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

• 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
• 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

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）是一种非进行性大脑发育障碍，会导致力量下降，从而对功能能力产生负面影响并限制活动水平。缺乏身体活动是美国主要的健康问题之一，并与肥胖、心血管疾病、糖尿病和其他慢性疾病相关。对于身体残疾的青少年来说，活动和锻炼的需求尤其迫切，因为他们比非残疾人同龄人参与的体力活动较少，因此健康状况下降的风险更大。活动选择较少的影响对于患有脑瘫的儿童尤其不利，他们的能力往往在青春期之前达到顶峰，然后在青少年时期到成年期间逐渐下降。肌肉衰退的主要原因之一是由于生长而增加的肌肉力量与体型或体重的增加不相称时出现的差异。用于减轻导致畸形、肌肉紧张和关节挛缩的肌肉骨骼和软组织变化的干预措施往往会加剧这种差异。因此，患有脑瘫的儿童在维持和提高力量、健康和功能方面处于压倒性劣势。固定式自行车运动是针对缺乏直立运动的平衡、力量和协调能力的人提出的一种运动方法；然而，我们证明患有脑瘫的人的生物力学受损，限制了他们的骑行输出。为了实现更大的骑行输出，我们采用功能性电刺激 (FES) 辅助，并证明 FES 辅助能够产生比 CP 儿童自己能够达到的更高的心率、功率输出和步频。此外，FES 辅助功能可以让您以目标功率进行更长时间的骑行，且步频变化更小，但与我们最初的调查不同；我们不知道有任何涉及 FES 辅助自行车治疗 CP 的研究。该项目的目标是利用 FES 辅助骑行来改善 CP 青少年的身体状况和一般下肢肌肉力量。将进行前瞻性单盲、随机对照分组实验设计，以研究使用意志努力的卧式自行车训练与通过 FES 辅助增强意志努力的训练相比，与非干预对照相比，对身体状况、肌肉力量和步行的相对影响痉挛性脑瘫青少年的能力和边缘步行能力。将研究改善自行车性能的中枢和外围机制。

项目成果

Aerobic Responses to FES-Assisted and Volitional Cycling in Children with Cerebral Palsy.

脑瘫儿童对 FES 辅助和意志自行车的有氧反应。

• 发表时间: 2021-11-15
• 作者: Sansare, Ashwini;Harrington, Ann Tokay;Wright, Henry;Alesi, James;Behboodi, Ahad;Verma, Khushboo;Lee, Samuel C K
• 通讯作者: Lee, Samuel C K

Evaluation of functional electrical stimulation to assist cycling in four adolescents with spastic cerebral palsy.

功能性电刺激辅助四名痉挛性脑瘫青少年骑自行车的评估。

• 发表时间: 2012
• 作者: Harrington, Ann Tokay;McRae, Calum G A;Lee, Samuel C K
• 通讯作者: Lee, Samuel C K