RERC on Technologies for Children with Orthopaedic Disabilities

Among children under the age of 18, an estimated 4.0 million (6.1% of the U.S. population under age 18) have some type of chronic disabling condition or impairment limiting function. Orthopaedic impairments represent over 5% of the total population.

The purpose of this RERC is to develop a national center with a focus on advanced engineering research and development based on innovative technologies addressing children with orthopaedic disabilities. Our development, training and knowledge dissemination plans will transfer and commercialize these efforts to offer new tools, better technologies, and improved evidence-based treatment strategies.

The RERC consists of 4 research (R1-R4) and 4 development (D1-D4) projects. Characterization of tissue through nano/mircro-structural analysis is the topic of R1 which proposes improvements in care for children with osteogenesis imperfecta (OI) and severe clubfoot deformity (CF). The prognostic value of CNS plasticity associated with rehabilitative treatment and changes in brain activity associated with mobility and manipulation will be determined in R2 to better direct future rehabilitative intervention of children with cerebral palsy (CP). R3 evaluates home-based robot-guided therapy and tele-assessment to determine effectiveness in reducing premature declines in mobility in children with CP. R4 utilizes advanced modeling of the upper and lower extremities to improve function and longer term transitional care of children with myelomeningocele (MM), CP, spinal cord injury (SCI), OI and planovalgus foot deformities. R4 will determine the relationship between joint forces, assistive devices, ankle arthroeresis and longer term tissue level effects as they relate to pain and function. D1 will develop an elliptical machine to improve neuromuscular control and stability in the axial and frontal planes in children with patellofemoral instability and CP. A novel 3D pediatric robotic gait trainer will be developed in project D2 to allow naturalistic stepping during treadmill training of children with CP. A unique biplanar fluoroscopic imaging system will be developed in D3 for in vivo motion analysis of the foot and ankle during walking. D4 will develop a customized orthotic for severe planovalgus foot deformity through computer based, rapid prototyping techniques.

RERC resources and existing training programs will be used to offer high level research training to physicians, engineers, therapists and other professionals. Specialization in areas of manipulation, mobility, transitional care, and outcomes/evidence-based practice will be offered to catalyze the R and D findings, disseminate results, and optimize commercialization potential.

Anticipated Project Outcomes will be improvements in mobility and manipulation, reduced fracture occurrence and secondary complications, improved functional outcomes, and increased patient satisfaction as evaluated quantitatively in the various projects.

Dissemination will be accomplished through peer reviewed scientific publications and presentations at national/global conferences, websites, continuing education courses and newsletters. A State of the Science Conference will be held in the third year of the grant.

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