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Robotic Exoskeleton Gait Training in Transition Aged Persons with Cerebral Palsy

Award Number: F31AG081043
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 08/23/2023
PERIOD OF PERFORMANCE END DATE: 04/29/2025

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Robotic Exoskeleton Gait Training in Transition Aged Persons with Cerebral Palsy - PROJECT SUMMARY/ABSTRACT Cerebral palsy (CP) results from a perinatal brain injury and is one of the most prevalent and costly developmental disabilities in the United States. As persons with CP transition from adolescence into adulthood they continue to be faced with prominent mobility challenges. Despite the increased recognition of the mobility deteriorations, NIH funding related to transition aged persons with CP is remarkably low. Thus, research focused on enhancing the mobility of persons with CP during this critical transition period is sorely needed to help narrow the gap and eliminate this disparity. Over the last decade, there has been considerable interest in utilizing robotic exoskeletons in a therapeutic setting for improved mobility. This therapeutic approach is interesting because the exoskeleton can be used while the patient practices real-world tasks (i.e., stair and obstacle negotiation). However, the current therapeutic approaches used with these robotic exoskeletons are primarily focused on compensation (i.e., body weight support, passive leg facilitation), which might dampen motor learning since it can disengage the nervous system. This proposal opposes this treatment strategy in that we will use the exoskeleton as a treatment tool for perturbing the legs during locomotion, in order to generate heightened muscular activity and relevant motor errors in the context of real-world tasks. Our central hypothesis is that the heightened neuromuscular activity during our exoskeleton gait training will result in clinically relevant gait improvements that will be tightly connected with beneficial neuroplasticity in the spinal cord and key brain circuits that govern the leg motor actions. The Specific Aims of this project are: (1) To quantify the degree of mobility changes in transition aged persons (16- 25 years) with CP who undergo our innovative robotic exoskeleton gait training protocol, and (2) To identify whether transition aged persons with CP who undergo our robotic exoskeleton gait training protocol exhibit greater neurophysiological alterations in the key brain circuits and spinal cord dynamics that are involved in planning and executing leg motor actions. In brevity, the experimental design of this project involves transition aged persons with CP who will undergo 24 physical therapy sessions while wearing a robotic exoskeleton that will perturb the spatiotemporal gait kinematics during an overground therapeutic gait training protocol. Baseline and post-therapy measures will include clinical mobility assessments (Functional Gait Assessment, fast-as- possible 10-meter walk, 1-minute walk, time up and down stairs), magnetoencephalographic (MEG) brain imaging, and Hoffman reflex (i.e., H-reflex) assessments of the spinal cord interneuron dynamics. Clinical outcomes will be compared with a cohort of persons with CP that undergo standard gait training without using the exoskeleton. Beneficial outcomes from this clinical trial will create a new perspective on the use of robotic exoskeletons as a therapeutic tool for improving the gait of persons with CP.


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 = -$8,859 )
2025	2024	FATHER FLANAGAN'S BOYS' HOME	14100 CRAWFORD ST	BOYS TOWN	NE	68010	DOUGLAS	USA	Aging Research	000	2	3/19/2025	NON-COMPETING CONTINUATION	-$8,859
														Subtotal = -$8,859

Issue Date FY: 2024 ( Subtotal = $40,080 )
2024	2024	FATHER FLANAGAN'S BOYS' HOME	14100 CRAWFORD ST	BOYS TOWN	NE	68010	DOUGLAS	USA	Aging Research	000	2	7/16/2024	NON-COMPETING CONTINUATION	$40,080
														Subtotal = $40,080

Issue Date FY: 2023 ( Subtotal = $38,300 )
2023	2023	FATHER FLANAGAN'S BOYS' HOME	14100 CRAWFORD ST	BOYS TOWN	NE	68010	DOUGLAS	USA	Aging Research	000	1	8/23/2023	NEW	$38,300
2023	2023	FATHER FLANAGAN'S BOYS' HOME	14100 CRAWFORD ST	BOYS TOWN	NE	68010	DOUGLAS	USA	Aging Research	001	1	8/23/2023	NEW	$0
														Subtotal = $38,300

Grand Total All Awards = $69,521

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Robotic Exoskeleton Gait Training in Transition Aged Persons with Cerebral Palsy

Award Number: F31AG081043

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 08/23/2023

PERIOD OF PERFORMANCE END DATE: 04/29/2025

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