A Model-Based Analysis of Supraspinal Mechanisms of Inter-Leg Coordination in Human Gait: Toward Model-Informed Robot-Assisted Rehabilitation
A Model-Based Analysis of Supraspinal Mechanisms of Inter-Leg Coordination in Human Gait: Toward Model-Informed Robot-Assisted Rehabilitation
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DOI：
10.1109/tnsre.2021.3072771
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发表时间：
2021-01-01
影响因子：
4.9
通讯作者：
Artemiadis, Panagiotis
中科院分区：
文献类型：
--
作者：
Chambers, Vaughn;Artemiadis, Panagiotis
中风幸存者通常会因偏瘫而导致步态不稳。这种步态障碍会导致更高的跌倒率和整体生活质量的下降。虽然目前有许多中风后的步态康复方法，但没有一种方法能让患者恢复完全的功能。肢间协调是行走的主要机制之一，在大多数卒中后步态康复方案中通常被忽视。这项工作试图通过研究对侧对单侧刚度扰动的反应，帮助进一步了解肢间协调的机制以及大脑如何参与其中。一种独特的机器人装置，可变刚度跑步机（VST），与预先建立的神经肌肉步态模型相结合，首次分析了单侧扰动引起的腿间协调所涉及的椎上控制机制。试图通过步态模型解释观察到的运动学和肌肉激活数据，结果确定了两个控制变量，这两个变量似乎在扰动后的步态稳定性和恢复中起着重要作用：目标攻角和目标髋踝关节跨距。这很重要，因为这两个参数直接关系到在挥拍阶段更长的步幅和更大的足部间隙。这两个变量都有助于纠正偏瘫步态的常见问题，如偏瘫腿摆动阶段的步幅缩短和脚趾拖拽。这项工作的结果可以帮助设计未来基于模型的中风康复方法，该方法将以系统的方式干扰受试者，并允许针对步态的特定功能结果进行有针对性的干预。此外，这项工作——以及未来的研究——可以帮助改进健壮的双足机器人的控制器，以及我们对大脑如何控制行走时的平衡的理解。
Stroke survivors are often left suffering from gait instability due to hemiparesis. This gait dysfunction can lead to higher fall rates and an overall decrease in quality of life. Though there are many post-stroke gait rehabilitation methods in use currently, none of them allow patients to regain complete functionality. Interlimb coordination is one of the main mechanisms of walking and is usually overlooked in most post-stroke gait rehabilitation protocols. This work attempts to help further understand the mechanism of interlimb coordination and how the brain is involved in it, studying the contralateral response to unilateral stiffness perturbations. A unique robotic device, the Variable Stiffness Treadmill (VST), is used in conjunction with a pre-established neuromuscular gait model to analyze for the first time the supraspinal control mechanisms involved in inter-leg coordination induced after unilateral perturbations. The attempt to explain the observed kinematic and muscular activation data via the gait model results in the identification of two control variables that seem to play an important role in gait stability and recovery after perturbations: the target angle of attack and target hip to ankle span. This is significant because these two parameters are directly related to longer stride length and larger foot clearance during swing phase. Both variables work toward correcting common issues with hemiparetic gait, such as a shorter stride and toe drag during swing phase of the paretic leg. The results of this work could aid in the design of future model-based stroke rehabilitation methods that would perturb the subject in a systematic way and allow targeted interventions with specific functional outcomes on gait. Additionally, this work-along with future studies-could assist in improving controllers for robust bipedal robots as well as our understanding of how the brain controls balance during perturbed walking.