CAREER: Neuromechanical modeling for gait neurorehabilitation design and prescription

恢复行走能力是患者康复的重中之重。神经机械模拟——一种模拟神经系统和身体如何相互作用以控制运动的计算机建模方法——有望成为确定最佳康复干预措施以改善行走功能的工具。然而，当前的模拟通常侧重于预测最优解决方案（例如走得更快或更对称），而不考虑如何实现这一目标。这个CAREER项目旨在开发一种新的神经力学模拟框架，模拟患者如何适应步行康复。该框架将为一种新的、潜在的、针对患者的步态康复处方的变革性方法奠定基础。该CAREER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；(2)教育临床医生和患者关于神经力学模拟在步态康复中的潜力。研究者的长期目标是为步态神经康复的临床决策开发神经力学模拟。为了实现这一目标，本CAREER项目寻求开发一种新的模拟框架，模拟神经肌肉控制的适应，以恢复功能性步态能力。作为概念验证，研究者将开发基于误差增强的步态训练干预框架，放大不稳定性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。焦点1将捕捉不同人群的肌肉活动和运动学——年轻人、老年人跌倒者和中风幸存者——在错误增强环境中行走。焦点二将开发一个模拟框架来模拟个体对这种环境的特定适应。该项目将首先建立一个基于理论的框架，其中神经肌肉控制通过探索来优化，以最大化行走平衡和最小化努力。该框架将通过纳入个体特异性肌肉协调障碍和从实验中得出的适应约束来增强，以更好地模拟患者群体的适应过程。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值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.