DOWN-TRAINING SPINAL STREACH REFLEXES

降低脊柱伸展反射训练

• 批准号: 3415430
• 负责人: STEVEN L. WOLF
• 金额: $ 22.85万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-09-01 至 1994-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3415430
• 关键词: body movement; human subject; human therapy evaluation; motor neurons; nervous system disorder; neurophysiology; operant conditionings; posture; rehabilitation; spasm; spinal reflex

Abnormal spinal stretch reflexes (SSRS) are a major problem for many patients with traumatic brain injury, stroke, cerebral palsy or multiple sclerosis. Spinal hyperreflexia causes postural abnormalities and contractures, and interferes with voluntary movement. Available therapeutic approaches are rarely wholly effective and often ineffective. Operant conditioning can reduce SSRs in non-human primates, and recent studies indicate that it can reduce SSRs in humans also. Thus SSR conditioning could provide a new approach to treating hyperreflexia in humans. The goal of this proposal is to determine whether SSR conditioning can become an effective treatment for hyperreflexia in patients. To achieve this goal, this project will: 1) determine to what extent normal individuals and patients with lesions of specific types can reduce SSRs by operant conditioning; 2) assess how long those reflex changes persist; 3) determine whether reflex changes are accompanied by improvements in function and changes in stiffness about the elbow joint; and 4) define which classes of patients benefit from this new approach. Both normal individuals and hyperreflexive patients will participate. Each will be randomly assigned to the controI group or to the treatment group. Control subjects will have biceps brachii SSRs elicited during a 10-week - extended baseline phase and during a 1-year follow-up phase. Treatment subjects will have a 2-week baseline phase, an 8-week treatment phase, and the same 1 -year follow-up phase as controls. During the treatment phase, SSRs of treatment subjects will be operantly conditioned, i.e., subjects will be rewarded for smaller reflexes. Control subjects will receive no such conditioning, their SSRs will simply be measured. After the treatment group completes the treatment phase and the control group completes the extended baseline, both groups will enter the follow-up phase, which will assess the persistence of reflex change caused by conditioning. In addition, all patient subjects will receive periodic functional evaluations throughout the study to determine whether reflex decrease is associated with functional improvement. This project should determine whether operant conditioning of SSRs can reduce hyperreflexia, reveal whether such reduction is accompanied by persistent functional improvement, and define which patients are most likely to benefit. It may also lead to development of additional conditioning techniques for alleviating other varieties of abnormal CNS function.

脊柱牵张反射异常 (SSRS) 是许多人面临的一个主要问题 患有脑外伤、中风、脑瘫或多发性硬化症的患者 硬化。 脊髓反射亢进会导致姿势异常 挛缩，并干扰随意运动。 可用的 治疗方法很少完全有效，而且常常无效。 操作性条件反射可以减少非人类灵长类动物的 SSR，最近的研究 研究表明它也可以减少人类的 SSR。 因此SSR 条件反射可以为治疗反射亢进提供一种新方法 人类。 该提案的目标是确定 SSR 调节是否 可以成为治疗反射亢进患者的有效方法。 为了实现这一目标，该项目将：1）确定达到什么程度 正常个体和患有特定类型病变的患者可以减少 通过操作性条件反射实现 SSR； 2）评估这些反射变化多长时间 坚持; 3）判断反射变化是否伴有 肘关节功能的改善和僵硬的变化； 4) 确定哪些类别的患者可以从这种新方法中受益。 正常人和反射亢进的患者都会参加。 每个 将被随机分配到对照组或治疗组。 对照受试者将在 10 周内引发肱二头肌 SSR - 延长基线阶段和一年的随访阶段。 治疗 受试者将有 2 周的基线阶段、8 周的治疗阶段，以及 与对照组相同的 1 年随访阶段。 在治疗阶段， 治疗对象的 SSR 将受到操作性调节，即对象 较小的反应会受到奖励。 对照受试者将不会收到 这样的条件下，他们的 SSR 将被简单地测量。治疗后 治疗组完成治疗阶段，对照组完成治疗阶段 延长基线后，两组都将进入随访阶段，这将 评估条件反射引起的反射变化的持续性。 在 此外，所有患者受试者将接受定期功能评估 在整个研究过程中确定反射减弱是否与之相关 随着功能的改进。 该项目应确定 SSR 的操作条件是否可以 减少反射亢进，揭示这种减少是否伴随着 持续的功能改善，并确定哪些患者最有改善 可能会受益。 它还可能导致额外的开发 缓解其他中枢神经系统异常的调理技术 功能。