A wearable myoelectric computer interface to reduce muscle co-activation in acute and chronic stroke

可穿戴肌电计算机接口可减少急性和慢性中风中的肌肉协同激活

基本信息

批准号：
9983199
负责人：
Marc W. Slutzky
金额：
$ 34.48万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-01 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9983199
关键词：
Abnormal coordination Activities of Daily Living Acute Address Adhesives American Brain Chronic Clinical Trials Communities Computer Interface Computer software Control Groups Development Devices Dose Electrodes Electronics Equipment Exhibits Goals Hand Healthcare Home environment Impairment Individual Intervention Laboratories Maps Measures Motivation Motor Skills Movement Muscle Outcome Patients Pattern Phase Physical therapy Positioning Attribute Process Psychological Transfer Recovery Regimen Rehabilitation device Research Residual state Resources Signal Transduction Stroke Survivors System Tablets Testing Therapeutic Time Training Translating Triplet Multiple Birth Upper Extremity Video Games Wireless Technology acute stroke arm arm function arm movement base chronic stroke computer game conventional therapy design disability experience experimental group functional gain functional improvement hemiparesis hemiparetic stroke improved innovation kinematics motor function improvement motor impairment novel novel therapeutics portability post stroke spasticity stroke hemiparesis stroke recovery stroke survivor stroke therapy synergism wearable device

项目摘要

Hemiparesis from stroke is the leading cause of disability in the world. Arm impairment after stroke is due not only to weakness, but also to impaired muscle coordination—abnormal co-activation—during attempted movement. This is especially true in the most severely-impaired patients, who are most in need of new treatments. We have developed a myoelectric computer interface (MCI) paradigm to remedy this co-activation. The long term goal of this research is to develop an affordable, wearable MCI device that will improve motor function in stroke survivors. However, to date we have studied MCI use only in chronic stroke survivors in the laboratory, using cumbersome and expensive equipment. Little information exists as to how soon after stroke abnormal co-activation starts to impede arm function, but it seems likely that averting it would be easier in the acute stage, when the brain exhibits greater plasticity. Moreover, as healthcare resources become ever scarcer, it is important to design new therapies that are portable and affordable to enable extensive use in the community. The objective of this proposal is to advance the MCI paradigm by 1) creating a wearable MCI device that can be used outside the laboratory, 2) enhancing the training regimen, and 3) testing the MCI in stroke survivors in both the acute and chronic stages of recovery. The central hypothesis of this proposal is that making MCI therapy more intense, more similar to everyday movements, and starting training early in stroke recovery, will result in even greater functional improvement. We will design a wearable device and test this hypothesis in stroke survivors in both early and late stages after stroke via these specific aims: 1) To design and implement a wearable MCI device that controls therapeutic, tablet-based games, 2) To develop and enhance home-based MCI training in chronic stroke survivors, and 3) To assess the effect of acute-phase MCI training on stroke survivors' movement and function. This proposal's innovative development of a wearable device paradigm to reduce abnormal co-activation will enable us to study the benefits of MCI training both early and late after stroke. Achieving our objectives will be significant because it will address unmet needs to develop new treatments for stroke that are inexpensive and wearable to enable widespread use. We expect MCI training will help people with severe arm impairment as well as those with moderate impairment, since the severely-impaired have more abnormal co-activation and since the MCI only requires some residual myoelectric activity, not overt movements. We also expect this proposal to provide an unprecedented characterization of the temporal development of abnormal co-activation early after stroke. This will impact our overall understanding of the process of recovery from stroke. We expect that the MCI paradigm will be synergistic with other therapies, since it has a novel mechanism of action (reducing co-activation using EMGs). Finally, we anticipate that this proposal will provide critical results that will position us to translate this research into clinical trials.

中风的偏瘫是世界残疾的主要原因。中风后的手臂障碍不是到期只是为了弱点，但也损害了肌肉协调（强烈的共同激活）。移动。在最严重的患者中尤其如此，最需要新的患者治疗。我们已经开发了一个肌电计算机接口（MCI）范式来记住这种共同激活。这项研究的长期目标是开发一种负担得起的可穿戴MCI设备，以改善电动机中风存活中的功能。但是，迄今实验室，使用笨拙且昂贵的设备。关于中风后多久的信息很少异常的共同激活开始阻碍手臂功能，但似乎避免它会更容易当大脑表现出更大的可塑性时，急性阶段。而且，随着医疗保健资源的发展稀缺，重要的是设计可移植且负担得起的新疗法，以便在该疗法中广泛使用社区。该建议的目的是通过1）创建可穿戴的MCI来推进MCI范式可以在实验室外使用的设备，2）增强训练方案，3）测试MCI 恢复的急性和慢性阶段的中风存活。该提议的核心假设是这使MCI疗法更加激烈，与每天的运动更相似，并在早期开始训练中风恢复将导致更大的功能改进。我们将设计可穿戴设备并进行测试通过这些特定目的，中风后阶段和晚期的中风存活中的这一假设：1）设计和实施可穿戴的MCI设备，该设备可以控制基于平板电脑的游戏，2）开发并增强慢性中风存活中基于家庭的MCI训练，以及3）评估急性期的影响 MCI训练中风生存的运动和功能。该提议的创新发展可穿戴设备范式以减少异常共激活将使我们能够研究MCI培训的好处中风后的早期和晚期。实现我们的目标将是重要的，因为它将解决未满足的问题需要开发廉价且可穿戴的中风的新疗法，以实现宽度。我们预计MCI训练将帮助患有严重手臂障碍的人以及中度损害的人，由于严重受损的共同激活异常，而且MCI仅需要一些残留肌电活动，而不是明显的运动。我们还希望该建议提供前所未有的中风后早期共同激活异常共激活的临时发展的表征。这将影响我们的对从中风恢复过程的总体理解。我们希望MCI范式将是与其他疗法协同作用，因为它具有新颖的作用机理（使用EMG降低共激活）。最后，我们预计该提案将提供关键的结果，使我们能够翻译这项研究进入临床试验。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Portable, open-source solutions for estimating wrist position during reaching in people with stroke.

DOI：
10.1038/s41598-021-01805-2
发表时间：
2021-11-18
期刊：
Scientific reports
影响因子：
4.6
作者：
Nie JZ;Nie JW;Hung NT;Cotton RJ;Slutzky MW
通讯作者：
Slutzky MW

Wearable myoelectric interface enables high-dose, home-based training in severely impaired chronic stroke survivors.

DOI：
10.1002/acn3.51442
发表时间：
2021-09
期刊：
Annals of clinical and translational neurology
影响因子：
5.3
作者：
Hung NT;Paul V;Prakash P;Kovach T;Tacy G;Tomic G;Park S;Jacobson T;Jampol A;Patel P;Chappel A;King E;Slutzky MW
通讯作者：
Slutzky MW

The effect of myoelectric computer interface training on arm kinematics and function after stroke.

肌电计算机接口训练对中风后手臂运动学和功能的影响。