Harnessing the Kohler Effect to Promote Motor Learning During Physically Assisted Rehabilitation

利用科勒效应促进物理辅助康复期间的运动学习

• 批准号: 10679557
• 负责人: Julia Rose Manczurowsky
• 金额: $ 4.77万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679557
• 关键词: Address; Affect; Architecture; Biological Models; Caregivers; Caring; Cognitive; Economic Burden; Effectiveness; Engineering; Equilibrium; Exercise; Feedback; Fellowship; Gait; Goals; Impaired cognition; Impairment; Individual; Interdisciplinary Study; Intervention; Learning; Leg; Length; Locomotion; Mechanics; Mediating; Medical Care Costs; Mentorship; Motivation; Motor; Movement; Nervous System Trauma; Neurologic; Neuronal Plasticity; Neurosciences; Outcome; Participant; Patients; Perception; Performance; Physical Rehabilitation; Population; Process; Psychological reinforcement; Quality of life; Rehabilitation Outcome; Rehabilitation therapy; Rewards; Role; Savings; Science; Scientist; Sensory; Social Psychology; Spinal cord injury; Standardization; System; Telerobotics; Time; Training; Translating; Traumatic Brain Injury; Walking; Work; acute stroke; barrier to testing; cognitive neuroscience; cognitive task; comorbidity; comparison control; environmental enrichment for laboratory animals; fall risk; functional independence; functional restoration; gait rehabilitation; habituation; hamstring; improved; innovation; kinematics; learning outcome; member; motor learning; motor recovery; neuromuscular; physical therapist; post stroke; pressure; programs; rate of change; rehabilitative care; robotic system; social; socioeconomics; stroke-like episode; success; theories; treadmill

PROJECT SUMMARY: Effective gait rehabilitation must be engaging, intense, repetitive, and focused on purposeful movement. However, patients after stroke can have neuromuscular or cognitive impairments that make this ideal unattainable without physical assistance. Paradoxically, this assistance can hinder motor recovery when patients habituate and reduce their sensorimotor engagement (the active correction of motor errors). To counter habituation and improve learning during assisted gait training, this project newly combines two theoretical frameworks: one from social psychology governing how social pressure impacts motivation, and another from neuroscience describing motor learning as processes of error-driven adaptation and reinforcement learning. Positive social pressure from working in a team can boost motivation compared to working individually, which may improve rehabilitation by enhancing active error correction and increasing the value of successful actions. This motivation enhancement in a team setting is termed the Köhler effect and is moderated by two mechanisms: upward social comparison (comparing self-performance to others) and indispensability (when success requires effort from all team members). Although these mechanisms have robust positive effects in exercise and cognitive tasks, their role in motor learning is unknown. Addressing this gap could improve rehabilitation care for millions who annually acquire and live with impairments from neurological injury. This fellowship’s complementary specific aims target the impact of each Köhler mechanism on locomotor rehabilitation. Aim 1 investigates how promoting upward social comparison affects sensorimotor engagement and motor learning during assisted locomotion and Aim 2 investigates the effects of indispensability. To enhance scientific rigor, a new model system is used: healthy participants walk on a treadmill and receive a standardized, temporary neuromotor impairment by electrically activating their right hamstrings during leg swing. This perturbation decreases participants’ net mechanical work during swing and shortens step length. The goal is to reach a target mechanical work while viewing step-by-step work feedback. Unlike a kinematic target, which a therapist can correct, the work goal can only be achieved if the participant contributes a significant amount of effort to the rehabilitation task. Showing the separated participant and therapist work contributions is expected to evoke upward social comparison. In Aim 2, therapist assistance is provided through a telerobotic system to rebalance effort contributions, making the therapist “weaker” and participants indispensable. This project is accompanied by a robust fellowship plan of interdisciplinary training that bridges neuroscience, rehabilitation, social psychology, engineering, and post-acute stroke care. The major theoretical advancement will be a new understanding of how sensorimotor engagement and motor learning are influenced by positive social pressure. The results will serve to increase the effectiveness of rehabilitation interventions by shifting patient perceptions, so they view themselves not as lesser contributors to a shared rehabilitation goal but as indispensable to success.

项目摘要：有效的步态康复必须引人入胜，激烈，重复，并专注于 有目的的运动。但是，中风后的患者可能患有神经肌肉或认知障碍 在没有身体援助的情况下使这一理想无法实现。矛盾的是，这种帮助会阻碍电动机 患者习惯并减少感官的接合时恢复（电动机的主动校正 错误）。为了应对辅助聚集培训期间的习惯和改善学习，该项目新结合 两个理论框架：一个来自社会心理学的一个，负责社会压力如何影响动机， 另一个来自神经科学的研究，将运动学习描述为错误驱动和强化的过程 学习。与单独工作相比，在团队中工作的积极社会压力可以提高动力 这可以通过增强主动误差纠正并增加成功的价值来改善康复 动作。在团队环境中的这种动机增强被称为Köhler效应，并由两个主持 机制：向上的社会比较（将自我绩效与他人进行比较）和不可或缺的能力（当 成功需要所有团队成员的努力）。尽管这些机制在 运动和认知任务，它们在运动学习中的作用尚不清楚。解决这一差距可以改善 每年都会因神经损伤而受到损害的数百万计的康复护理。这 奖学金的完整特定目标针对每种科勒机制对运动的影响 康复。 AIM 1调查促进向上的社会比较如何影响感觉运动参与 在辅助运动期间的运动学习和目标2调查了不可或缺的性能的影响。增强 科学严谨，使用了一个新的模型系统：健康参与者在跑步机上行走，并获得标准化的， 通过在腿挥杆期间电气激活其右腿筋，暂时的神经运动障碍。这 扰动会在挥杆过程中降低参与者的净机械工作，并缩短步长。目标是 在查看分步工作反馈的同时，达到目标机械工作。与运动靶标不同， 治疗师可以纠正，只有在参与贡献大量的情况下才能实现工作目标 努力康复任务。预计将显示分开的参与者和治疗师的工作贡献 唤起社会比较。在AIM 2中，通过远程动物系统提供治疗师的帮助 重新平衡努力贡献，使治疗师变得“弱”，参与者必不可少。这个项目是 伴随着强大的跨学科培训奖学金计划，该计划桥接了神经科学，康复， 社会心理学，工程和急性中风后护理。主要的理论进步将是新的 了解感觉运动参与和运动学习如何受到积极的社会压力的影响。 结果将有助于通过转移患者的看法来提高康复干预措施的有效性， 因此，他们认为自己不是对共同的康复目标的贡献者，而是成功所必不可少的。