Agonist-Antagonist Myoneural Interface for Functional Limb Restoration after Transtibial Amputation

项目摘要/摘要 人类有能力精确地感觉到他们身体部位的位置、速度和扭矩。这种感觉是 被称为本体感觉。在创造人机交互的许多尝试中，仍然没有 稳健、可重复的方法，将本体感觉信息从合成设备反映到神经上 系统。这项研究提出了一种新的双向神经交流范式--激动者-- 拮抗剂肌神经接口(AMI)-用于经胫骨截肢后的功能肢体重建。急性心肌梗死是一种 由两块肌肉组成的神经通信结构--一个是激动者，一个是拮抗者--外科手术 在截肢残端内串联，使一块肌肉的收缩伸展另一块肌肉。这个 AMI保留了存在于本地解剖学中的重要的动态肌肉关系，从而允许 来自两个肌肉中的机械感受器的本体感觉信号传递到中枢神经 系统。据推测，手术构建的急性心肌梗死是在肢体残端内形成的 截肢，可以提供一个改进的独立控制关节的位置和阻抗在多个程度- 自由假体，同时也将本体感觉从每个假体关节反射到中央 神经系统。遵循前瞻性病例对照干预模式，我们招募健康、积极的 接受和不接受新型急性心肌梗死手术干预的经胫骨截肢患者。中的每个主题 干预组有截肢的残留物，包括两个急性心肌梗死，使临床可翻译的研究成为可能 踝关节和距下关节致动假体的肌电控制和实验演示 对假体关节扭矩进行了闭环控制。特定目标1调查急性心肌梗死是否可以改善对 自愿性假体运动。特定目标2确定急性心肌梗死是否可以保持不自主(反射性)步态 不规则地形移动时的行为。具体目标3探索AMI构造是否可以提供闭合的 体位匹配力反馈的环路关节力矩控制。研究设计包括 肌电、超声、生物力学(运动学和运动学)和心理测量数据的收集。 通过功能电刺激提供闭环式关节扭矩控制。功能的范围 将使用基于指标的性能评估来评估由AMIS实现的肢体恢复。穿过 对手术创建的双向神经接口能力的洞察，这项研究提供了一个框架 将仿生系统与人类生理学相结合，以提高健康、生产力、独立性和 截肢者的生活质量。

Project Summary/Abstract Humans have the ability to precisely sense the position, speed, and torque of their body parts. This sense is known as proprioception. In the many attempts to create human-mechatronic interactions there is still no robust, repeatable methodology to reflect proprioceptive information from a synthetic device onto the nervous system. The study presents a novel bi-directional neural communication paradigm – called the Agonist- antagonist Myoneural Interface (AMI) – for functional limb restoration after transtibial amputation. The AMI is a neural communication architecture comprised of two muscles – an agonist and an antagonist – surgically connected in series within the amputated residuum so that contraction of one muscle stretches the other. The AMI preserves important dynamic muscle relationships that exist within native anatomy, thereby allowing proprioceptive signals from mechanoreceptors within both muscles to be communicated to the central nervous system. It is hypothesized that surgically-constructed AMIs, created within the residuum during limb amputation, can afford an improved independent control of joint position and impedance in a multi-degree-of- freedom prosthesis while also reflecting proprioceptive sensation from each prosthetic joint onto the central nervous system. Following a prospective, case-control intervention model, we recruit healthy, active participants with transtibial amputations with and without the novel AMI surgical intervention. Each subject in the intervention group has an amputated residuum comprising two AMIs, enabling clinically translatable studies of myoelectric control of a prosthesis with actuated ankle and subtalar joints, and experimental demonstrations of closed-loop prosthetic joint torque control. Specific Aim 1 investigates if AMIs can improve control over voluntary prosthesis movement. Specific Aim 2 determines if AMIs can preserve involuntary (reflexive) gait behaviors during irregular terrain ambulation. Specific Aim 3 explores if an AMI construct can provide closed- loop joint torque control with somatotopically-matched force feedback. The research design includes the collection of electromyography, ultrasound, biomechanical (kinematic and kinetic), and psychometric data. Closed-loop joint torque control is provided through functional electrical stimulation. The extent of functional limb restoration enabled by the AMIs will be assessed using metric-based performance evaluations. Through insights on the capabilities of surgically-created bi-directional neural interfaces, the study provides a framework for integrating bionic systems with human physiology to improve the health, productivity, independence, and quality of life of persons with amputations.