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Can ankle assistance and ankle moment biofeedback improve gait mechanics and joint loads during incline walking in cerebral palsy?

Award Number: F32HD109018
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: 07/11/2022
PERIOD OF PERFORMANCE END DATE: 02/28/2023

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Can ankle assistance and ankle moment biofeedback improve gait mechanics and joint loads during incline walking in cerebral palsy? - Project Summary/Abstract Cerebral palsy (CP) is the most common childhood physical disability. CP causes gait disorders that are associated with decreased mobility, increased pain, and low quality of life. A primary contributor to gait deficits in CP is ankle impairment. Due to the lack of ankle power generation, people with CP adopt crouched, inefficient gait patterns that negatively affect their joint health. To date, gait rehabilitation that employs task specificity and intensity has achieved the best clinical outcomes, and incline walking stands out as a promising gait intervention because it shares similar locomotion and requires greater muscular effort compared to level walking. A major concern is that the challenges of walking on an incline may result in exacerbated gait patterns that negatively affect long-term mobility and joint health. Therefore, this project will investigate two distinct strategies to improve ankle function and gait in incline walking in CP: the first will provide ankle assistance from a wearable exoskeleton to passively improve ankle mechanics, and the other uses ankle moment biofeedback to incentivize active improvement in ankle mechanics. The purpose of this project is to investigate whether ankle assistance and ankle moment biofeedback can improve lower limb extension, ankle mechanics, and joint loads during incline walking in CP. Aim 1 will test the hypothesis that ankle assistance can increase lower limb extension and ankle moment and power, and decrease joint loads in incline walking compared to incline walking with no assistance. Aim 2 will determine the effect of ankle moment biofeedback during incline walking without and with assistance. The hypothesis is that biofeedback will increase lower limb extension and ankle moment and power but will not change joint loads, and that walking with biofeedback and assistance will increase lower limb extension and ankle moment and power, and reduce joint loads. The proposed research will offer two strategies - assistive device and biofeedback - to improve gait mechanics and joint loads in incline walking in CP. Both will directly contribute to pediatric CP gait training and the lifelong musculoskeletal function and joint health of this population. By understanding the impact of each tool, clinicians and researchers can make informed decisions to use assistance and/or biofeedback to achieve specific clinical goals (i.e., reduce joint loads, increase neuromuscular engagement, reduce crouch, etc.) for patients with different levels of impairment. The fellowship training will expand the applicant’s expertise in musculoskeletal modeling and mechatronics, and provide mentorship and experience in clinical study design, clinical trial management, and biostatistics. The completion of the study will be the foundation of a career as an independent investigator to achieve the long-term research goal of developing and evaluating evidence-based interventions to facilitate precise, personalized, and progressive rehabilitation for people with neuromuscular impairments.


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: 2024 ( Subtotal = -$2,720 )
2024	2022	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR RM 220	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	000	1	12/28/2023	NEW	-$2,720
														Subtotal = -$2,720

Issue Date FY: 2023 ( Subtotal = -$21,212 )
2023	2022	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	000	1	3/24/2023	NEW	-$21,212
														Subtotal = -$21,212

Issue Date FY: 2022 ( Subtotal = $69,802 )
2022	2022	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR ROOM 220	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	000	1	7/8/2022	NEW	$69,802
2022	2022	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR ROOM 220	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	001	1	7/8/2022	NEW	$0
														Subtotal = $69,802

Grand Total All Awards = $45,870

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Can ankle assistance and ankle moment biofeedback improve gait mechanics and joint loads during incline walking in cerebral palsy?

Award Number: F32HD109018

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: 07/11/2022

PERIOD OF PERFORMANCE END DATE: 02/28/2023

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