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.

项目摘要步行可促进日常生活中的独立性，参与，健身和探索。像其他活动一样步行需要我们吃的食物的代谢能量，我们的肌肉最终将其用于供电移动。在实验上，我们可以使用间接量热法测量该能量，该量热法可以监视氧气和二氧化碳随着人体将储存的能量转化为每日活动中肌肉使用的形式活的。数十年的能量研究表明，人的步行非常有效。然而，对于脑瘫患者，步行的能量成本显着增加，平均两次比通常发展的个体高。这意味着对于脑瘫的人来说，步行很累慢跑或爬楼梯。这种大小的充满活力限制了日常生活的活动精疲力尽。尽管我们的团队和许多其他团队试图通过手术干预措施降低这些成本，但康复，矫形器或其他辅助设备，这些策略未能导致有意义减少能量。要设计成功降低步行成本的策略，我们必须首先了解脑瘫患者成本升高的基本机制。拟议的研究试图通过检查生物力学因素来填补这一知识差距，这些因素有助于提高能量患有脑瘫的人。具体而言，我们将评估支撑身体的能量成本（AIM-1）和稳定身体（AIM-2）在为脑瘫儿童行走时，将这些费用与通常是发展的同行。这些任务在不损坏的步行过程中几乎不需要能量（例如，<10％的10％总步行成本），但是脑瘫患者的成本仍然未知，并且有直接影响用于治疗决策和辅助设备设计。基于数十年的能量研究这项研究将使用无障碍行走，将使用机电设备来精确提供支持和稳定步行过程中的帮助并量化了这种援助对步行成本的影响。在不受影响的成年人中，类似的方法导致了外骨骼和培训计划的设计，从而有效地减少了步行和运行能量。这项研究将为创建基于证据的策略以减少的基础能源成本，最小化疲劳和增加脑瘫和其他神经系统的人的生活质量受伤。