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Augmenting Ankle Plantarflexor Function and Walking Capacity in Children with Cerebral Palsy

Award Number: R01HD107277
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/22/2021
PERIOD OF PERFORMANCE END DATE: 08/31/2026

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Augmenting Ankle Plantarflexor Function and Walking Capacity in Children with Cerebral Palsy - PROJECT SUMMARY A child’s ability to walk effectively is essential to their physical health and general well-being. Unfortunately, many children with cerebral palsy (CP), the most common cause of pediatric physical disability, have difficulty walking and completing higher-intensity ambulatory tasks. This leads to children with CP engaging in levels of habitual physical activity that are well below guidelines and those of children without disabilities, which in turn contributes to many secondary conditions, including metabolic dysfunction and cardiovascular disease. There is broad clinical consensus that plantarflexor dysfunction is a primary contributor to slow, inefficient, and crouched walking patterns in CP; individuals with CP need more effective treatments and mobility aids for plantarflexor dysfunction. To meet this need, this proposal aims to evaluate a holistic strategy to address impaired mobility from plantarflexor dysfunction in CP using a lightweight, dual-mode (assistive or resistive) wearable robotic device. This strategy combines two complementary techniques: (1) targeted ankle resistance for neuromuscular gait training that provides precision therapy to elicit long-term improvements in ankle muscle function, and (2) adaptive ankle assistance to make walking easier during sustained, high-intensity, or challenging tasks. The first specific aim is to quantify improvement in ankle muscle function and functional mobility following targeted ankle resistance gait training in ambulatory children with CP. The primary hypothesis for the first aim is that targeted ankle resistance training will produce larger improvements in lower-extremity motor control, gait mechanics, and clinical measures of mobility assessed four- and twelve-weeks post intervention compared to standard physical therapy and standard gait training. The second specific aim is to determine the efficacy of adaptive ankle assistance to improve capacity and performance during sustained, high-intensity, and challenging tasks in ambulatory children with CP. The primary hypothesis for the second aim is that adaptive ankle assistance will result in significantly greater capacity and performance during the six-minute-walk-test and graded treadmill and stair stepping protocols compared to walking with ankle foot orthoses and walking with just shoes. Both Specific Aims will explore the participant characteristics (e.g., age, gender, GMFCS level, walking speed, spasticity rating) that are associated with the greatest improvement in outcomes following each intervention to provide guidance for future clinical and at-home implementation. The proposed studies will establish fundamental knowledge on the ability for adaptive ankle interventions to treat walking impairment relative to standard of care in 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 = $412,402 )
2025	2025	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR RM 220	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	000	5	8/6/2025	NON-COMPETING CONTINUATION	$412,402
														Subtotal = $412,402

Issue Date FY: 2024 ( Subtotal = $408,823 )
2024	2024	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR RM 220	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	000	4	8/5/2024	NON-COMPETING CONTINUATION	$408,823
														Subtotal = $408,823

Issue Date FY: 2023 ( Subtotal = $420,796 )
2023	2023	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	000	3	8/10/2023	NON-COMPETING CONTINUATION	$420,796
														Subtotal = $420,796

Issue Date FY: 2022 ( Subtotal = $418,021 )
2022	2022	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR ROOM 220	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	001	2	8/29/2022	NON-COMPETING CONTINUATION	$418,021
2022	2021	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR ROOM 220	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	000	1	6/29/2022	NEW	$0
														Subtotal = $418,021

Issue Date FY: 2021 ( Subtotal = $447,017 )
2021	2021	NORTHERN ARIZONA UNIVERSITY	601 S KNOLES DR ROOM 220	FLAGSTAFF	AZ	86011	COCONINO	USA	Child Health and Human Development Extramural Research	000	1	9/22/2021	NEW	$447,017
														Subtotal = $447,017

Grand Total All Awards = $2,107,059

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Augmenting Ankle Plantarflexor Function and Walking Capacity in Children with Cerebral Palsy

Award Number: R01HD107277

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/22/2021

PERIOD OF PERFORMANCE END DATE: 08/31/2026

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