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.

对于许多人来说，异常的脊柱拉伸反射（SSR）是一个主要问题 脑损伤，中风，脑瘫或多个患者 硬化。 脊柱高反射症会导致姿势异常和 缔约方，干扰自愿运动。 可用的 治疗方法很少完全有效，而且常常无效。 操作条件可以减少非人类灵长类动物的SSR，最近 研究表明，它也可以减少人类的SSR。 因此SSR 条件可以提供一种新的方法来治疗超反射症 人类。 该提案的目的是确定SSR是否条件 可以成为患者过度反射症的有效治疗方法。 为了实现这一目标，该项目将：1）确定在多大程度上 普通人和患有特定类型病变的患者可以减少 SSR通过操作条件； 2）评估这些反射变化多长时间 坚持; 3）确定反射变化是否伴随 肘关节的功能改善和刚度的变化； 4）定义哪种患者从这种新方法中受益。 正常人和超反射性患者都将参加。 每个 将随机分配给腐败组或治疗组。 对照对象将在10周内引起二头肌Brachii SSRS。 扩展基线阶段以及1年的随访阶段。 治疗 受试者将具有2周的基线阶段，一个8周的治疗阶段，并且 与对照相同的1年随访阶段。 在治疗阶段， 治疗受试者的SSR将受到操作，即受试者 对于较小的反射，将获得奖励。 控制对象将不收到 这种条件，将简单地测量其SSR。治疗后 小组完成治疗阶段，对照组完成 扩展基线，两组将进入后续阶段，这将 评估由调节引起的反射变化的持久性。 在 此外，所有患者受试者都将获得定期功能评估 在整个研究中，以确定反射减少是否相关 功能改进。 该项目应确定SSR的操作条件是否可以 减少超反射症，揭示这种减少是否伴随 持续的功能改进，并定义哪些患者最多 可能受益。 这也可能导致进一步的发展 用于减轻其他异常中枢神经系统品种的调节技术 功能。