Agonist-antagonist muscle strain in the residual limb preserves motor control and perception after amputation.
Agonist-antagonist muscle strain in the residual limb preserves motor control and perception after amputation.
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DOI：
10.1038/s43856-022-00162-z
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Herr, Hugh M
中科院分区：
文献类型：
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作者：
Song, Hyungeun;Israel, Erica A;Gutierrez-Arango, Samantha;Teng, Ashley C;Srinivasan, Shriya S;Freed, Lisa E;Herr, Hugh M
阐明截肢后受试者特异性运动控制和知觉的潜在机制可以指导先进外科和神经假肢技术的发展。在这项研究中，研究了残肢保留的激动剂-拮抗剂肌肉劳损与保留的运动控制和感知能力之间的关系。14例单侧经胫骨截肢患者，年龄、病因和手术方式各不相同，接受了包括下肢自由空间镜像运动的评估。研究表明，在生物完整的肢体中，各种运动控制是通过激活肌肉协同作用来执行的。在这里，我们基于提取的肌肉协同作用及其激活谱来评估截肢后幻关节运动控制的自然性。肌肉协同作用提取、激动剂-拮抗剂肌肉劳损程度和感知能力分别由肌电图、超声图和测角法估计。在这里，我们发现感觉运动反应与残肢激动-拮抗剂肌肉劳损之间存在显著的正相关（P < 0.005-0.05）。已确定的趋势表明，与生物完整的肢体相比，在残肢中保留20-26%的激动剂-拮抗剂肌肉劳损可以有效地保留截肢后的自然运动控制，尽管保留肢体感知能力需要更多（61%）的激动剂-拮抗剂肌肉劳损。结果表明，激动剂-拮抗剂肌肉劳损是残肢的一种特征，易于确定，可以帮助解释截肢结果的变异性，而保留激动剂-拮抗剂肌肉劳损的手术截肢策略是实现截肢后更有效和仿生感觉运动控制的一种方法。接受肢体截肢的人可能在控制运动和感知残肢方面存在问题。这反过来又会影响神经假肢策略的成功，这种策略使用来自身体的信号来控制假肢。在这里，我们想了解肌肉内的感觉信号是如何帮助截肢后保持运动和肢体感知的。我们使用超声成像和其他方法测量了14名下肢截肢患者的肌肉活动和肢体知觉。我们表明，相关肌肉对之间关系的保存水平与截肢后肢体运动的更自然控制有关。开发保留这种关系的外科技术可能有助于截肢患者自然地感知和控制他们的残肢，并最终可能提高辅助假肢装置的可控性。Song等人研究了激动-拮抗剂肌肉劳损（AMS）与下肢截肢者运动控制和知觉之间的关系，其中一些截肢者接受了肌神经界面干预。作者报告说，残肢AMS的程度与保留的运动控制和知觉有关。
Elucidating underlying mechanisms in subject-specific motor control and perception after amputation could guide development of advanced surgical and neuroprosthetic technologies. In this study, relationships between preserved agonist-antagonist muscle strain within the residual limb and preserved motor control and perception capacity are investigated. Fourteen persons with unilateral transtibial amputations spanning a range of ages, etiologies, and surgical procedures underwent evaluations involving free-space mirrored motions of their lower limbs. Research has shown that varied motor control in biologically intact limbs is executed by the activation of muscle synergies. Here, we assess the naturalness of phantom joint motor control postamputation based on extracted muscle synergies and their activation profiles. Muscle synergy extraction, degree of agonist-antagonist muscle strain, and perception capacity are estimated from electromyography, ultrasonography, and goniometry, respectively. Here, we show significant positive correlations (P < 0.005–0.05) between sensorimotor responses and residual limb agonist-antagonist muscle strain. Identified trends indicate that preserving even 20–26% of agonist-antagonist muscle strain within the residuum compared to a biologically intact limb is effective in preserving natural motor control postamputation, though preserving limb perception capacity requires more (61%) agonist-antagonist muscle strain preservation. The results suggest that agonist-antagonist muscle strain is a characteristic, readily ascertainable residual limb structural feature that can help explain variability in amputation outcome, and agonist-antagonist muscle strain preserving surgical amputation strategies are one way to enable more effective and biomimetic sensorimotor control postamputation. People who undergo limb amputation can have issues with controlling movement and perception of residual limbs. This, in turn, can impact the success of neuroprosthetic strategies, which use signals from the body to control a prosthetic limb. Here, we wanted to understand how sensory signals within the muscle help to preserve movement and limb perception following amputation. We used ultrasound imaging and other methods to measure muscle activity and limb perception in fourteen people who have undergone lower limb amputations. We show that the level at which the relationship between pairs of related muscles is preserved is associated with more natural control of limb movement after amputation. Developing surgical techniques that preserve this relationship may help people living with amputations to naturally perceive and control their residual limbs, and ultimately may improve controllability of assistive prosthetic devices. Song et al. study the relationship between agonist-antagonist muscle strain (AMS) and motor control and perception in lower limb amputees, with some receiving a myoneural interface intervention. The authors report that the degree of AMS within the residual limb is associated with preserved motor control and perception.