Neurorehabilitation and Biomechanics Research Section

Our Research

Getting involved in our research:

We are always seeking children with cerebral palsy to participate in our different studies. If you are interested in learning more about our studies and to see which ones you may qualify for, we would love to hear from you! Some of our studies may also be recruiting children and adults with a range of neurological disorders, and we also include children and adults without neurological disorders in many of studies as well.

Review this web page to learn about our currently enrolling studies.

You may also contact Mayra Medrano at: (phone) 301-451-7529 or (email) to learn more or be added to our list of potential participants.

If you think you might like to participate in a study, we will schedule a visit for you at the NIH Clinical Center where you would meet with a physician and others on the research team who will help determine whether you qualify and answer any questions you might have. If you do qualify and decide to participate, you will be formally enrolled in the study and you will be compensated for your time.

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Our Research Teams

Our Section is comprised of two research teams, the Pediatric Imaging and Neuroplasticity Team and the NeuroRobtics Research Group, that collaborate closely with each other as well as others within and outside NIH.

Pediatric Imaging and Neuroplasticity Team (PINT)

Dr. Diane Damiano’s research focuses on deciphering the neural and biomechanical mechanisms underlying the motor disabilities in children with cerebral palsy (CP) and on developing novel interventions to promote motor development and neuroplasticity and enhance mobility. More specifically, she investigates the brain and muscle activation patterns during motor tasks in children with and without CP using state-of-the-science methods such as electroencephalography (EEG) and functional Near-infrared spectroscopy (fNIRS) which are mobile brain imaging technologies, 3D motion tracking and electromyography (EMG) and muscle synergy analyses.

The ultimate goal is to develop novel more effective and personalized interventions to optimize each child’s ability to be as active and independent as possible. As an example, we are currently conducting a study using EEG neurofeedback to train movements that are difficult or seemingly impossible to perform. These aim to strengthen the link between the brain and the body that was disrupted by the brain injury. Dr. Damiano spearheaded the development of novel wearable robotic devices for enhancing motor development and training, including our first pediatric exoskeleton for crouch gait and an infant mobility training device, as well as conducting other device-augmented clinical trials including the use of a wearable functional electrical stimulation (FES) device, a pediatric elliptical trainer and a motor-assisted cycle. Because of the enhanced potential for neuroplasticity in the first months to a year of life, we now have a special interest in investigating and promoting early motor development in infants with cerebral palsy.

We are recruiting for the following studies at this time:

  1. Brain activity and muscle synergy during gait of children with CP

    We are interested in studying brain activity during walking in children with and without cerebral palsy (CP) and relating this to how they use their muscles. Little is known about brain activity during walking in children, especially those with brain injuries. This information is important for developing better treatments for CP. Each participant will come into the lab for a detailed assessment that would include placing an EEG cap (like a swimming cap) on their head that records the electrical signals in their brain while walking. We will also place adhesive stickers on their legs to measure muscle activity and how their legs are moving. The entire session may last up to three to four hours, and will be scheduled based on participant preferences. To participate, you should be between 5 to 17 years of age, have cerebral palsy that affects both legs and be able to walk at least 10 feet with or without walking aids.

  2. Neuromuscular electrical stimulation (NMES)-assisted standing and walking for children with CP

    We are interested in studying the effect of electrical stimulation to several leg muscles at the same time for improving standing and walking posture. Electrical stimulation has been used safely and comfortably in CP for many years with promising effects. Stimulating muscles during standing and walking is challenging because muscles should only be stimulated at precise times. We have developed a system that can stimulate up to four leg muscles at times when they are supposed to be active and which we think will have a far greater effect than stimulating only a single muscle at a time. This is a single session study, which may last up to four hours, and will be scheduled based on participant preferences. Individuals 5 to 17 years of age, with cerebral palsy in both legs who can walk come up to a stand and/or can walk at least 10 feet with or without their walking aid are eligible for this study.

  3. Neurofeedback training for children with CP

    We are interested in investigating a new treatment to improve ankle movement in children with cerebral palsy (CP) which uses a child’s own brain signals in combination with low level electrical simulation to help train their muscles. Brain signals will be recorded by placing an EEG cap with many small electrodes on the child’s head and we will also place stickers on their legs to record muscle activity and ankle movement. This pilot study will involve an assessment of each child’s brain activity using EEG while they are trying to lift their foot towards their shin. Then the child will practice this movement many times while we assist their movement with electrical stimulation triggered by their own brain activity. Children will receive feedback about how their motion is improving throughout the practice sessions. We will also evaluate whether their ankle motion improves when they are walking. Each child will come in for 10 sessions that will last between 2 -3 hours and will be scheduled based on participant preferences. Individuals 5 to 17 years of age with cerebral palsy and difficulty moving one or both ankles are eligible for this study.

  4. Infant NIRS-EEG

    We are conducting a research study to learn more about the motor and brain development of infants who are at high-risk for or diagnosed with cerebral palsy as well as infants without CP. The results of this study may eventually assist with better methods for early diagnosis as well as improved treatment for children with cerebral palsy. Your infant will wear a comfortable, non-invasive cap during the motor tasks to measure brain activity while we encourage them to perform various movements such as reaching, clapping, sitting, standing, or stepping. Your infant will also receive a full developmental assessment using the Bayley Scales of Infant and Toddler Development. You have the option to receive the results of this test. You and your infant have the option to come for one or multiple visits at the NIH Clinical Center. The visit(s) will last approximately 2-3 hours. Compensation will be provided for participation.

    We are enrolling Infants ages 3-12 months with or at risk for cerebral palsy.

For study questions or to schedule a visit, please email or call 301-451-7529.

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NeuroRobtics Research Group

Dr. Tom Bulea’s lab goal is to improve the lives of individuals with neurological disorders by engineering novel technology-based approaches for their evaluation, treatment and rehabilitation.

We combine neuroscience and engineering principles to create new rehabilitation paradigms that maximize functional outcomes by optimizing human-machine interaction. These therapies are then evaluated clinically within our motion analysis laboratory, where their effects are studied using motion capture, EMG and functional neuroimaging (EEG / fNIRS). We also develop new ways of applying these methods to study the underlying causes of movement disorders and enhance our scientific understanding of how the body’s motor and somatosensory systems control movement, with the ultimate goal of closing the loop between these clinical findings and design of neurorehabilitation therapies.

Some prior examples of our approach are our development of a new method for providing exoskeleton assistance to improve crouch gait in children with cerebral palsy, creation of novel EEG processing pipelines to quantify movement-related cortical activity, design of a new exergaming interface combined with EEG to study how the brain reacts to exoskeleton assistance during exercise, and development of a new tool for assessing hand grip myotonia in individuals with myotonic dystrophy.

We are recruiting for the following studies at this time:

  1. 13-CC-0210: Robotic Exoskeleton for Crouch Gait

    We have created the first wearable robot designed specifically to improve crouch gait – or persistent knee flexion – in children with cerebral palsy, spina bifida, muscular dystrophy, and incomplete spinal cord injury. Our robot was proven safe and effective during over-ground and treadmill walking in an earlier study. The purpose of this study is to evaluate the robot’s effects on voluntary muscle activity and walking ability. It is an outpatient study that takes place at the NIH Clinical Center in Bethesda, MD. Each participant will complete a course of over-ground gait training using the wearable robot consisting of 10 total visits. Each visit lasts several hours and can be scheduled around family preferences. There is no cost to participate in the study and compensation for your time is provided. To be eligible, you must be at least 5 years old, have a diagnosis of cerebral palsy, spina bifida, muscular dystrophy or incomplete spinal cord injury with an abnormal walking pattern, and be able to walk at least 10 feet with or without a walking aid.

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This page last updated on 01/13/2023

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