Control of Arm Posture and Movement Followoing Stroke

中风后手臂姿势和运动的控制

• 批准号: 7564066
• 负责人: Robert A. Scheidt
• 金额: $ 29.8万
• 依托单位: MARQUETTE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-05 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7564066
• 关键词: Accounting; Activities of Daily Living; Biofeedback; Biomechanics; Coupling; Data; Development; Dyskinetic syndrome; Elbow; Equilibrium; Feedback; Hand; Impairment; Joints; Lead; Learning; Limb structure; Mechanics; Methods; Middle Cerebral Artery Occlusion; Motor; Motor Neurons; Movement; Muscle; Muscle Hypertonia; Musculoskeletal; Oral cavity; Patients; Performance; Plants; Positioning Attribute; Posture; Property; Psychological Transfer; Recruitment Activity; Reflex action; Regulation; Rehabilitation therapy; Relaxation; Robot; Robotics; Shoulder; Spastic; Specific qualifier value; Stroke; System; Testing; Time; Training; Upper arm; Work; abstracting; base; disability; disorder control; electromyographic biofeedback; functional disability; hemiparesis; hemiparetic stroke; motor deficit; neuromechanism; novel; novel strategies; post stroke; research study; spinal reflex; visual motor

DESCRIPTION (provided by applicant): Project Summary/Abstract This project analyzes disordered control of posture and movement during reaching in patients with stroke resulting from middle cerebral artery occlusion. Prior studies have shown that control of posture and movement may both be impaired, and contribute importantly to disability. Our recent work has shown that normal reaching requires control of both posture and movement, that these two functions are specified by different neural mechanisms, and that accuracy is dependent on adaptation (learning) and coordination between the two. Based on our preliminary observations, we hypothesize that stroke degrades the ability to recruit and relax the balanced muscle co-contractions needed both to overcome limb postural bias associated with hypertonia and to stabilize the hand against unsteady loads across the workspace. We further hypothesize that major impairment in reaching post-stroke arises from improper scaling and timing of muscle coactivation, thus limiting the independence of arm trajectory and position control. Using a planar robot arm and novel EMG biofeedback methods, Aim 1 proposes to characterize the stroke- related changes in: 1) the ability to maintain postural stability throughout the workspace via graded coactivation of antagonist muscles; 2) the latency and developmental time course of different levels of coactivation, and 3) the use of proprioceptive feedback to counteract reflex abnormalities during regulation of limb position in the presence of mechanical perturbations. Aim 2 examines stroke-related changes in the integration of posture and movement control. Using the planar robot we will: 1) explore transfer of learning between posture and movement tasks, assessing whether coupling between the two controllers increases post-stroke, and 2) determine whether trajectory planning adapts post-stroke to account for the biomechanical effects of posture regulation. We expect our results will ultimately lead to new approaches for rehabilitating arm function post-stroke. We anticipate that improvement in arm function will be promoted by applying robotic and biofeedback methods first to train coactivation, posture and movement control separately, then in combination.

描述（由申请人提供）： 项目摘要/摘要 该项目分析了因大脑中动脉闭塞导致的中风患者在伸手过程中对姿势和运动的控制紊乱。先前的研究表明，姿势和运动的控制可能都会受到损害，并且会导致残疾。我们最近的工作表明，正常的伸展需要控制姿势和运动，这两种功能由不同的神经机制指定，并且准确性取决于两者之间的适应（学习）和协调。根据我们的初步观察，我们假设中风会降低平衡肌肉协同收缩的能力，这既是克服与肌张力过高相关的肢体姿势偏差的需要，也是稳定手部对抗工作空间不稳定负载所需的能力。我们进一步假设，中风后到达的主要障碍是由于肌肉共激活的缩放和时间不当造成的，从而限制了手臂轨迹和位置控制的独立性。 使用平面机器人手臂和新颖的肌电图生物反馈方法，目标 1 建议描述中风相关变化的特征：1）通过拮抗肌的分级协同激活在整个工作空间中保持姿势稳定性的能力； 2）不同水平共激活的潜伏期和发育时间过程，以及3）在存在机械扰动的情况下调节肢体位置期间使用本体感觉反馈来抵消反射异常。 目标 2 检查与中风相关的姿势和运动控制整合的变化。使用平面机器人，我们将：1）探索姿势和运动任务之间的学习迁移，评估两个控制器之间的耦合是否增加中风后，2）确定轨迹规划是否适应中风后以考虑姿势调节的生物力学效应。 我们预计我们的结果最终将带来中风后手臂功能康复的新方法。我们预计，通过应用机器人和生物反馈方法首先分别训练协同激活、姿势和运动控制，然后组合起来，将促进手臂功能的改善。