Motor Learning in a Customized Body-Machine Interface for Persons with Paralysis

描述（由申请人提供）：这些研究的目标是使脊髓损伤（SCI）瘫痪的人能够驾驶电动轮椅，并通过利用和适应其剩余上肢运动能力的接口与计算机交互。这被称为“身体-机器接口”，因为它将上半身的运动——由可穿戴传感器检测到——（手臂和肩膀）以最佳方式映射到设备控制信号的空间。这样，由于手部活动能力不足而无法操作摇杆控制器的瘫痪患者可以有效地利用整个上半身作为虚拟摇杆装置。所提出的方法的一个重要特征是它包含了一个交互式学习过程，其中界面适应主体的移动性，主体通过界面学习行动。本研究旨在开发和测试该界面的定制，以一组脊髓损伤后四肢瘫痪的参与者为对象。本研究有三个具体目标：（目标1）通过定制身体-机器接口来发展脊髓损伤患者的新功能，以适应其个人上肢活动能力。在将界面与每个受试者的剩余动作相匹配之后，参与者将练习旨在训练两类控制动作的电脑游戏：操作虚拟操纵杆和操作虚拟键盘。本研究将测试受试者在模拟轮椅上进行熟练动作的能力。(目标2)。为了验证练习上肢控制个性化界面对脊髓损伤后的生理和心理有显著益处的假设。在脊髓损伤中，继发性并发症的康复是很重要的。一项研究将通过传统的临床方法和测量受试者产生协调的上肢运动和应用等距力的能力来评估和量化练习功能性上肢运动对肩部和手臂活动的影响。在这个目标下的其他研究将评估操作身体-机器界面对肌肉骨骼疼痛以及参与者的情绪和精神状态的影响。（目标3）训练脊髓损伤幸存者利用他们增强的上半身运动技能和定制的接口参数熟练地操作电动轮椅。这项研究的目的是将在虚拟环境中学习的技能转移到实际的动力轮椅的控制上。在模拟轮椅上达到稳定的性能后，受试者将在安全的测试环境中通过相同的身体-机器接口练习控制物理轮椅。如果成功，这项研究将导致电动轮椅的有效操作，使用一个定制的接口，以适应其用户的剩余电机能力。通过使用这种身体-机器界面进行持续和协调的活动，有望获得身体和心理上的益处

DESCRIPTION (provided by applicant): The goal of these studies is to enable persons paralyzed by spinal cord injury (SCI) to drive powered wheelchairs and interact with computers by acting through an interface that utilizes and adapts to their residual upper-body motor capabilities. This is called a "body-machine interface" because it maps the motions of the upper body -detected by wearable sensors- (arms and shoulders) to the space of device control signals in an optimal way. In this way, paralyzed persons who cannot operate a joystick controller because of lack of hand mobility can effectively use their whole upper body as virtual joystick device. An important characteristic of the proposed approach is that it incorporates an interactive learning process, in which the interface adapts to the subject's mobility and the subject learns to act through the interface. This study aims at developing and testing the customization of this interface to a group of SCI participants with tetraplegia, resulting from hig-level cervical injury. The proposed research is organized in three specific aims: (Aim 1) To develop new functional capabilities in persons with spinal cord injury by customizing a body- machine interface to their individual upper body mobility. After fitting the interface to the residal movements of each subject, participants will practice computer games aimed at training two classes of control actions: operating a virtual joystick and operating a virtual keyboard. This study will test the ability of the subjects to perform skilled maneuvers with a simulated wheelchair. (Aim 2.) To test the hypothesis that practicing the upper-body control of personalized interfaces results in significant physical and psychological benefits after spinal-cord injury. Rehabilitation of secondary complications is important in SCI. A study will evaluate and quantify the impact of the practicing functional upper-body motions on the mobility of the shoulder and arms by conventional clinical methods and by measuring the subjects' ability to generate coordinated upper body movements and to apply isometric forces. Other studies under this aim will evaluate the effects of operating the body-machine interface on musculoskeletal pain and on the mood and mental state of the participants. (Aim 3) To train spinal-cord injury survivors to skillfully operate a powered wheelchair using their enhanced upper body motor skills and customized interface parameters. The goal of this study is to transfer the skills learne in the virtual environment to the control of an actual powered wheelchair. After reaching stable performance in the simulated wheelchair, subjects will practice the control of the physical wheelchair via the same body-machine interface within safe a testing environment. If successful, this study will lead to effective operation of powered wheelchairs using a customized interface that adapts to the residual motor capability of its users. Physical and psychological benefits are expected to derive from the sustained and coordinated activity associated with the use of this body-machine interface PUBLIC HEALTH RELEVANCE: People with tetraplegia often retain some level of mobility of the upper body. The proposed study will develop personalized interfaces, which utilize this residual mobility to enable paralyzed persons to control computers, wheelchairs and other assistive devices. If successful the project will result into the establishment of a new family of human-machine interfaces based on wearable sensors that adapt their functions to their users' abilities.