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，以显着改善经桡动脉截肢者对肌电假体的控制。该提案包括一个基于已证明有效的算法的模式识别控制包、一种针对经桡动脉截肢患者的创新手术技术，该技术将大大提高他们控制假肢和接收来自假肢的感觉反馈的能力，以及先进的模式识别工具，这将带来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经桡动脉假体的控制。受试者将被允许将这些假肢带回家进行为期一个月的试用，以观察并纠正任何剩余的问题。将对六名受试者进行定向肌肉神经重建 (TMR)。 TMR 是一种新的外科技术，可将截断的神经转移到备用的肌肉和皮肤上。它提供新的肌电信号，允许直观和同步控制，以改善截肢者的功能。TMR 将提高控制的准确性、可稳健控制的类别数量，并有可能允许同时、独立控制手和腕部。 TMR 可以更自然地控制假肢，并提供有针对性的感觉反馈，其中受试者通过残肢上重新神经支配的皮肤感觉自己的截肢手。这两种手术将大大改善经桡动脉假体的功能。 TMR 受试者也将接受现场试验。最后，将研究自适应模式识别技术和并行分类器技术。随着用户适应分类器，自适应控制可能对日复一日的临床鲁棒性至关重要。并行控制将允许受试者同时控制手腕和手部类别，并且具有高精度。该提案将推动多个科学领域的发展，包括模式识别和神经支配生理学。并行分类器和自适应算法理论将大大超出当前技术水平，并且将在肌电信号的背景下探索在缺乏已知类别的情况下的鲁棒性概念。当我们实施这些新颖的控制技术时，该提案还将增进我们对运动控制的理解，并为未来的实验提供支持，这将进一步加深我们对运动和感觉神经支配的理解。芝加哥康复研究所、新不伦瑞克大学和奥托博克公司组成了一支出色的团队。我们相信拟议的研究将提高截肢患者的护理标准。它还将作为持续改善假肢功能的重要研究平台。 公共卫生相关性。该项目将创新的手术技术应用于经桡动脉截肢的受试者，以改善对假肢的控制。它还将开发新技术，以推进具有更多功能的假肢的控制，包括手腕旋转、手腕弯曲/伸展以及可移动手指和拇指的手。这些研究将显着改善肘部以下截肢患者的假肢功能。

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.