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Investigation of the neuromuscular response and training effects of wearable adaptive resistance in children with cerebral palsy

Award Number: F30HD103318
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 03/02/2021
PERIOD OF PERFORMANCE END DATE: 05/05/2024

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Investigation of the neuromuscular response and training effects of wearable adaptive resistance in children with cerebral palsy - PROJECT SUMMARY/ABSTRACT Cerebral palsy (CP) is a movement disorder characterized by deficits in strength and coordination. The subsequent gait deficits associated with CP lead to a progressive decline in function due to the secondary effects of having a movement disorder during development. Interventions seeking to mitigate these effects have only been partially successful because they have not addressed both muscle recruitment (i.e. strength) and coordination within one, top-down therapy. Recently, we developed a wearable adaptive resistance therapy that is able to address both of these aspects with promising results for improving neuromuscular control, metabolic efficiency, and functional mobility. To maximize the efficacy of this intervention, two important considerations must be addressed: 1) What is the appropriate level of resistance to prescribe for maximizing neuromuscular response as children acclimate to the intervention? 2) What is the overall trajectory in training effects from this therapy and are these effects maintained after the therapy stops? In addition, there is limited understanding of the underlying mechanisms of observed improvements in neuromuscular control with this novel therapy. The high levels of co-contraction in children with CP have been attributed to deficits in stretch reflex modulation, but whether or not improvements in reflex modulation are responsible for the observed decreases in ankle co- contraction with wearable adaptive resistance has not yet been explored. The main objective of this research proposal is to further investigate a wearable adaptive resistance intervention for children with CP. The first specific aim is to assess the acclimation to adaptive resistance by measuring the neuromuscular response of children with CP, across five visits, as a low, moderate, and high level of resistance is applied while walking. The second specific aim to quantify the time-course and maintenance of training effects for the ten participants by measuring changes in neuromuscular control (i.e., co-contraction about the ankle and the complexity of neural control) and reflex modulation (via H-reflex testing) across five training visits with wearable adaptive resistance, as well as a two-week post-training follow-up visit. Our primary outcome variable for Aim 1 ix plantar flexor activation magnitude, relative to baseline, while walking with resistance. Our primary outcome variables for Aim 2 are ankle co-contraction level, neural control complexity (as determined by a muscle synergy analysis), and reflex modulation (via H-reflex testing) while walking without resistance. The completion of this work will improve our understanding of wearable adaptive resistance, including fundamental knowledge about appropriate training levels and underlying mechanisms, with the ultimate goal of developing an intervention that can enable physical activity for children with CP, allowing them to engage with their peers and environment for healthy development and functional independence.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$65,945 )
2025	2024	UNIVERSITY OF ARIZONA	845 N PARK AVE RM 538	TUCSON	AZ	85721	PIMA	USA	Child Health and Human Development Extramural Research	002	4	5/27/2025	NON-COMPETING CONTINUATION	-$28,391
2025	2024	UNIVERSITY OF ARIZONA	845 N PARK AVE RM 538	TUCSON	AZ	85721	PIMA	USA	Child Health and Human Development Extramural Research	000	4	4/22/2025	NON-COMPETING CONTINUATION	-$25,583
2025	2023	UNIVERSITY OF ARIZONA	845 N PARK AVE RM 538	TUCSON	AZ	85721	PIMA	USA	Child Health and Human Development Extramural Research	001	3	5/27/2025	NON-COMPETING CONTINUATION	-$11,971
														Subtotal = -$65,945

Issue Date FY: 2024 ( Subtotal = $53,974 )
2024	2024	UNIVERSITY OF ARIZONA	845 N PARK AVE RM 538	TUCSON	AZ	85721	PIMA	USA	Child Health and Human Development Extramural Research	001	4	5/1/2024	NON-COMPETING CONTINUATION	$1,280
2024	2024	UNIVERSITY OF ARIZONA	845 N PARK AVE RM 538	TUCSON	AZ	85721	PIMA	USA	Child Health and Human Development Extramural Research	000	4	2/16/2024	NON-COMPETING CONTINUATION	$52,694
														Subtotal = $53,974

Issue Date FY: 2023 ( Subtotal = $52,694 )
2023	2023	UNIVERSITY OF ARIZONA	845 N PARK AVE RM 538	TUCSON	AZ	85721	PIMA	USA	Child Health and Human Development Extramural Research	000	3	4/17/2023	NON-COMPETING CONTINUATION	$52,694
														Subtotal = $52,694

Issue Date FY: 2022 ( Subtotal = $51,271 )
2022	2022	UNIVERSITY OF ARIZONA	888 N EUCLID AVE RM 510	TUCSON	AZ	85719	PIMA	USA	Child Health and Human Development Extramural Research	000	2	3/1/2022	NON-COMPETING CONTINUATION	$50,555
2022	2022	UNIVERSITY OF ARIZONA	888 N EUCLID AVE RM 510	TUCSON	AZ	85719	PIMA	USA	Child Health and Human Development Extramural Research	002	2	6/23/2022	NON-COMPETING CONTINUATION	-$1
2022	2022	UNIVERSITY OF ARIZONA	888 N EUCLID AVE RM 510	TUCSON	AZ	85719	PIMA	USA	Child Health and Human Development Extramural Research	001	2	4/22/2022	NON-COMPETING CONTINUATION	$717
														Subtotal = $51,271

Issue Date FY: 2021 ( Subtotal = $50,555 )
2021	2021	UNIVERSITY OF ARIZONA	888 N EUCLID AVE RM 510	TUCSON	AZ	85719	PIMA	USA	Child Health and Human Development Extramural Research	001	1	3/2/2021	NEW	$0
2021	2021	UNIVERSITY OF ARIZONA	888 N EUCLID AVE RM 510	TUCSON	AZ	85719	PIMA	USA	Child Health and Human Development Extramural Research	000	1	3/2/2021	NEW	$50,555
														Subtotal = $50,555

Grand Total All Awards = $142,549

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Investigation of the neuromuscular response and training effects of wearable adaptive resistance in children with cerebral palsy

Award Number: F30HD103318

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 03/02/2021

PERIOD OF PERFORMANCE END DATE: 05/05/2024

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