NIH-FES-ASSISTED CYCLING TO IMPROVE FITNESS AND STRENGTH IN CHILDREN WITH CP

NIH-FES 辅助骑自行车提高脑瘫儿童的体能和力量

基本信息

批准号：
8687981
负责人：
SAMUEL C.K. LEE
金额：
$ 45.52万
依托单位：
UNIVERSITY OF DELAWARE
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-01 至 2016-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8687981
关键词：
Abate Activities of Daily Living Acute Adolescence Adolescent Adult Affect Age Agonist Ankle Biomechanics Body Size Body Weight Bone Density Botulinum Toxins Brain Cerebral Palsy Child Chronic Disease Classification Contracture Control Groups Deformity Diabetes Mellitus Disadvantaged Disease Dose Electric Stimulation Equilibrium Exercise Experimental Designs Gait Growth Health Heart Rate Hip region structure Impairment Individual Infant Injection of therapeutic agent Intervention Investigation Joints Knee Lead Length Lesion Lower Extremity Methods Motion Motor Muscle Muscle Contraction Muscle Weakness Musculoskeletal Obesity associated cardiovascular disease Operative Surgical Procedures Output Paralysed Performance Peripheral Phase Physical activity Physically Handicapped Population Procedures Quality of life Randomized Recreation Relative (related person)Risk Rotation Self Perception Single-Blind Study Spastic Cerebral Palsy Speed Spinal cord injury System Testing Time Torque Training United States National Institutes of Health Walking Withdrawal Work Youth developmental disease fetal fitness functional decline group intervention improved interest motor impairment muscle form muscle strength peer physical conditioning prospective soft tissue spatiotemporal

项目摘要

DESCRIPTION (provided by applicant): Cerebral palsy (CP) is a non-progressive developmental disorder of the brain that results in reduced strength which negatively affects functional abilities and limits levels of activity. Lack of involvement in physical activity is one of the leading health concerns in the US and is associated obesity, cardiovascular disease, diabetes and other chronic diseases. The need for activity and exercise is especially acute for youth with physical disabilities, who participate in less physical activity than their non-CP peers and thus are at more risk for declines in health. The impact of having fewer options for activity is particularly detrimental for children with CP who tend to peak in ability prior to adolescence and then decline through their teenage years into adulthood. One major cause of decline is the disparity that occurs when muscle strength gains due to growth are not commensurate to gains in body size or weight. The disparity is often exacerbated by the interventions used to abate musculoskeletal and soft tissue changes that contribute to deformity, muscle tightness and joint contractures. Thus, children with CP have an overwhelming disadvantage for maintaining and improving strength, fitness and function. Stationary cycling is a proposed method of exercise for individuals that lack the balance, strength and coordination for upright exercise; however, we demonstrate that individuals with CP have impaired biomechanics that limit their cycling output. To enable greater cycling output, we employ functional electrical stimulation (FES) assistance and demonstrate the ability of FES assistance to produce higher heart rates, power output and cadences than children with CP are able to achieve on their own. Additionally, FES assistance enables cycling at a target powers for longer durations with less variance in cadence, however other than our initial investigations; we are unaware of any studies involving FES-assisted cycling in CP. The objective of this project is to improve physical conditioning and general lower extremity muscle strength for adolescents with CP using FES-assisted cycling. A prospective single blind, randomized controlled grouped experimental design will be conducted to investigate the relative effects of recumbent cycling training using volitional effort vs. training with volitional effort augmented by FES assistance compared to non-intervention controls on physical conditioning, muscle strength, and walking ability in adolescents with spastic CP and marginal walking ability. Both central and peripheral mechanisms for improvements in cycling performance will be investigated.

描述（由申请人提供）：脑瘫（CP）是一种非促进性的大脑发育障碍，导致强度降低，对功能能力产生负面影响和限制活动水平。缺乏体育锻炼是美国领先的健康问题之一，是肥胖，心血管疾病，糖尿病和其他慢性疾病。对于身体残疾的年轻人来说，进行活动和运动的需求尤其急切，他们的体育锻炼比非CP同伴少，因此健康状况下降的风险更大。对于CP倾向于在青春期之前倾向于达到能力，然后在成年期间衰落的CP儿童而言，有较少的活动选择的影响尤其有害。下降的一个主要原因是，当由于生长而肌肉力量增长与体型或体重的增长不相称时，发生差异。通常，用于减轻肌肉骨骼和软组织变化的干预措施通常会加剧差异，这有助于造成畸形，肌肉紧密度和关节染色。因此，CP儿童在维持和提高力量，健身和功能方面具有压倒性的劣势。静止骑自行车是针对缺乏直立锻炼平衡，力量和协调的个体的一种锻炼方法；但是，我们证明了CP患者的生物力学受损，这些生物力学限制了其骑自行车的产量。为了实现更大的循环输出，我们采用功能电刺激（FES）辅助，并证明了FES援助能够产生更高心率，功率输出和节奏的能力，而CP的儿童能够自行实现。此外，FES援助可以在较长的持续时间内骑自行车，而节奏的差异较小，但是除了我们的初步研究以外；我们没有意识到涉及CP中FES辅助循环的任何研究。该项目的目的是使用FES辅助循环改善CP青少年的身体状况和一般下肢肌肉力量。将进行一种前瞻性的单一盲人，随机对照组的实验设计，以研究凭借努力与自愿训练的相对影响，而与非际交往控制对物理条件，肌肉力量，肌肉力量和步行能力相比，FES援助的自愿努力增加了，具有痉挛性CP和Marginal步行能力的步行能力。将研究改善循环性能的中央和外围机制。