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Neuromotor Research Clinic

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About the Neuromotor Research Clinic

Located in Roanoke, VA, the Fralin Biomedical Research Institute Neuromotor Research Clinic is where Virginia Tech scientists create new treatment strategies for children and young adults with cerebral palsy and other neuromotor movement disorders. For many years, cerebral palsy was considered a static condition with only limited opportunities to teach children to use their impaired arms or legs. Research supported by the National Institutes of Health (NIH) over the past several decades, however, has led to a new understanding of the brain’s capacity for functional reorganization through focused, intensive training that taps into neuroplasticity processes intrinsic to the nerve cells of the brain throughout life, even after brain disease or injury.

The directors of the Fralin Biomedical Research Institute's Neuromotor Research Clinic, Dr. Sharon Ramey and Dr. Stephanie DeLuca, pioneered the use of a high-intensity therapeutic intervention that has allowed children with weakness on one side of their bodies — a hallmark of one form of cerebral palsy known as hemiparesis — to make large, rapid, and enduring gains in their everyday neuromotor skills.

The Fralin Biomedical Research Institute Neuromotor Research Clinic seeks to enable children with neuromotor impairment to make large, rapid, and enduring gains in their everyday neuromotor skills. To improve the children’s abilities, our therapists use a set of rehabilitation approaches based on intensive therapeutic dosages guided by learning principles. Broadly, we call these approaches ACQUIRE therapy. ACQUIRE therapy involves a systematic shaping of brain function and motor behavior through a cycle of movement, reinforcement, repetition, and refinement. The children work diligently to make steady improvements while engaged in fun activities, games, and self-help skills. The children also help set their own goals and the therapists provide multiple supports to allow each child to realize major gains.

To ensure long-term effectiveness, our therapists work in a homelike or community setting so new skills become part of a child’s everyday routine. The therapists educate parents about ACQUIRE and develop a transition plan that engages the entire family. We measure each child’s progress using standardized assessments to ensure we monitor progress closely.

For children with hemiparesis or asymmetry between the abilities of the two sides of their body your child’s intensive burst of treatment may involve constraint of your child’s arm and hand on the side that has more mobility (your child’s more functional arm and hand). The constraint used will be a lightweight cast, specially fitted for your child. The casting procedure is designed to immobilize the functional arm and hand in order to help facilitate use of the involved arm and hand. This intensive treatment is based on previous research surrounding Pediatric Constraint-Induced Movement Therapy (P-CIMT). The ACQUIRE Therapy model began with this form of treatment. While it now extends beyond this single form of therapy, the guidelines (beyond the constraint) were originally developed in clinical trials to inform this treatment approach.

Children are eligible for treatment when the following criteria are met-

(1) Child has demonstrated significant motor impairment attributable neurological condition which presents with asymmetry between the two sides of the body;

(2) is between 2 – 21 years of age; and

(3) does not have any serious complicating conditions or acute medical concerns (seizures must be under control).

For children with hemiparesis or asymmetry between the abilities of the two sides of their body your child’s intensive burst of treatment may involve constraint of your child’s arm and hand on the side that has more mobility (your child’s more functional arm and hand). The constraint used will be a lightweight cast, specially fitted for your child. The casting procedure is designed to immobilize the functional arm and hand in order to help facilitate use of the involved arm and hand. This intensive treatment is based on previous research surrounding Pediatric Constraint-Induced Movement Therapy (P-CIMT). The ACQUIRE Therapy model began with this form of treatment. While it now extends beyond this single form of therapy, the guidelines (beyond the constraint) were originally developed in clinical trials to inform this treatment approach.

Children are eligible for treatment when the following criteria are met-

(1) Child has demonstrated significant motor impairment attributable neurological condition which presents with asymmetry between the two sides of the body;

(2) is between 2 – 21 years of age; and

(3) does not have any serious complicating conditions or acute medical concerns (seizures must be under control).

This protocol is aimed at helping children who have more global levels of motor impairment gain increased motor function. Successive approximation for motor skills and intensive therapeutic bursts are guiding principles.

Children are eligible for treatment when the following criteria are met-

(1) Child has demonstrated significant motor impairment attributable neurological condition which presents with motor impairments that may involve all 4 extremities;

(2) is between 12 months – 21 years of age; and

(3) does not have any serious complicating conditions or acute medical concerns (seizures must be under control).

Similar, to the above we have now worked with a variety of children with diagnoses who have delays in development that often include areas beyond just motor skills. It is important to note that we have primarily focused on diagnoses that do manifest in some manner with motor delays of limitations, but we have now successfully used our learning protocols and intensive therapeutic bursts to target other domains of development (e.g., communication, appropriate social skills (reciprocal play), and processing to follow multiple step requests/activities.

Children are eligible for treatment when the following criteria are met-

(1) Child has demonstrated significant impairments or delays in multiple areas or development attributable neurological condition which presents with some motor challenges;

(2) is between 12 months- 21 years of age; and

(3) does not have any serious complicating conditions or acute medical concerns (seizures must be under control).

The National Pediatric Rehabilitation Resource Center, also known as C-PROGRESS, helps clinical scientists studying pediatric rehabilitation by funding pilot studies, providing mentorship, and offering training and tools to support clinical trials research. C-PROGRESS stands for the Center for Pediatric Rehabilitation: Growing Research, Education, and Sharing Science, the center’s primary objective is to “see progress” in the emerging field of pediatric rehabilitation science. The Center is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Neurological Disorders and Stroke, and the National Institute of Biomedical Imaging and Bioengineering. C-PROGRESS is one of six national centers in the Medical Rehabilitation Resource Network (MR3).

 

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