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

激动剂-拮抗剂肌神经接口用于小腿截肢后肢体功能恢复

• 批准号: 9893886
• 负责人: HUGH M HERR
• 金额: $ 58.68万
• 依托单位: MASSACHUSETTS INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-14 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9893886
• 关键词: Acute; Affect; Agonist; American; Amputation; Anatomy; Ankle; Architecture; Behavior; Biomechanics; Biomimetics; Bionics; Body part; Clinical; Collection; Communication; Data; Devices; Electrodes; Electromyography; Emotional; Esthesia; Evaluation; Exhibits; Feedback; Freedom; Gait; Goals; Health; Human; Intervention; Intervention Studies; Joint Prosthesis; Joints; Kinetics; Leg; Limb structure; Lower Extremity; Mechanics; Mechanoreceptors; Methodology; Methods; Modeling; Motion; Motor; Movement; Muscle; Natural regeneration; Nervous system structure; Neuraxis; Operative Surgical Procedures; Participant; Performance; Persons; Phantom Limb; Physiological; Physiology; Positioning Attribute; Productivity; Proprioception; Prosthesis; Psychometrics; Quality of life; Reflex action; Rehabilitation therapy; Research Design; Research Personnel; Resistance; Sensory; Series; Signal Transduction; Speed; Stretching; Subtalar joint structure; System; Testing; Time; Tissues; Torque; Ultrasonography; Work; active lifestyle; ankle joint; base; case control; clinically translatable; cohort; communication device; cost; electric impedance; first-in-human; force feedback; functional electrical stimulation; graphical user interface; group intervention; healthy lifestyle; improved; insight; joint mobilization; kinematics; limb amputation; meetings; motor control; myoelectric control; novel; preservation; prospective; prosthesis control; recruit; regenerative; relating to nervous system; response; restoration; visual feedback

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.

项目总结/摘要 人类有能力精确地感知他们身体部位的位置、速度和扭矩。这个意义 称为本体感受。在创造人机交互的许多尝试中，仍然没有 将本体感受信息从合成设备反射到神经上的可靠、可重复的方法 系统这项研究提出了一种新的双向神经通信范式-称为激动剂- 肌神经界面拮抗剂（AMI）-用于经胫骨截肢后的肢体功能恢复。AMI是一个 神经通信结构由两块肌肉组成--一个激动剂和一个拮抗剂--手术 在被切断的残余物中串联起来，这样一块肌肉的收缩会拉伸另一块肌肉。的 AMI保留了天然解剖结构中存在的重要动态肌肉关系，从而允许 来自两块肌肉内的机械感受器的本体感受信号被传递到中枢神经 系统据推测，在肢体运动过程中残留物内产生的人工构建的AMI 截肢，可以提供一个改进的独立控制关节的位置和阻抗在一个多程度的- 同时还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的病例对照干预模型，我们招募健康，活跃， 接受经胫骨截肢术的参与者，接受和不接受新型AMI手术干预。中的每个受试者 干预组有一个截肢残体，包括两个AMI，使临床翻译研究 肌电控制的假肢与驱动踝关节和距下关节，和实验演示 闭环假肢关节扭矩控制。具体目标1调查AMI是否可以改善对 自主假肢运动。具体目标2确定AMI是否可以保留不自主（反射）步态 在不规则地形下的行为。具体目标3探讨了AMI结构是否可以提供封闭的- 具有身体定位匹配力反馈的回路关节扭矩控制。研究设计包括 收集肌电图、超声、生物力学（运动学和动力学）和心理测量数据。 通过功能性电刺激提供闭环关节扭矩控制。功能范围 将使用基于度量的性能评估来评估AMI所实现的肢体修复。通过 深入了解人工创建的双向神经接口的能力，该研究提供了一个框架 将仿生系统与人体生理学相结合，以改善健康，生产力，独立性， 截肢者的生活质量。