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.

项目总结：有效的步态康复必须是引人入胜的，强烈的，重复的，专注于 有目的的运动。然而，中风后的患者可能有神经肌肉或认知障碍， 如果没有物质上的帮助，这个理想是无法实现的。巧合的是，这种帮助会阻碍运动 当患者习惯并减少他们的感觉运动参与（运动的主动矫正）时， 错误）。为了在辅助步态训练过程中对抗习惯化并改善学习，该项目新结合了 两个理论框架：一个来自社会心理学，研究社会压力如何影响动机， 另一种来自神经科学，将运动学习描述为错误驱动的适应和强化过程 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纠错和增加成功的价值来改善康复。 行动在团队环境中，这种激励增强被称为科勒效应，并受到两个因素的调节。 机制：向上的社会比较（将自我表现与他人进行比较）和不可或缺性（当 成功需要团队所有成员的努力）。尽管这些机制在以下方面具有强大的积极作用： 运动和认知任务，它们在运动学习中的作用是未知的。解决这一差距可以改善 每年为数百万因神经损伤而受损的人提供康复护理。这 奖学金的补充具体目标针对每一个科勒机制对运动的影响 康复活动.目的1研究促进向上社会比较如何影响感觉运动参与 和辅助运动过程中的运动学习，目标2研究不可或缺性的影响。加强 科学严谨，使用新的模型系统：健康参与者在跑步机上行走并接受标准化， 暂时性神经运动障碍，在腿部摆动过程中电激活他们的右腿肌。这 扰动减少了参与者在挥杆过程中的净机械功并缩短了步长。目标是 在查看逐步工作反馈的同时达到目标机械功。与运动学目标不同， 治疗师可以纠正，工作目标只能实现，如果参与者贡献了大量的 努力完成康复任务。显示分开的参与者和治疗师的工作贡献是预期的 唤起向上的社会比较。在目标2中，通过远程机器人系统提供治疗师协助， 重新平衡努力的贡献，使治疗师“更弱”和参与者不可或缺。这个项目是 伴随着跨学科培训的强大奖学金计划，将神经科学，康复， 社会心理学、工程学和急性中风后护理。这一重大理论进展将是一个新的 理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。 研究结果将有助于通过改变患者的观念， 因此，他们并不认为自己对共同的康复目标贡献较小，而是认为自己对成功必不可少。