Adaptive Electrical Stimulation for Locomotor Retraining

用于运动再训练的自适应电刺激

• 批准号: 7418654
• 负责人: JAMES J. ABBAS
• 金额: $ 20.28万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7418654
• 关键词: Accounting; Area; Arizona; Asia; Biochemical; Biomechanics; Body Weight; Boxing; Chest; Classification; Clinical; Combined Modality Therapy; Computer Systems Development; Computer software; Development; Diagnosis; Electric Stimulation; Evaluation; Exhibits; Fatigue; Financial compensation; Future; Generations; Genetic; Goals; Hormonal; Individual; Injury; Institutes; Lead; Locomotion; Locomotor retraining; Lower Extremity; Measurement; Medical; Motor; Movement; Muscle; Muscle Contraction; Musculoskeletal; Natural regeneration; Nature; Nerve Regeneration; Neurologic; Neurosciences; Outcome; Output; Participant; Pattern; Performance; Phase; Physical therapy; Physiologic pulse; Physiological; Principal Investigator; Production; Property; Protein Engineering; Published Comment; Pulse taking; Range; Recovery; Recovery of Function; Recruitment Activity; Rehabilitation Centers; Research; Research Personnel; Research Project Grants; Residual state; Solid; Specific qualifier value; Spinal Cord; Spinal cord injury; Standards of Weights and Measures; System; Techniques; Therapeutic; Therapeutic Effect; Time; Tissue Engineering; Training; Treatment Efficacy; Universities; Walking; Weaning; Week; Weight; Work; base; design; functional gain; improved; motor learning; muscle strength; neural circuit; novel; novel strategies; prescription document; prescription procedure; programs; rehabilitation engineering; relating to nervous system; response; sensor; technique development

DESCRIPTION (provided by applicant): Recent studies have indicated that functional recovery of locomotor function after spinal cord injury may be enhanced by performing repetitive stepping movements on a treadmill with a harness for partial body weight support with passive assistance provided by therapists. The putative mechanism that underlies this recovery is activity-dependent plasticity of neural circuits both in the spinal cord and in supraspinal centers. Although results in some subjects have been encouraging, in general, the functional gains that have been demonstrated from locomotor therapy are moderate and there is a high variability across subjects. We believe that the 'standard' form of this therapy (treadmill/harness with passive assistance from therapists) is soundly based on well established principles of motor learning, but the manner in which the therapy is delivered does not enable maximization of the therapeutic effect. We propose that locomotor therapy may be enhanced by: 1) producing sensorimotor patterns that are more 'physiological' - i.e. that include appropriately timed muscle contractions and are therefore more similar to sensorimotor patterns in the intact state and 2) generating movement patterns in a more repeatable manner. Our approach utilizes adaptive control of electrical stimulation to activate muscles in order to generate repeatable movements on the treadmill. We believe that the combination of appropriately timed contractions and repeatable movement patterns will result in an improved form of locomotor therapy. Furthermore, the adaptive nature of the control system may be used to encourage gradual increases in voluntary input, therefore providing a mechanism for weaning the individual from FES-assistance during locomotion. The long-term goal of this work is to develop a system that will provide a more effective and efficient form of locomotor retraining therapy. In this work, we will develop a technique that uses adaptive control of electrically-stimulated muscles to produce repeatable stepping movements with coordinated sensorimotor patterns of activity. The system will use transcutaneous neuromuscular stimulation to assist in movement generation while walking on the treadmill with partial body weight support provided by a harness. Adaptive control techniques will be used to automatically determine an appropriate set of stimulation parameters for a given individual and to automatically adjust the stimulation parameters to account for fatigue and/or motor retraining effects. The goals of the proposed project are to develop the adaptive system and to evaluate its ability to generate specified movement patterns. We will implement the adaptive system and experimentally demonstrate that it is capable of reliably producing stepping movements by individuals with spinal cord injury on a treadmill with partial body weight support. In future work (beyond the scope of this proposal), we will compare the efficacy of adaptive FES-assisted locomotor therapy with other forms of locomotor therapy.

描述(申请人提供)：最近的研究表明，脊髓损伤后运动功能的功能恢复可以通过在治疗师提供被动帮助的情况下，在带着部分体重支持的背带的跑步机上进行重复的踏步运动来促进。这种恢复的可能机制是脊髓和脊髓上中枢神经回路的活动依赖性可塑性。尽管一些受试者的结果令人鼓舞，但总的来说，运动疗法证明的功能收益是适度的，而且不同受试者之间存在很大的变异性。我们认为，这种疗法的“标准”形式(在治疗师的被动帮助下跑步机/安全带)是基于公认的运动学习原则的，但提供疗法的方式不能使治疗效果最大化。我们认为，运动疗法可以通过以下方式得到加强：1)产生更具生理性的感觉运动模式--即包括适当定时的肌肉收缩，因此更类似于完整状态下的感觉运动模式；2)以更可重复的方式产生运动模式。我们的方法利用电刺激的自适应控制来激活肌肉，以便在跑步机上产生可重复的运动。我们相信，适当时机的收缩和可重复的运动模式的结合将导致一种改进的运动疗法。此外，控制系统的适应性可以用来鼓励逐渐增加自愿投入，从而提供一种机制，使个人在运动期间摆脱FES辅助。这项工作的长期目标是开发一种系统，提供一种更有效和更高效的运动再训练疗法。在这项工作中，我们将开发一种技术，利用对电刺激肌肉的自适应控制来产生具有协调感觉运动模式的可重复的步进运动。该系统将使用经皮神经肌肉刺激，在由安全带提供部分体重支持的跑步机上行走时，帮助产生运动。自适应控制技术将用于为给定的个体自动确定一组适当的刺激参数，并自动调整刺激参数以考虑疲劳和/或运动再训练的影响。拟议项目的目标是开发自适应系统，并评估其产生特定运动模式的能力。我们将实施自适应系统，并通过实验证明，它能够在部分体重支持的跑步机上可靠地产生脊髓损伤患者的踏步动作。在未来的工作中(超出本提案的范围)，我们将比较适应性FES辅助运动疗法与其他形式的运动疗法的疗效。