Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation.
Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation.
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DOI：
10.1073/pnas.2019555118
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发表时间：
2021-03-02
影响因子：
11.1
通讯作者：
Herr HM
中科院分区：
文献类型：
--
作者：
Srinivasan SS;Gutierrez-Arango S;Teng AC;Israel E;Song H;Bailey ZK;Carty MJ;Freed LE;Herr HM
尽管假肢技术取得了进步，但今天截肢者的行动能力和生活质量都大大降低。这主要是由于过时的截肢模式阻碍了残肢和假体之间的有效交流。一种利用激动-拮抗剂肌神经界面（AMIs）在残肢中构建神经肌肉基质以增强感觉运动信号的截肢方法。在我们的研究中，与传统截肢患者相比，AMI截肢患者表现出更好的运动控制、幻相感觉、运动范围和疼痛减轻。随着运动协调和位置分化的增加，我们的研究结果表明AMI截肢患者将能够更有效地控制仿生假肢。尽管假肢技术取得了进步，但截肢患者的活动能力和生活质量却大大降低。我们已经开发了一种改良的膝下截肢（BKA）手术，该手术结合了激动剂-拮抗剂肌神经界面（AMIs），可以在手术中保存和耦合距下关节和踝关节的激动剂-拮抗剂肌肉对。ami旨在恢复生理神经肌肉动力学，实现双向神经信号，并提供比传统截肢技术更大的神经假肢可控制性。在这项前瞻性、非随机、无掩饰的研究设计中，15名AMI膝下截肢（AB）患者与7名传统膝下截肢（TB）患者相匹配。与TB受试者相比，AB受试者对残肢肌肉组织的控制能力显著增强，输出控制信号的差异性更强，运动精度更高（P < 0.008）。这可能是由于AB受试者由于协调的肌肉漂移而产生的显著更高的肌束张力促进了更大的本体感觉输入（P < 0.05）。与TB组相比，AB组截肢后的幻肢活动范围（AB: 12.47±2.41度，TB: 10.14±1.45度）明显大于TB组（P < 0.05）。此外，AB患者的疼痛（12.25±5.37）也比TB患者（17.29±10.22）少，与术前基线相比显著降低（P < 0.05）。与传统截肢相比，ami在截肢过程中的构建可以增强生理神经肌肉动力学、本体感觉和幻肢感知。受试者ami的激活产生了更可区分的肌电图（EMG），用于肌电假体控制，并显示出更积极的临床结果。
Despite advancements in prosthetic technologies, persons with amputation today suffer great diminution in mobility and quality of life. This is largely due to an outdated amputation paradigm that precludes efficacious communication between the residual limb and prosthesis. An amputation method utilizing agonist–antagonist myoneural interfaces (AMIs) constructs neuromuscular substrates in the residual limb to avail enhanced sensorimotor signaling. In our study, subjects with AMI amputation demonstrate improved motor control, phantom sensations, range of motion, and decreased pain when compared to patients with traditional amputation. With the demonstrated increases in motor coordination and position differentiation, our results suggest that patients with AMI amputation will be able to more efficaciously control bionic prostheses. Despite advancements in prosthetic technologies, patients with amputation today suffer great diminution in mobility and quality of life. We have developed a modified below-knee amputation (BKA) procedure that incorporates agonist–antagonist myoneural interfaces (AMIs), which surgically preserve and couple agonist–antagonist muscle pairs for the subtalar and ankle joints. AMIs are designed to restore physiological neuromuscular dynamics, enable bidirectional neural signaling, and offer greater neuroprosthetic controllability compared to traditional amputation techniques. In this prospective, nonrandomized, unmasked study design, 15 subjects with AMI below-knee amputation (AB) were matched with 7 subjects who underwent a traditional below-knee amputation (TB). AB subjects demonstrated significantly greater control of their residual limb musculature, production of more differentiable efferent control signals, and greater precision of movement compared to TB subjects (P < 0.008). This may be due to the presence of greater proprioceptive inputs facilitated by the significantly higher fascicle strains resulting from coordinated muscle excursion in AB subjects (P < 0.05). AB subjects reported significantly greater phantom range of motion postamputation (AB: 12.47 ± 2.41, TB: 10.14 ± 1.45 degrees) when compared to TB subjects (P < 0.05). Furthermore, AB subjects also reported less pain (12.25 ± 5.37) than TB subjects (17.29 ± 10.22) and a significant reduction when compared to their preoperative baseline (P < 0.05). Compared with traditional amputation, the construction of AMIs during amputation confers the benefits of enhanced physiological neuromuscular dynamics, proprioception, and phantom limb perception. Subjects’ activation of the AMIs produces more differentiable electromyography (EMG) for myoelectric prosthesis control and demonstrates more positive clinical outcomes.
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DOI：
10.1109/tnsre.2013.2294907
发表时间：
2014-07-01
影响因子：
4.9
作者：
Hebert, Jacqueline S.;Olson, Jaret L.;Chan, K. Ming
通讯作者：
Chan, K. Ming
影响因子：
120.7
作者：
Kuiken, Todd A.;Li, Guanglin;Lock, Blair A.;Lipschutz, Robert D.;Miller, Laura A.;Stubblefield, Kathy A.;Englehart, Kevin B.
通讯作者：
Englehart, Kevin B.
影响因子：
17.1
作者：
Clites, Tyler R.;Carty, Matthew J.;Herr, Hugh. M.
通讯作者：
Herr, Hugh. M.
影响因子：
2.6
作者：
O'Reilly, M. A. R.;O'Reilly, P. M. R.;O'Reilly, M. J.
通讯作者：
O'Reilly, M. J.
影响因子：
2.2
作者：
NELSON, AW
通讯作者：
NELSON, AW