Electromyographic response is altered during robotic surgical training with augmented feedback.
Electromyographic response is altered during robotic surgical training with augmented feedback.
复制标题
在机器人手术训练过程中，肌电图反应会通过增强反馈发生改变。
DOI：
10.1016/j.jbiomech.2008.09.039
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发表时间：
2009
影响因子：
2.4
通讯作者：
Stergiou,Nick
中科院分区：
文献类型：
--
作者：
Judkins,TimothyN;Oleynikov,Dmitry;Stergiou,Nick
用于外科腹腔镜手术的机器人系统越来越普遍。我们以前开发了定量措施来评估机器人手术熟练程度，并使用增强反馈来加强训练，以减少施加的握力并提高速度。然而，还需要了解外科医生在机器人手术期间的生理需求，以及培训是否可以减少这些需求。因此，本研究的目标是通过肌电图（EMG）使用临床生物力学技术来研究短期训练期间实时增强视觉反馈对肌肉激活和疲劳的影响。20名新手接受了使用达芬奇手术系统的三项无生命手术任务的培训。受试者被分为五个反馈组（速度，相对相位，握力，视频和控制）。在训练前后获得时域和频域EMG测量结果。从平均EMG和EMG包络线发现，手术训练降低了肌肉工作。握力反馈进一步减少平均和总肌肉工作，而速度反馈增加平均肌肉工作和减少总肌肉工作。训练还增加了中位频率响应，这是由于在每次任务期间增加了速度和/或减少了疲劳。更多样化的运动单位被招募的频率带宽后培训的增加。我们证明了使用EMG分析的临床生物力学可以帮助更好地理解机器人手术训练的效果。训练期间的实时增强反馈可以进一步降低生理需求。未来的研究将调查其他反馈手段，如机器人手术训练过程中的EMG生物反馈。
There is a growing prevalence of robotic systems for surgical laparoscopy. We previously developed quantitative measures to assess robotic surgical proficiency, and used augmented feedback to enhance training to reduce applied grip force and increase speed. However, there is also a need to understand the physiological demands of the surgeon during robotic surgery, and if training can reduce these demands. Therefore, the goal of this study was to use clinical biomechanical techniques via electromyography (EMG) to investigate the effects of real-time augmented visual feedback during short-term training on muscular activation and fatigue. Twenty novices were trained in three inanimate surgical tasks with the da Vinci Surgical System. Subjects were divided into five feedback groups (speed, relative phase, grip force, video, and control). Time- and frequency-domain EMG measures were obtained before and after training. Surgical training decreased muscle work as found from mean EMG and EMG envelopes. Grip force feedback further reduced average and total muscle work, while speed feedback increased average muscle work and decreased total muscle work. Training also increased the median frequency response as a result of increased speed and/or reduced fatigue during each task. More diverse motor units were recruited as revealed by increases in the frequency bandwidth post-training. We demonstrated that clinical biomechanics using EMG analysis can help to better understand the effects of training for robotic surgery. Real-time augmented feedback during training can further reduce physiological demands. Future studies will investigate other means of feedback such as biofeedback of EMG during robotic surgery training.