NIH 1R21AG059184-01A1资助
步态功能障碍难以康复，尽管最近的进步，但我们缺乏许多临床人口的有效治疗选择。在这里，我们提出了实验，该实验将建立一种新的思考行程康复后的思考方式。而不是训练患者重复地执行特定的行走模式（如在常规治疗中的经常进行），我们建议康复应该旨在使所需的行走模式成本更低的能量，因为人们自然更喜欢最小化能量成本的步行模式。考虑到这一点，我们将执行一系列实验，证明行程后的人为1）能够操纵其行走模式的对称性，并且如果新的模式成本更低的能量，则采用新的步态模式。这些介绍性研究将为设计步态康复干预措施奠定了重要的基础，其专注于降低所需步态模式的能源成本。在AIM 1中，我们将调查中风后的人员以改变步态对称的能力。许多人在日常生活中与不对称步骤一起走路。We have designed a visual feedback system where we can show participants how symmetrically they are walking in terms of either step position (i.e., where the feet are placed in global space) or step length (i.e., how far one foot is placed ahead of the other). We hypothesize that persons post-stroke will be able to use the visual feedback to improve their gait symmetry in both step position and step length, revealing that persons post-stroke retain the capacity to walk more symmetrically than they do in daily life. This leads to an important question that we will address in Aim 2 – if persons post-stroke can walk more symmetrically, why do they prefer asymmetric walking patterns? In Aim 2, we will investigate how energy cost influences walking after stroke. Persons post-stroke often walk with asymmetric steps and the energy cost of walking is elevated relative to healthy adults. However, it is possible that persons post-stroke prefer to walk asymmetrically because symmetric stepping is even more effortful given the unilateral motor deficits that affect many patients. We will assess how speed and asymmetry affect the energy cost of walking in persons post-stroke by having participants walk at different speeds and manipulate their asymmetry using visual feedback. We hypothesize that persons post-stroke will not experience any energetic benefit from walking symmetrically. We will then use a novel treadmill controller to create an environment where symmetric walking costs less energy than asymmetric walking. We hypothesize that persons post-stroke will walk more symmetrically in this environment, revealing that persons post-stroke may naturally walk more symmetrically if rehabilitation can reduce the energy cost of symmetric walking. Overall, this proposal will establish that persons post-stroke can manipulate their gait symmetry and will change how they walk to minimize energy cost. These findings will establish a foundation for building new rehabilitation interventions that drive improvements in patient gait patterns by reshaping energetic landscapes.
人们喜欢以消耗较少能量的方式走路。在这里，我们将证明我们可以利用能量成本来驱动步行的变化;人们将采用新的步态模式，当这些模式节省能源。我们将专注于了解如何利用能量来改变中风后患者的步行，但我们将建立的总体框架具有更广泛的应用，可以用于治疗许多临床人群的步态缺陷。