Multi-Joint Sensorimotor Dysfunction of the Stroke Arm

这项研究合作的目的是调查使用传感器反馈，以加强中风后手臂的运动控制的功能影响。将检查手臂运动控制的两个关键功能方面：1）伸展，涉及肩和肘肌肉组织的协调动作; 2）抓握，包括手指位置和力量控制。对于每一个系统，我们将证明，从非同源关节的感觉反馈对运动控制有显着的影响。首先，我们将研究肘和肩肌肉组织上的腕/手感觉反馈的肢体内反射耦合，反之亦然。对于本研究的目标1，我们将证明手肘和手指的机动伸展在未受干扰的肌肉中产生反射活动。将使用肌腱敲击扰动在中风后和神经完整的个体之间比较这些影响。将使用包括姿势电刺激、振动和麻醉在内的感觉操作来改变异名反射反应。在展示了关节之间的反射耦合之后，我们将检查这种反射耦合可能对运动功能的影响。在目标2中，将在手指和手腕的感觉操作期间测试上臂的运动控制任务（例如，伸展）。同样，手部的运动任务将通过对手肘和肩部的感觉输入的修改进行测试。这些研究将证明，来自非同源关节的感觉信号可以显著增强运动功能。 本研究结果将为脑卒中后手臂功能的康复提供一种新的途径。我们假设，手臂功能的实质性改善可以通过开发提供人工感觉反馈的新技术来实现。此外，使用本研究将证明的原则，可以更有效地应用常规治疗。

The purpose of this research partnership is to investigate the functional implications of using sensor feedback to enhance motor control of the arm post-stroke. Two key functional aspects of motor control of the arm will be examined: 1) Reach, which involves coordinated actions of the shoulder and elbow musculature and 2) grasp, which incorporates both finger position and force controls. For each system, we will demonstrate that sensory feedback from nonhomologous joints has a significant effect on motor control. Initially, we will examine the intralimb reflex coupling of wrist/hand sensory feedback on elbow and shoulder musculature and visa versa. For Aim 1 of this study, we will show that motorized stretch of the elbow and fingers produces reflex activity in muscles that are not perturbed. These effects will be compared between post-stroke and neurologically intact individuals using tendon tap perturbations. Sensory manipulations consisting of posture electrical stimulation, vibration and anesthesia will be used to modify the heteronymous reflex responses. Having demonstrated reflex coupling across joints, we will then examine the effects that this reflex coupling may have on motor function. In Aim 2, motor control tasks of the upper arm (e.g. reach) will be tested during sensory manipulations of the fingers and wrist. Similarly, motor tasks of the hand will be tested with modifications of sensory inputs to the elbow and shoulder. These studies will demonstrate that sensory signals from nonhomologous joints can substantialy enhance motor function. The results of this study will suggest a new type of approach for rehabilitation of arm function post-stroke. We postulate that substantial improvements in arm function can be achieved by developing new technologies that provide artificial sensory feedback. In addition, conventional therapies may be applied more efficiently or effectively using the principles that will be demonstrated by this study.