽然我们的团队和许多其他人试图通过手术干预来降低这些成本，康复、矫形器或其他辅助装置，这些策略未能产生有意义的结果能源减少。为了设计成功降低步行成本的策略，我们必须首先了解导致脑瘫患者费用增加的潜在机制。拟议的研究试图通过检查有助于提高能量的生物力学因素来填补这一知识空白脑瘫患者。具体来说，我们将评估支持身体的能量成本（Aim-1）和脑瘫儿童在行走过程中稳定身体（Aim-2），并将这些成本与典型发展的同龄人。这些任务在正常行走期间需要很少的能量（例如，<10% 总步行成本），但对于脑瘫患者来说，其成本仍然未知，并且具有直接影响用于治疗决策和辅助设备设计。以数十年的能量学研究为基础不受损害的行走，这项研究将使用机电设备来精确提供支撑和稳定步行期间的援助，并量化这种援助对步行成本的影响。在未受损的成年人中，类似的方法导致了有效减少步行的外骨骼和训练计划的设计和跑步能量。这项研究将为创建基于证据的策略提供基础，以减少降低能源成本，最大限度地减少疲劳，提高脑瘫和其他神经系统疾病患者的生活质量受伤。