Assessment of Locomotor Potential Following Stroke

中风后运动潜力的评估

• 批准号: 9773417
• 负责人: Carolynn Patten
• 金额: $ 22.5万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9773417
• 关键词: Assessment; Locomotor; Potential; Following; Stroke

Contact PD/PI: Patten, Carolynn Stroke is the leading cause of serious, chronic disability in adults worldwide. Over 750,000 new strokes occur in the United States each year accounting for over half of all acute neurological hospital admissions. While two- thirds of persons who suffer a stroke regain ambulatory function, the resulting gait pattern is slow, asymmetrical and metabolically inefficient. Walking dysfunction represents one of the greatest physical limitations post-stroke and improved walking is among the most frequently articulated goals of neurorehabilitation. To date, rehabilitation for walking dysfunction post-stroke has produced highly variable outcomes revealing minimal genuine change in walking function including walking speed or walking pattern. Our long term goal is to improve walking function in persons post-stroke. The objective of this application is to develop a prognostic indicator to determine the physiological potential to improve walking capacity following stroke. The rationale for our proposal stems from our previous work, which has identified distinct patterns of response to therapeutic intervention for hemiparetic walking dysfunction, `responders' and `non-responders'. Responders are characterized by significant changes in overground walking speed and multiple changes in spatio-temporal coordination. Non-responders produced minimal changes in overground walking speed and few, if any, changes in spatio-temporal coordination. While the presence of responders and non-responders in the post-stroke population is not surprising, at study baseline responders and non-responders could not be differentiated using clinical instruments of motor impairment, activity, or walking speed. Moreover, clinical characteristics of chronicity and severity failed to predict these patterns of response. Taken together our findings suggest the presence of intrinsic, as-yet-unidentified subject-specific characteristics that mediate successful recovery of walking function. Here we propose development of a prognostic indicator to identify: a) neurophysiologic deficits contributing to walking dysfunction and b) an individual's potential to improve walking capacity following stroke. Informed by our prior work, we recognize neurophysiologic function contributes to neuromechanical output during walking. Attainment of a threshold of neurophysiologic functioning will suggest the presence of a neurobiological substrate requisite to improvement in walking capacity. Thus we will be able to differentiate individuals with the capacity to respond to traditional interventions from those who may need more aggressive approaches to remediate neurophysiologic function. Keywords: stroke, locomotion, recovery, rehabilitation, biomechanics Project Summary/Abstract Page 6

联系PD/PI：Patten，Carolynn 中风是全球成人严重，慢性残疾的主要原因。超过75万新笔触 在美国，每年占所有急性神经病医院入院的一半以上。而两个 - 三分之一的遭受中风的人恢复了门诊功能，由此产生的步态模式很慢， 不对称和代谢效率低下。步行功能障碍代表最大的身体之一 局限性后，势头和改进的步行是最频繁明确的目标之一 神经康复。迄今为止，中风后恢复功能障碍已产生高度可变的 结果表明，步行功能的真正变化最小，包括步行速度或步行方式。 我们的长期目标是在势头后改善人行功能。此应用的目的是 开发预后指标，以确定提高步行能力的生理潜力 中风。我们提案的理由源于我们以前的工作，该工作已经确定了不同的模式 对偏瘫步行功能障碍，“反应者”和“无反应者”的治疗干预措施的反应。 响应者的特征是地球步行速度发生了重大变化，并且多次变化 时空协调。无响应者在地面步行速度和 很少有时空协调的变化（如果有的话）。而在 中风后人口并不奇怪，在研究基线响应者和非反应者都不是 使用运动障碍，活动或步行速度的临床仪器进行区分。而且，临床 慢性和严重性的特征无法预测这些反应模式。总结我们 调查结果表明存在介导的固有，尚未确定的特定于特定的主题特征 成功恢复步行功能。 在这里，我们建议开发预后指标以识别：a）神经生理缺陷有助于 步行功能障碍和b）一个人在中风后提高步行能力的潜力。告知 我们先前的工作，我们认识到神经生理功能在步行过程中有助于神经力学输出。 达到神经生理功能的阈值将表明存在神经生物学 底物需要提高步行能力。因此，我们将能够将个人与 从可能需要更具侵略性方法来应对传统干预措施的能力 修复神经生理功能。 关键字：中风，运动，恢复，康复，生物力学 项目摘要/摘要页面6