Targeted Reinnervation and Pattern-Recognition Control for Transradial Amputees

描述(由申请人提供)：我们建议提供一套临床上可行的工具和程序，以显著改善经桡骨截肢者对肌电假体的控制。这一建议包括一个基于已证明有效的算法的模式识别控制包，一种适用于经桡骨截肢患者的创新的新手术技术，将显著提高他们控制假肢和从假肢接收感觉反馈的能力，以及先进的模式识别工具，将导致更强大的自适应控制。在这个项目中，我们将进行一系列测试，利用模式识别技术改善对经骨假体的控制。受试者将被允许将这些假体带回家进行为期一个月的试验，以观察和纠正任何剩余的问题。将对6名受试者进行靶向肌肉再神经支配(TMR)。TMR是一种将离断的神经转移到剩余的肌肉和皮肤上的新外科技术。它提供了新的肌电信号，允许对截肢者进行直观和同时的控制，以改善截肢者的功能。TMR将提高控制的准确性，增加可稳健控制的类别数量，并潜在地允许同时、独立地控制手和手腕。TMR允许对假肢进行更自然的控制，并提供有针对性的感觉反馈，受试者通过残肢上重新支配的皮肤感觉到他们被截肢的手。这两种手术方式将极大地改善经桡骨假体的功能。TMR受试者还将接受现场试验。最后，对自适应模式识别技术和并行分类器技术进行了研究。随着用户对分类器的适应，自适应控制可能对每天的临床稳健性至关重要。并行控制将允许受试者以高精度同时控制手腕和手部类别。这项提议将推动几个科学领域的发展，包括模式识别和神经再支配的生理学。并行分类器和自适应算法理论的发展将大大超出当前技术水平，并且将在肌电信号的上下文中探索在缺少已知类别的情况下的稳健性概念。这一建议还将促进我们在实施这些新的控制技术时对运动控制的理解，并为未来的实验提供支持，这些实验将进一步发展我们对运动和感觉再支配的理解。芝加哥康复研究所、新不伦瑞克大学和奥托博克公司已经组建了一个杰出的团队。我们相信，拟议的研究将提高截肢者的护理标准。它也将成为继续改善假肢功能的重要研究平台。与公共卫生相关。该项目将把一种创新的外科技术应用于经骨截肢的受试者，以改善对假体的控制。它还将开发新技术，以推进假体的控制，这些假体具有更多功能，包括手腕旋转、手腕屈曲/伸展以及手指和拇指移动的手。这些研究将显著改善肘下截肢者的假臂功能。

DESCRIPTION (provided by applicant): We propose to provide a set of clinically viable tools and procedures to substantially improve the control of myoelectric prostheses by transradial amputees. This proposal includes a pattern-recognition control package based on algorithms with demonstrated efficacy, an innovative new surgical technique for patients with transradial amputation that will substantially improve their ability to control prostheses and receive sensation feedback from them, and advanced pattern-recognition tools that will lead to even more robust adaptive control. In this project we will perform a series of tests that will improve the control of transradial prostheses using pattern recognition techniques. Subjects will be allowed to take these prostheses home for a month-long trial, to observe and rectify any remaining problems. Targeted Muscle Reinnervation (TMR) will be performed on six subjects. TMR is a new surgical technique that transfers amputated nerve to spare muscle and skin. It provides new myoelectric signals allowing intuitive and simultaneous control for improved function in amputees TMR will improve the accuracy of control, the number of classes that may be robustly controlled, and potentially allow for simultaneous, independent control of the hand and wrist. TMR allows for more natural control of the prosthesis, and also provides targeted sensory feedback, in which the subject feels their amputated hand through reinnervated skin on the residual limb. These two surgical procedures will greatly improve the function of transradial prostheses. TMR subjects will also undergo a field trial. Finally, adaptive pattern recognition techniques and parallel classifier technology will be investigated. Adaptive control may be crucial to clinical robustness from day to day as the user adapts to the classifier. Parallel control will allow subjects to simultaneously control wrist and hand classes, with high accuracy. This proposal will advance several areas of science, including pattern recognition and the physiology of reinnervation. Parallel classifiers and adaptive algorithm theory will be substantially developed beyond the current state of the art, and the concept of robustness in the absence of a known class will be explored in the context of electromyographic signals. This proposal will also advance our understanding of motor control as we implement these novel control techniques, and provide support for future experiments which will further develop our understanding in both motor and sensory reinnervation. An outstanding team has been assembled including the Rehabilitation Institute of Chicago, the University of New Brunswick, and Otto Bock, Inc. We believe the proposed research will advance the standard of care of persons with amputation. It will also serve as an important research platform for continuing to improve artificial limb function. PUBLIC HEALTH RELEVANCE. This project will apply an innovative surgery technique to subjects with transradial amputation, to improve control of their prosthesis. It will also develop new technologies to advance the control of prostheses that have more functions including wrist rotation, wrist flexion/extension and hands with moving fingers and thumbs. These studies will significantly improve the function of artificial arms for people with below elbow amputations.