# Locomotor learning in infants at high risk for cerebral palsy

> **NIH NIH R01** · CHILDREN'S HOSP OF PHILADELPHIA · 2021 · $781,458

## Abstract

PROJECT SUMMARY
Physical disability in individuals with cerebral palsy (CP) is caused by a failure to learn and/or refine motor control
during the first two years of life, during a critical period for neuroplasticity in motor control centers. Despite this,
very little is known about how infants at high risk for CP learn (or fail to learn) to move and acquire early locomotor
skills that are building blocks for later functional mobility. The long-term goal of our work is to reduce physical
disability in individuals with CP by promoting the development of evidence-based motor training strategies to
train and shape motor learning during infancy and toddlerhood. The objective of this project is to characterize
the evolution of locomotor learning over the first 18 months of life in infants at high risk for CP. To characterize
how locomotor skill is learned (or not learned) during this critical period, we will combine our established protocols
using robust, unbiased robotic and sensor technology to longitudinally study infant movement across three
consecutive stages during the development of impaired human motor control – early spontaneous
movement, prone locomotion (crawling), and upright locomotion (walking). The spontaneous leg
movements of sixty infants will be captured in real time using wearable sensors in their natural environment over
the first 4 months of life. Infants who remain at high risk for CP at 4 months of age, which we expect to be
approximately 50% of those enrolled, will progress to novel locomotor training protocols using robotic technology
for crawling (5-9 months of age) and walking (9-18 months of age). The locomotor training protocols are
introduced before the infants’ locomotor milestones emerge or fail to emerge, and are reward- and error-based,
allowing ample opportunities for error learning while providing assistance to move when even small effort is
made (reinforcement). Repeated measures of training characteristics and locomotor skill will quantify locomotor
learning over time in infants at high risk for CP. Key training characteristics, combined with neurobehavioral
moderators such as cognition and motivation to move, will be identified and used to develop a predictive model
of locomotor learning. We hypothesize that experiencing and responding to error is a key mechanism for
locomotor learning in CP, that learning is mediated by neurobehavioral factors outside of training, and that critical
thresholds of error and other training characteristics predict the transfer of locomotor skill from prone to upright
locomotion. Our team includes experts in motor control and development, computer science, robotics,
biomechanics and neonatology. Characterizing and predicting locomotor learning in infants at high risk for CP
will inform the design of future multi-site efficacy studies and the development of new treatments to shape motor
learning during the critical years of the development of motor control, supporting the Eunice Kenne...

## Key facts

- **NIH application ID:** 10129985
- **Project number:** 5R01HD098364-02
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Hlapang A. Kolobe
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $781,458
- **Award type:** 5
- **Project period:** 2020-03-18 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10129985

## Citation

> US National Institutes of Health, RePORTER application 10129985, Locomotor learning in infants at high risk for cerebral palsy (5R01HD098364-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10129985. Licensed CC0.

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