Multi-Joint Sensorimotor Dysfunction of the Stroke Arm

中风臂的多关节感觉运动功能障碍

• 批准号: 7118610
• 负责人: BRIAN D SCHMIT
• 金额: $ 27.99万
• 依托单位: MARQUETTE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7118610
• 关键词: arm; clinical research; elbow; electromyography; electrostimulus; human subject; joints; medical complication; neuromuscular disorder; patient oriented research; proprioception /kinesthesia; reflex; sensorimotor system; sensory feedback; shoulder; stroke

The purpose of this research partnership is to investigate the functional implications of using sensor feedback to enhance motor control of the arm post-stroke. Two key functional aspects of motor control of the arm will be examined: 1) Reach, which involves coordinated actions of the shoulder and elbow musculature and 2) grasp, which incorporates both finger position and force controls. For each system, we will demonstrate that sensory feedback from nonhomologous joints has a significant effect on motor control. Initially, we will examine the intralimb reflex coupling of wrist/hand sensory feedback on elbow and shoulder musculature and visa versa. For Aim 1 of this study, we will show that motorized stretch of the elbow and fingers produces reflex activity in muscles that are not perturbed. These effects will be compared between post-stroke and neurologically intact individuals using tendon tap perturbations. Sensory manipulations consisting of posture electrical stimulation, vibration and anesthesia will be used to modify the heteronymous reflex responses. Having demonstrated reflex coupling across joints, we will then examine the effects that this reflex coupling may have on motor function. In Aim 2, motor control tasks of the upper arm (e.g. reach) will be tested during sensory manipulations of the fingers and wrist. Similarly, motor tasks of the hand will be tested with modifications of sensory inputs to the elbow and shoulder. These studies will demonstrate that sensory signals from nonhomologous joints can substantialy enhance motor function. The results of this study will suggest a new type of approach for rehabilitation of arm function post-stroke. We postulate that substantial improvements in arm function can be achieved by developing new technologies that provide artificial sensory feedback. In addition, conventional therapies may be applied more efficiently or effectively using the principles that will be demonstrated by this study.

这项研究合作的目的是研究使用传感器反馈来增强中风后手臂运动控制的功能影响。将检查手臂运动控制的两个关键功能方面：1）伸展，涉及肩部和肘部肌肉组织的协调动作；2）抓握，包括手指位置和力量控制。对于每个系统，我们将证明来自非同源关节的感觉反馈对运动控制有显着影响。首先，我们将检查肘部和肩部肌肉组织上腕/手感觉反馈的肢体内反射耦合，反之亦然。对于本研究的目标 1，我们将证明肘部和手指的机动拉伸会在不受干扰的肌肉中产生反射活动。将使用腱敲击扰动在中风后和神经系统完整的个体之间比较这些影响。包括姿势电刺激、振动和麻醉在内的感觉操作将用于改变异义反射反应。在演示了跨关节的反射耦合后，我们将检查这种反射耦合可能对运动功能产生的影响。在目标 2 中，将在手指和手腕的感觉操作过程中测试上臂的运动控制任务（例如伸展）。同样，手的运动任务将通过修改肘部和肩部的感觉输入来测试。这些研究将证明来自非同源关节的感觉信号可以显着增强运动功能。 这项研究的结果将为中风后手臂功能康复提出一种新型方法。我们假设通过开发提供人工感觉反馈的新技术可以实现手臂功能的实质性改善。此外，使用本研究将证明的原理，可以更有效地应用常规疗法。