CAREER: Neuromechanical modeling for gait neurorehabilitation design and prescription

恢复行走能力是患者康复的首要任务。神经机械模拟-一种模拟神经系统和身体如何相互作用控制运动的计算机建模方法-显示出作为一种工具的前景，它可以确定改善步行功能的最佳康复干预措施。然而，目前的模拟往往侧重于预测最优解决方案(如更快或更对称地行走)，而不考虑如何实现这一点。这个职业项目寻求开发一种新的神经机械模拟框架，模拟患者如何适应步行康复。该框架将为一种新的、具有潜在变革性的方法奠定基础，用于针对患者的步态康复处方。该职业项目还将开展外展和教育活动，以(1)培训下一代工程师，优先考虑临床医生和患者的观点，以及(2)教育临床医生和患者有关步态康复中神经机械模拟的潜力。研究人员的长期目标是为步态神经康复的临床决策开发神经机械模拟。为了实现这一目标，这个职业项目试图开发一种新的模拟框架，模拟功能性步态能力恢复的基础上的神经肌肉控制的适应。作为概念验证，研究人员将在基于错误放大的步态训练干预的基础上开发这个框架，该干预放大不稳定以挑战和重新训练行走平衡控制。研究活动分为两个相互关联的焦点。Focus One将捕捉不同人群-年轻人、老年人跌倒患者和中风幸存者-的肌肉活动和运动学，同时在错误增强环境中行走。焦点二将开发一个模拟框架，以模拟特定个人对这种环境的适应。这个项目将首先开发一个基于理论的框架，其中通过探索来优化神经肌肉控制，以最大限度地保持行走平衡，最大限度地减少工作量。该框架将通过纳入来自实验的个人特定肌肉协调障碍和适应限制来扩大，以更好地模拟患者群体的适应过程。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

Restoring the ability to walk is a high priority for rehabilitation in patient populations. Neuromechanical simulations – a computer modeling approach for simulating how the nervous system and body interact to control movement – show promise as a tool to identify the best rehabilitation intervention to improve walking function. However, current simulations often focus on predicting an optimal solution (such as walking faster or more symmetrically) without regard to how this will be achieved. This CAREER projects seeks to develop a new neuromechanical simulation framework that models how patients adapt to walking rehabilitation. The framework will lay the foundation for a new and potentially transformative approach for patient-specific prescription of gait rehabilitation. This CAREER project will also pursue outreach and educational activities to (1) train the next generation of engineers to prioritize clinician and patient perspectives and (2) educate clinicians and patients about the potential of neuromechanical simulations in gait rehabilitation. The investigator’s long-term goal is to develop neuromechanical simulations for clinical decision-making in gait neurorehabilitation. Towards this goal, this CAREER project seeks to develop a novel simulation framework that models the adaptation of neuromuscular control underlying the restoration of functional gait ability. As a proof-of-concept, the investigator will develop this framework on an error-augmentation based gait training intervention that amplifies instability to challenge and retrain walking balance control. The research activities are divided into two interconnected foci. Focus one will capture muscle activity and kinematics from a diverse population - young adults, older adult fallers, and stroke survivors - while walking in the error-augmentation environment. Focus two will develop a simulation framework to model individual-specific adaptation to this environment. This project will first develop a theory-based framework in which neuromuscular control is optimized via exploration to maximize walking balance and minimize effort. The framework will be augmented by incorporating individual-specific muscle coordination impairments and adaptation constraints derived from experiments to better simulate the adaptation process in patient populations.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.