Restoring upper limb movement sense to amputees; a move towards natural control o

使截肢者恢复上肢运动感觉；

• 批准号: 8412370
• 负责人: Paul D. Marasco
• 金额: $ 32.7万
• 依托单位: CLEVELAND VA MEDICAL RESEARCH/ED/FDN
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-27 至 2013-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8412370
• 关键词: Achievement; Address; Amputation; Amputees; Artificial Arm; Back; Biological; Brain; Caring; Clinical; Cognitive; Cutaneous; Data; Devices; Elbow; Engineering; Esthesia; Eye; Feedback; Generations; Goals; Hand; Human; Illusions; Individual; Investigation; Investments; Joint Prosthesis; Joints; Kinesthesis; Kinesthetic Illusions; Limb Development; Limb Prosthesis; Limb structure; Link; Location; Maps; Measures; Methods; Modeling; Motion; Motor; Movement; Muscle; Muscle Spindles; Nerve; Nervous system structure; Operative Surgical Procedures; Perception; Peripheral; Peripheral Nerves; Play; Population; Positioning Attribute; Process; Proprioception; Prosthesis; Psychophysiology; Public Health; Research; Robot; Robotics; Role; Sensory; Sensory Receptors; Skin; Solutions; Structure; System; Technology; Testing; Time; Tissues; Touch sensation; Translating; United States National Institutes of Health; Upper Extremity; Upper limb movement; Vision; Visual; Visual attention; Work; Wrist; arm; brain machine interface; clinical application; design; innovation; insight; limb movement; motor control; novel; pressure; prevent; receptor; reinnervation; relating to nervous system; research study; restoration; restraint; robotic device; sensory feedback; sensory integration; standard of care; tool; vibration; visual tracking

DESCRIPTION (provided by applicant): In recent years there has been a substantial investment in research to create dexterous, multi- functional, prosthetic limbs for restoration of upper limb function following amputation. The focus on prosthetic limb development has, has in many ways, been fueled by advances in clinically operational motor neural- machine-interfaces; such as Targeted Reinnervation, the surgical redirection of amputated nerves for motor control of multifunction limbs, and other brain and peripheral neural-machine-interfaces on the near horizon. Although these motor interfaces provide considerable advantage to the control of the new prosthetic limbs, which are wonders of modern engineering, a fundamental problem still remains. Without natural and intuitive sensory feedback artificial limbs are still just insensate tools. Proprioception is the basic ability to sense where your arm is in space without looking. Amputees lack this sensory feedback, and this is the fundamental challenge in the implementation of advanced prosthetic limbs. Vision confirmation is needed for an amputee to use a prosthesis; from the most basic device to the most advanced. This is the key issue that we seek to address with our research objectives. We propose to attack the problem of prosthetic limbs that lack kinesthetic feedback in 3 Aims focused on developing and implementing approaches to harness and utilize a cognitive illusion of limb movement in human amputees with targeted sensory reinnervation. This research is important to the NIH scientific enterprise because it is highly translational and results directly impact amputee care. We hypothesize that we can stimulate the appropriate sensory receptors in the reinnervated tissue of targeted reinnervation amputees to generate the "kinesthetic illusion" and provide a sense of physiologically relevant limb movement for prosthetic limbs. Aim 1) We will use vibration and pressure to selectively activate the illusion and look at how targeted reinnervation amputees perceive this kinesthetic input. Aim 2) We will develop a small wearable robotic interface to selectively activate the kinesthetic receptors and assign sensations of limb movement to a prosthesis. With this we will look at how the subject interprets joint angle from a neutrally connected but physically unattached prosthesis. We will evaluate limb function with psychophysical examination of internal dynamic models related to constant velocity movements. We will also evaluate function using eye tracking and motion capture to track visual loading during prosthesis use. Aim 3) The prosthetic socket is the physical junction between the prosthesis and the amputee. This junction will need to evolve to reflect implementation restraints of the robot interface. To address this we will develop new socket designs to provide a limb movement feedback system with clinical applicability. PUBLIC HEALTH RELEVANCE: This research is relevant to public health because it is highly translational and the results will likely directly impact standard of care for amputees. As of 2011 there were 770,000 traumatic upper limb amputees in the US; a population that is young and active and will benefit substantially from more functional artificial arms that are neutrally integrated and provide a physiologically relevant sense of limb movement. Furthermore, our lines of investigation into neural interfaces and cognitive mechanisms of sensory feedback could provide far reaching scientific insight into challenges arising from sensory integration issues in many different fields.

描述（由申请人提供）：近年来，人们在研究上投入了大量资金，以创造灵巧的多功能假肢，以恢复截肢后的上肢功能。在很多方面，临床操作运动神经机器接口的进步推动了对假肢开发的关注。例如有针对性的神经再支配，通过外科手术重新定向截肢神经以控制多功能肢体的运动，以及即将出现的其他大脑和周围神经机器接口。尽管这些运动接口为新型假肢的控制提供了相当大的优势，这是现代工程的奇迹，但仍然存在一个基本问题。如果没有自然和直观的感觉反馈，假肢仍然只是无知觉的工具。 本体感觉是一种无需看就能感知手臂在空间中位置的基本能力。截肢者缺乏这种感觉反馈，这是实施先进假肢的根本挑战。截肢者需要确认视力才能使用假肢；从最基本的设备到最先进的设备。这是我们研究目标要解决的关键问题。 我们建议在 3 个目标中解决假肢缺乏动觉反馈的问题，重点是开发和实施通过有针对性的感觉神经支配来驾驭和利用人类截肢者肢体运动认知错觉的方法。这项研究对 NIH 的科学事业非常重要，因为它具有高度转化性，其结果直接影响截肢者的护理。我们假设我们可以刺激目标神经支配截肢者的神经支配组织中适当的感觉受体，以产生“动觉错觉”，并为假肢提供生理相关的肢体运动感觉。目标 1) 我们将使用振动和压力来选择性地激活幻觉，并观察目标神经支配截肢者如何感知这种动觉输入。目标 2）我们将开发一个小型可穿戴机器人界面，以选择性地激活动觉受体并将肢体运动的感觉分配给假肢。通过这个，我们将了解受试者如何解释中性连接但物理上未连接的假肢的关节角度。我们将通过与匀速运动相关的内部动态模型的心理物理学检查来评估肢体功能。我们还将使用眼动追踪和动作捕捉来评估功能，以跟踪假肢使用过程中的视觉负荷。目标 3) 假肢接受腔是假肢和截肢者之间的物理连接处。该连接点需要不断发展以反映机器人接口的实现限制。为了解决这个问题，我们将开发新的插座设计，以提供具有临床适用性的肢体运动反馈系统。 公共卫生相关性：这项研究与公共卫生相关，因为它具有高度转化性，结果可能会直接影响截肢者的护理标准。截至2011年 美国有 770,000 名因外伤而被截肢的上肢患者；年轻且活跃的人群将从功能更强大的人工手臂中受益匪浅，这些人工手臂是中性集成的，并提供与生理相关的肢体运动感觉。此外，我们对感觉反馈的神经接口和认知机制的研究路线可以为许多不同领域的感觉统合问题带来的挑战提供深远的科学见解。