Proprioceptive Augmentation With Illusory Kinaesthetic Sensation in Stroke Patients Improves Movement Quality in an Active Upper Limb Reach-and-Point Task.
Proprioceptive Augmentation With Illusory Kinaesthetic Sensation in Stroke Patients Improves Movement Quality in an Active Upper Limb Reach-and-Point Task.
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中风患者的本体感受增强与不适的动觉感觉改善了主动上肢到达和指向任务的运动质量。
DOI：
10.3389/fnbot.2021.610673
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发表时间：
2021
影响因子：
3.1
通讯作者：
Marasco PD
中科院分区：
文献类型：
--
作者：
Ferrari F;Shell CE;Thumser ZC;Clemente F;Plow EB;Cipriani C;Marasco PD
中风患者经常难以完成运动任务，即使在实质性康复后也是如此。运动功能恢复不佳往往与中风导致的运动通路损伤有关。然而，影响感觉反馈与运动控制有效整合的通路中的中风损伤可能是顺畅运动协调的一个意想不到的障碍。在这项研究中，我们调查了6名中风患者在一项到达任务中增强运动本体感觉的效果，作为概念的证明。我们使用了一个可穿戴的神经机器人本体感觉反馈系统，通过振动参与者的上臂肌肉来产生虚幻的动觉感觉，而不是主动的肢体运动。参与者被指示将肘部伸展到不同距离的不同大小的目标上，同时对他们的二头肌或三头肌的远端肌腱施加幻觉诱发振动(90赫兹)、假振动(25赫兹)或不振动。为了评估增强的动觉反馈对运动功能的影响，我们比较了中风患者和健全参与者在手臂伸展时振动二头肌或三头肌的结果。我们通过使用运动捕捉跟踪肢体/手的运动学，以及通过菲茨定律分析达到目标获取，来量化不同条件和参与者的表现。运动学分析表明，在主动收缩的(激动者)三头肌中注入90赫兹的幻觉运动感觉可以增加运动的平稳性、运动的直接性和肘部的伸展。相反，在到达时向对抗的二头肌注入90赫兹的幻觉运动感觉会对这些参数产生负面影响。菲茨定律分析反映了类似的影响，在到达过程中，随着三头肌的振动，吞吐量有增加的趋势。在所有的分析中，身体健全的参与者对虚幻的振动增强基本上没有反应。这些发现提供了证据，表明振动诱导的运动错觉传递到参与主动运动的主要激动肌，可能被整合到康复方法中，以帮助促进中风患者的功能性运动恢复。
Stroke patients often have difficulty completing motor tasks even after substantive rehabilitation. Poor recovery of motor function can often be linked to stroke-induced damage to motor pathways. However, stroke damage in pathways that impact effective integration of sensory feedback with motor control may represent an unappreciated obstacle to smooth motor coordination. In this study we investigated the effects of augmenting movement proprioception during a reaching task in six stroke patients as a proof of concept. We used a wearable neurorobotic proprioceptive feedback system to induce illusory kinaesthetic sensation by vibrating participants' upper arm muscles over active limb movements. Participants were instructed to extend their elbow to reach-and-point to targets of differing sizes at various distances, while illusion-inducing vibration (90 Hz), sham vibration (25 Hz), or no vibration was applied to the distal tendons of either their biceps brachii or their triceps brachii. To assess the impact of augmented kinaesthetic feedback on motor function we compared the results of vibrating the biceps or triceps during arm extension in the affected arm of stroke patients and able-bodied participants. We quantified performance across conditions and participants by tracking limb/hand kinematics with motion capture, and through Fitts' law analysis of reaching target acquisition. Kinematic analyses revealed that injecting 90 Hz illusory kinaesthetic sensation into the actively contracting (agonist) triceps muscle during reaching increased movement smoothness, movement directness, and elbow extension. Conversely, injecting 90 Hz illusory kinaesthetic sensation into the antagonistic biceps during reaching negatively impacted those same parameters. The Fitts' law analyses reflected similar effects with a trend toward increased throughput with triceps vibration during reaching. Across all analyses, able-bodied participants were largely unresponsive to illusory vibrational augmentation. These findings provide evidence that vibration-induced movement illusions delivered to the primary agonist muscle involved in active movement may be integrated into rehabilitative approaches to help promote functional motor recovery in stroke patients.
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影响因子：
2
作者：
Albert, Frederic;Bergenheim, Mikael;Roll, Jean-Pierre
通讯作者：
Roll, Jean-Pierre
影响因子：
17.1
作者：
Marasco PD;Hebert JS;Sensinger JW;Shell CE;Schofield JS;Thumser ZC;Nataraj R;Beckler DT;Dawson MR;Blustein DH;Gill S;Mensh BD;Granja-Vazquez R;Newcomb MD;Carey JP;Orzell BM
通讯作者：
Orzell BM
影响因子：
3.7
作者：
Marasco, Paul D.;Bourbeau, Dennis J.;Ina, Jason G.
通讯作者：
Ina, Jason G.
影响因子：
3.4
作者：
Gulde, Philipp;Hermsdoerfer, Joachim
通讯作者：
Hermsdoerfer, Joachim
影响因子：
14.5
作者：
GOODWIN, GM;MCCLOSKEY, DI;MATTHEWS, PB
通讯作者：
MATTHEWS, PB