Patient-centered rehabilitation and dexterous assistive devices for stroke patients using bionic exoskeletons controlled by non-invasive electromyography

项目摘要/摘要 中风是世界范围内导致残疾的主要原因之一，与中风相关的最常见的损害是 上肢偏瘫，80%的中风患者急性影响，40%的患者慢性影响。完全恢复的可能性不大 在目前的康复方法下，中风降低了生活质量，增加了医疗成本， 并给照顾者带来负担。这个项目的长期目标是利用辅助仿生设备来恢复 运动功能和促进长期神经再生，最终取代更昂贵和更少 以病人为中心的康复策略的有效康复方法。这项提议的目的是 是控制辅助仿生外骨骼，并通过肌电(EMG)记录量化中风恢复 瘫痪手臂上残留的肌肉活动。我们的中心假设是肌电控制的能量 矫形器--帮助个人进行日常生活活动--可用作患者特有的康复工具 这可以提高中风的恢复能力。Aim 1将采用灵活的肌电控制算法用于上肢矫形器，以及 然后证明中风患者的手部灵活性和功能灵活性得到了改善。AIM 2将使用大型肌电 随时间推移的数据集，以精确量化恢复过程中肌肉力量和痉挛的变化，并 通过深度学习提供强大的长期辅助设备控制。目标3包括一项先导研究，以 确定针对患者的辅助设备驱动康复的可行性。拟议的研究是 创新是因为它将解决对融合辅助和康复设备至关重要的知识差距。 这些发现意义重大，因为它们将使设备能够立即和同时 促进使用，增强肌肉，并提供闭环视觉反馈-从而合并多个 将有效的康复战略纳入单一的整体办法。这项提议将对……产生积极影响 通过提高康复依从性、促进独立性和改善以下方面的康复成果 最终降低医疗成本，提高患者的生活质量。

PROJECT SUMMARY / ABSTRACT Stroke is one of the leading causes of disability worldwide and the most common stroke-related impairment is upper-limb hemiparesis, affecting 80% of stroke patients acutely and 40% chronically. Full recovery is unlikely with current rehabilitation approaches, and as a result, stroke reduces quality of life, increases healthcare costs, and burdens caregivers. The long-term goal of this project is to leverage assistive bionic devices to restore motor function and promote long-term neuro-regeneration, ultimately replacing more expensive and less effective rehabilitation approaches with a patient-centered rehabilitation strategy. The objective of this proposal is to control assistive bionic exoskeletons and quantify stroke recovery with electromyographic (EMG) recordings of residual muscle activity from the paretic arm. Our central hypothesis is that an EMG-controlled powered orthosis – that assists individuals in activities of daily living – can be used as a patient-specific rehabilitative tool that improves stroke recovery. Aim 1 will adapt dexterous EMG-control algorithms for upper-limb orthoses, and then demonstrate improved hand dexterity and functional mobility for stroke patients. Aim 2 will utilize large EMG datasets over time to precisely quantify changes in muscle strength and spasticity throughout recovery and to provide robust long-term control of assistive devices via deep learning. Aim 3 consists of a pilot study to determine the feasibility of patient-specific assistive-device-driven rehabilitation. The proposed research is innovative because it will address gaps in knowledge critical to merging assistive and rehabilitative devices. These findings are significant because they will enable devices that can immediately and simultaneously promote usage, strengthen muscles, and provide closed-loop visual feedback – thereby merging multiple effective rehabilitation strategies into a single holistic approach. This proposal will have a positive impact on society by increasing rehabilitation compliance, promoting independence and improving recovery outcomes for stroke patients, ultimately reducing healthcare costs and improving patients’ quality of life.