Error-enhanced learning & recovery in 2 & 3 dimensions

描述(申请人提供)：中风幸存者最普遍的问题之一是运动障碍。最近的研究有力地支持了延长上肢功能相关活动的实践，尽管治疗时间受到当前医疗经济体系的相当有限。这笔赠款侧重于人类-机器人交互(触觉)方面的新发展，这些发展揭示了运动教学和康复领域的前景。专门的机器人设备与计算机显示器相结合，可以不知疲倦地施加力、增强反馈和重定向错误，以加速、增强或触发运动重新学习过程。这些方法可以扩大并极大地加强恢复进程。在教授动作时，人们经常想到的第一个策略是引导肢体沿着所需的路径前进。然而，一个有希望的替代方法是通过偏离所需的路径来使移动变得更加困难。人们通过实践发展了抵消扭曲机械世界的力的能力，如果这些力被适当地设计和应用，当这些力最终被关闭时，所需的运动模式就会发生。我们和其他人也通过使用棱镜或虚拟现实显示器扭曲视觉世界，获得了类似的结果。在这些研究中，受试者看到一些意想不到的东西，被认为是错误的。我们的结果指向了一个统一的理论：错误导致学习，明智的错误增加(通过力量或视觉扭曲)可以带来持久的预期变化。有趣的是，这个过程似乎绕过了需要集中注意力的传统学习机制--如果受试者交谈或听音乐，结果是相同的。他们通常认为这是一场游戏。到目前为止，这项研究中很少有功能相关的，因为这些设备的运动范围很小，是二维的，并且缺乏合适的视觉界面。三维运动引入了重力效应这一令人望而生畏的新挑战，它可能会减少(或可能增加)错误增强训练的潜力。我们的实验室花了几年时间开发了一个大工作空间的三维触觉/图形系统。这笔赠款的目的是在我们充满希望的证据体系的基础上，将我们的错误增强培训工作扩展到三维的大型工作空间。因此，下面的实验进一步完善了我们对错误增加的理解(目标1)，将我们的方法扩展到三维(目标2)，然后通过测试中风幸存者的方法走向临床应用(目标3)。

DESCRIPTION (provided by applicant): One of the most pervasive problems for stroke survivors is movement deficits. Recent research strongly supports prolonged practice of functionally-relevant activities of the upper limb, even though therapy time is quite limited by the current medical economic system. This grant focuses on new developments in human- robot interactions (haptics) that have revealed prospects in the areas of motor teaching and rehabilitation. Specialized robotic devices combined with computer-displays can tirelessly exert force, augment feedback, and redirect error in order to speed up, enhance, or trigger the motor relearning process. These approaches could extend and greatly enhance the recovery process. The first strategy that often comes to mind for teaching movements is to guide the limb along the desired path. However, a promising alternative approach is to make movements more difficult by deflecting them from the desired path. People develop, through practice, the ability to counteract forces that distort the mechanical world, and if these forces are properly designed and applied, a desired movement pattern occurs when the forces are eventually switched off. We and others have also obtained similar results by distorting the visual world using prisms or virtual reality displays. In these studies, the subject sees something unexpected that is perceived as an error. Our results point to a single unifying theory: Errors induce learning, and judicious error augmentation (through forces or visual distortions) can lead to lasting desired changes. Interestingly, this process appears to bypass conventional learning mechanisms that require intense concentration - results are the same if the subjects have a conversation or listen to music. They often consider it a game. Until now very little of this research has been functionally relevant because the devices' ranges of motion were small, were two dimensional, and were lacking an appropriate visual interface. Three dimensional movements introduce the daunting new challenge of gravitational effects that could reduce (or perhaps heighten) the potential of error augmentation training. Our lab has spent several years developing a large- workspace, three dimensional haptics/graphics system. The aims of this grant are to build on our promising body of evidence and expand our error augmentation training work to a large workspace in three dimensions. Accordingly, the experiments below further refine our understanding of error augmentation (Aim 1), expand our approaches to three dimensions (Aim 2), and then move towards clinical application by testing our approaches on stroke survivors (Aim 3).