Robotically Augmented Mental Practice for Neuromotor Facilitation

摘要 由于中风和脊髓损伤等神经损伤，上肢运动功能经常受到损害。 最终目标是创新有效的运动康复，以提高中风患者的临床疗效。 通过发现和应用科学机制和开发新的工程技术来实现 以促进神经运动适应。在中风康复中，心理练习，如运动想象和动作 观察，是一种非常有效的干预措施，如果实施得当的话。挑战在于表演 心理练习的质量和效果是高度可变的，可能会受到影响。据推测， 通过协同近端肌肉激活Will控制和观察机器人抓取和释放动作 认知增加非激活远端肌肉的神经运动兴奋性和手功能 与外部呈现和可见的机器人假体接触。这一证明的具体目的是 概念和可行性研究是开发和测试具有协作性的机器人增强的心理练习 近端肌肉促进手部肌肉的神经运动。一种机器人增强的心理练习将是 为个人通过控制声音的相关动作来抓住和释放对象而开发的- 利用肩部/躯干深部肌肉的表面肌电信号生成机器人假体 学习算法。演示增加神经运动兴奋性和手的概念的证据 在身体健全的成年人中，将经颅磁刺激应用于运动皮质，以 将测试未激活的手部肌肉和反应时间以及最大自主收缩性能 用一根手指在各种练习条件下。高位卒中存活者的可行性和可能的趋势 还将检查肢体残疾。该项目将在佐治亚州理工学院 由与这项研究直接相关领域的跨学科专家团队提供的技术：一名应用生理学家， 机械和生物医学工程师，物理治疗师和临床神经学家。成功者 这项研究的完成将为远端肌肉的神经运动促进提供更多的心理练习， 疗效的证据将在健全的成年人身上提供，在中风后的个人身上也是可行的。这个 结果将导致在物理练习之前开发更有效的启动干预，这种干预可以 作为中风康复的一部分，促进功能改善。

SUMMARY Upper limb motor function is often impaired due to neurologic injuries such as stroke and spinal cord injury. The ultimate objective is to innovate effective motor rehabilitation for enhancing clinical outcomes in stroke populations by discovering and applying scientific mechanisms and developing new engineering technologies to facilitate neuromotor adaptation. In stroke rehabilitation, mental practice, such as motor imagery and action observation, is a very effective intervention when performed appropriately. The challenge is that performance quality and efficacy of mental practice are highly variable and can be compromised. It is hypothesized that control and observation of robotic grasp and release actions via synergistic proximal muscle activation will increase neuromotor excitability of the non-activated distal muscles and hand function due to cognitive engagement with the externally present and visible robotic prosthesis. The Specific Aim of this proof of concept and feasibility study is to develop and test robotically augmented mental practice with synergistic proximal muscles for neuromotor facilitation of hand muscles. A robotically augmented mental practice will be developed for individuals to grasp and release an object by controlling the associated actions of a sound- generating robotic prosthesis utilizing surface electromyography (EMG) of shoulder/trunk muscles with deep learning algorithms. To demonstrate the proof of concept of increased neuromotor excitability and hand performance in able-bodied adults, transcranial magnetic stimulation will be applied to the motor cortex for the non-activated hand muscles and reaction time and maximal voluntary contraction performances will be tested with a finger in various practice conditions. The feasibility and possible trends in stroke survivors with upper extremity disabilities will also be examined. The project will be performed at the Georgia Institute of Technology by an interdisciplinary team of experts in fields directly related to the study: an applied physiologist, mechanical and biomedical engineers, a physical therapist, and a clinical neuroscientist. The successful completion of the study will provide augmented mental practice for neuromotor facilitation for distal muscles, and evidence for efficacy will be provided in able-bodied adults and feasibility in post-stroke individuals. The results will lead to the development of a more effective priming intervention before physical practice that can facilitate functional improvement as part of stroke rehabilitation.