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Neuromuscular mechanisms of specific trunk interventions in children with cerebral palsy

Award Number: R01NS115487
ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 03/01/2020
PERIOD OF PERFORMANCE END DATE: 02/28/2025

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Neuromuscular mechanisms of specific trunk interventions in children with cerebral palsy - Abstract Many children with cerebral palsy (CP) show impairments in trunk postural control, which significantly impact their walking capacity and daily activities. For instance, children with severe CP, who have difficulties sitting independently, show poor directional specificity, with antagonists activating before agonists, which is distinct from typically developed children. Compared to typically developed peers, children with CP have a large range of motion for pelvis tilt, thorax, head, and kyphosis and lordosis during gait, even for some high functioning children with CP. While the significance of trunk motor control dysfunction in children with CP has been recognized, effective interventions for this core deficit are still lacking. Children with CP often receive or participate in a wide range of passive and active interventions aimed to improve postural control, but results have shown that current intervention approaches are not often effective in improving postural control in children with CP. For instance, hippotherapy, an intervention strategy that applies rhythmical force perturbations to the pelvis during sitting astride using horseback movement, has been used for improving balance and gait in children with CP for decades. However, while some studies showed improvements in balance and motor function in children with CP after hippotherapy, other studies indicated a mixed result regarding the effect of hippotherapy on Gross Motor Function Measure scores in children with CP. Thus, there is a critical need to improve the efficacy of current interventions for improving trunk postural control and gait in children with CP, which requires a thorough examination of the underlying neuromuscular mechanisms of the interventions. Our long-term goal is to develop rational-based intervention strategies to improve trunk postural control and gait in children with CP. The overall objective of this study is to examine the neuromuscular mechanisms of the trunk muscles to a force perturbation applied to the pelvis during sitting astride, and determine whether repeated exposure to pelvic perturbations during sitting astride using a robotic system will be effective in improving trunk postural control and gait in children with CP. Our central hypothesis is that repetitive activation of specific sensorimotor pathways through applying targeted force perturbations will improve postural control in children with CP, which may be due to the reinforcement in circuits and synapses used for trunk postural control through a use-dependent neuroplasticity mechanism. The rationale for the proposed study is that an understanding of the neuromuscular mechanisms of trunk muscle control in children with CP and determination of the therapeutic effect of targeted force perturbation are likely to provide a strong scientific foundation whereby new force perturbation based intervention strategies can be developed to improve postural control and gait in children with CP. The results from this study may be used to develop innovative clinical therapies aimed at improving trunk postural control and walking function in children 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 = $0 )
2025	2024	REHABILITATION INSTITUTE OF CHICAGO	355 E ERIE ST	CHICAGO	IL	60611	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	5	7/2/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $315,211 )
2024	2024	REHABILITATION INSTITUTE OF CHICAGO	355 E ERIE ST	CHICAGO	IL	60611	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	5	4/25/2024	NON-COMPETING CONTINUATION	$22,749
2024	2024	REHABILITATION INSTITUTE OF CHICAGO	355 E ERIE ST	CHICAGO	IL	60611	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	5	2/20/2024	NON-COMPETING CONTINUATION	$292,462
														Subtotal = $315,211

Issue Date FY: 2023 ( Subtotal = $324,957 )
2023	2023	REHABILITATION INSTITUTE OF CHICAGO	355 E ERIE ST	CHICAGO	IL	60611	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	4	4/7/2023	NON-COMPETING CONTINUATION	$324,957
														Subtotal = $324,957

Issue Date FY: 2022 ( Subtotal = $336,062 )
2022	2022	REHABILITATION INSTITUTE OF CHICAGO	355 EAST ERIE	CHICAGO	IL	60611	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	3	3/2/2022	NON-COMPETING CONTINUATION	$302,455
2022	2022	REHABILITATION INSTITUTE OF CHICAGO	355 EAST ERIE	CHICAGO	IL	60611	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	3	3/25/2022	NON-COMPETING CONTINUATION	$33,607
														Subtotal = $336,062

Issue Date FY: 2021 ( Subtotal = $348,294 )
2021	2021	REHABILITATION INSTITUTE OF CHICAGO	355 EAST ERIE	CHICAGO	IL	60611	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	2	3/9/2021	NON-COMPETING CONTINUATION	$348,294
														Subtotal = $348,294

Issue Date FY: 2020 ( Subtotal = $390,025 )
2020	2020	REHABILITATION INSTITUTE OF CHICAGO	355 EAST ERIE	CHICAGO	IL	60611	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	2/24/2020	NEW	$390,025
														Subtotal = $390,025

Grand Total All Awards = $1,714,549

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Neuromuscular mechanisms of specific trunk interventions in children with cerebral palsy

Award Number: R01NS115487

ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 03/01/2020

PERIOD OF PERFORMANCE END DATE: 02/28/2025

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