Current Research
The RESTORE Network Movement Impairment Team is committed to developing novel methods for assessing and treating individuals with neurological disorders that cause movement impairments, such as cerebral palsy. Using new technology we are developing more accurate assessment tools to examine sensorimotor function, as well as getting a deeper understanding of the symptoms and mechanisms behind movement impairment disorders. Our team is also involved in helping to improve therapies and rehabilitation for individuals with movement impairments.
Along with Red Iron Labs, a local Calgary company, the RESTORE Network is developing the Neuro RecoVR platform, which is designed to aid patients in the process of rehabilitation from neurological injury or disease. The platform consists of an instrumented split-belt treadmill and integrated virtual reality software. Patients engage with the platform by executing gait training exercises on the treadmill while interacting with virtual environments projected on large screens.
Patients with neurological diseases/disorders adjust and react to content in real time within the VR experience by adjusting their speed and altering their gait. Quantitative measurements of patient performance are recorded throughout rehabilitation sessions, and allow for assessment of various aspects of performance during each session. The aim of this platform is to motivate patients with an engaging form of rehabilitation to target neurological recovery of motor, visual, and cognitive functions.
Early childhood injury such as perinatal stroke or those related to premature birth can be devastating since children often experience lifelong challenges. These injuries often result in cerebral palsy, a condition described by disorders of movement and posture.
Our research aims to understand if intensive motor training, beginning at a very early age, is effective in improving leg function in children with early brain injury. The training activities are designed by a physical therapist and centred around play to encourage the child to use their legs intensively. In particular, we want to know if early intervention is better than standard care, and whether early intervention is better than later intervention to improve walking and other aspects of motor function. We also want to know if intervention impacts spasticity and contracture.
We use a novel technology, the Portable Spasticity Assessment Device (PSAD), to evaluate spasticity and contracture, as these impairments can be difficult to evaluate clinically. Our current research in this area involves two multi-centre clinical trials, which are led by Dr. Jaynie Yang from the University of Alberta.
Chronic fatigue is frequently reported by people with cerebral palsy as an issue impacting their health, mobility, and independence. Despite the negative effects on daily living, there is a poor understanding of the causes and development of fatigue and there are currently no established interventions which target fatigue to help people with cerebral palsy.
Dr. Elizabeth Condliffe’s PONI Lab is currently involved in two studies that aim to address this knowledge gap:
6-Minute Walk Test
Many people report fatigue while walking, but researchers have not been able to evaluate this well yet. The primary aim of this study is to examine whether a modified 6-minute walk test can be used to measure performance fatigability in people with cerebral palsy. Additional aims involve characterizing the changes in the walking patterns and muscle activity that occur as people begin to tire. This will help to improve our understanding of why people with cerebral palsy feel fatigue, so we can design personalized treatments to treat this fatigue.
Natural Course of Fatigue
In collaboration with Dr. Laura Brunton of Western University, we are working to understand fatigue around its time of onset in childhood or adolescence. The experience of fatigue cannot be attributed to any one factor or event; it’s often described as the result of cumulative strain on a system that has an already reduced capacity. We aim to determine how fatigue differs at different ages and for people with different levels of motor function.
Reducing sedentary and sitting time is associated with positive health outcomes. However, there are few interventions to support mobility and reduce sedentary time for children born with significant motor impairments.
Tréxō Robotics has developed a robotic exoskeleton that can be used for overground mobility and gait training. We are studying the clinical characteristics of people who are using Trexo at home and in their community and how they are using it. We are also studying how it impacts sleep, bowel movements, control of their body, walking, and mood.
Spasticity is a common physical impairment in children with upper motor neuron injury, such as cerebral palsy, acquired brain injury, stroke, spinal cord injury and myelomeningocele (spina bifida). Cerebral palsy is the most common physical disability in children and ~90% of children with CP have spasticity as their dominant motor impairment. Increased resistance to passive stretch is a characteristic of spasticity and is the characteristic most commonly assessed clinically. However, clinical assessments do not differentiate between the resistance caused by mechanical stiffness of the muscles and joints, and reflexive stiffness. As treatments usually target only one of these components, it is currently difficult to provide treatments targeted to an individual’s type of spasticity.
The Portable Spasticity Assessment Device (PSAD) differentiates the mechanical and reflexive contributions to spasticity. We are working to validate the PSAD across the broad range of developmental ages and translate it for use as a clinical tool.
As part of a collaboration with the Vi Riddell Pediatric Rehabilitation Research Program we are evaluating measures of spasticity and contractures in teens with and without cerebral palsy and the use of the PSAD in pediatric rehabilitation’s clinical settings.
Most people control one side of their body from the brain hemisphere on their other (contralateral) side. However, people with brain injuries early in life may control their body from the contralateral side, both sides or just the same (ipsilateral) side.
Early evidence suggests that the organization of an individual’s motor pathways is relevant to how a person moves and may impact how their motor skills develop. In partnership with the Non-invasive Neurostimulation Network we are creating new ways to evaluate the organization of motor pathways with Transcranial Magnetic Stimulation (TMS) and functional Magnetic Resonance Imaging (fMRI) and evaluating how these relate to motor function. We hope to use this information to design personalized rehabilitation strategies in the future.