Intraneural sensory feedback restores grip force control and motor coordination while using a prosthetic hand
Intraneural sensory feedback restores grip force control and motor coordination while using a prosthetic hand
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DOI：
10.1088/1741-2552/ab059b
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发表时间：
2019-04-01
影响因子：
4
通讯作者：
Cipriani, Christian
中科院分区：
文献类型：
--
作者：
Clemente, Francesco;Valle, Giacomo;Cipriani, Christian
Objective.人手中的触觉传入提供关于手-环境相互作用的基本信息，其被大脑用于使运动输出适应被操纵对象的物理特性。手部截肢会破坏手部的传入和传出通路，使患者的运动功能完全丧失。虽然运动功能可以通过使用肌电假肢部分恢复，但向假肢用户提供功能有效的感觉反馈是一个很大程度上未解决的挑战。虽然过去使用侵入性刺激的研究表明，感觉反馈可能有助于处理脆弱的物体，但没有人探索抓握过程中的基础，重新学习，运动协调。在这项研究中，我们的目的是第一次表明，神经内感觉反馈的握力（GF）提高了感觉运动控制的经桡截肢者控制的肌电假肢。Approach.我们进行了一项纵向研究，测试了单个受试者（临床试验注册号NCT 02848846）。在两周内进行堆叠杯测试（CUP），旨在测量受试者精细调节与假体一起施加的GF的能力。在研究结束时进行的拾取和举起测试（PLT）测量了运动协调的水平，以及受试者是否将在CUP中学到的运动技能转移到陌生的任务中。主要结果。结果表明，神经内感觉反馈增加了受试者调节GF的能力，并允许随着时间的推移改善性能。此外，PLT表明受试者能够将其操作技能概括并转移到未知任务中，并改善其运动协调性。意义我们的研究结果表明，神经内感觉反馈具有恢复功能有效的触觉反馈的潜力。这为使用神经假体改善截肢者的生活质量开辟了新的可能性。
Objective. Tactile afferents in the human hand provide fundamental information about hand-environment interactions, which is used by the brain to adapt the motor output to the physical properties of the object being manipulated. A hand amputation disrupts both afferent and efferent pathways from/to the hand, completely invalidating the individual's motor repertoire. Although motor functions may be partially recovered by using a myoelectric prosthesis, providing functionally effective sensory feedback to users of prosthetics is a largely unsolved challenge. While past studies using invasive stimulation suggested that sensory feedback may help in handling fragile objects, none explored the underpinning, relearned, motor coordination during grasping. In this study, we aimed at showing for the first time that intraneural sensory feedback of the grip force (GF) improves the sensorimotor control of a transradial amputee controlling a myoelectric prosthesis. Approach. We performed a longitudinal study testing a single subject (clinical trial registration number NCT02848846). A stacking cups test (CUP) performed over two weeks aimed at measuring the subject's ability to finely regulate the GF applied with the prosthesis. A pick and lift test (PLT), performed at the end of the study, measured the level of motor coordination, and whether the subject transferred the motor skills learned in the CUP to an alien task. Main results. The results show that intraneural sensory feedback increases the subject's ability in regulating the GF and allows for improved performance over time. Additionally, the PLT demonstrated that the subject was able to generalize and transfer her manipulation skills to an unknown task and to improve her motor coordination. Significance. Our findings suggest that intraneural sensory feedback holds the potential of restoring functionally effective tactile feedback. This opens up new possibilities to improve the quality of life of amputees using a neural prosthesis.