Agonist-Antagonist Myoneural Interface for Functional Limb Restoration after Transtibial Amputation

激动剂-拮抗剂肌神经接口用于小腿截肢后肢体功能恢复

• 批准号: 10560547
• 负责人: HUGH M HERR
• 金额: $ 52.39万
• 依托单位: MASSACHUSETTS INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-14 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10560547
• 关键词: Acute; Affect; Agonist; American; Amputation; Anatomy; Ankle; Architecture; Behavior; Biomechanics; Biomimetics; Bionics; Body part; Central Nervous System; Clinical; Collection; Communication; Data; Devices; Electrodes; Electromyography; Emotional; Esthesia; Evaluation; Exhibits; Feedback; Freedom; Gait; Goals; Health; Human; Intervention; Intervention Studies; Joint Prosthesis; Joints; Kinetics; Leg; Limb structure; Lower Extremity; Mechanics; Mechanoreceptors; Methodology; Methods; Modeling; Motion; Motor; Movement; Muscle; Natural regeneration; Nervous System; Operative Surgical Procedures; Participant; Performance; Persons; Phantom Limb; Physiological; Physiology; Positioning Attribute; Productivity; Proprioception; Prosthesis; Psychometrics; Quality of life; Rehabilitation therapy; Research Design; Research Personnel; Resistance; Sensory; Series; Signal Transduction; Specific qualifier value; Speed; Stretching; Subtalar joint structure; System; Testing; Time; Tissues; Torque; Work; active lifestyle; ankle joint; ankle prosthesis; antagonist; case control; clinical translation; cohort; communication device; cost; electric impedance; first-in-human; force feedback; functional electrical stimulation; graphical user interface; group intervention; healthy lifestyle; improved; insight; joint mobilization; kinematics; limb amputation; limb loss; meetings; motor control; myoelectric control; neural; novel; preservation; prospective; prosthesis control; recruit; regenerative; response; restoration; ultrasound; verbal; visual feedback

Project Summary/Abstract Humans have the ability to precisely sense the position, speed, and torque of their body parts. This sense is known as proprioception. In the many attempts to create human-mechatronic interactions there is still no robust, repeatable methodology to reflect proprioceptive information from a synthetic device onto the nervous system. The study presents a novel bi-directional neural communication paradigm – called the Agonist- antagonist Myoneural Interface (AMI) – for functional limb restoration after transtibial amputation. The AMI is a neural communication architecture comprised of two muscles – an agonist and an antagonist – surgically connected in series within the amputated residuum so that contraction of one muscle stretches the other. The AMI preserves important dynamic muscle relationships that exist within native anatomy, thereby allowing proprioceptive signals from mechanoreceptors within both muscles to be communicated to the central nervous system. It is hypothesized that surgically-constructed AMIs, created within the residuum during limb amputation, can afford an improved independent control of joint position and impedance in a multi-degree-of- freedom prosthesis while also reflecting proprioceptive sensation from each prosthetic joint onto the central nervous system. Following a prospective, case-control intervention model, we recruit healthy, active participants with transtibial amputations with and without the novel AMI surgical intervention. Each subject in the intervention group has an amputated residuum comprising two AMIs, enabling clinically translatable studies of myoelectric control of a prosthesis with actuated ankle and subtalar joints, and experimental demonstrations of closed-loop prosthetic joint torque control. Specific Aim 1 investigates if AMIs can improve control over voluntary prosthesis movement. Specific Aim 2 determines if AMIs can preserve involuntary (reflexive) gait behaviors during irregular terrain ambulation. Specific Aim 3 explores if an AMI construct can provide closed- loop joint torque control with somatotopically-matched force feedback. The research design includes the collection of electromyography, ultrasound, biomechanical (kinematic and kinetic), and psychometric data. Closed-loop joint torque control is provided through functional electrical stimulation. The extent of functional limb restoration enabled by the AMIs will be assessed using metric-based performance evaluations. Through insights on the capabilities of surgically-created bi-directional neural interfaces, the study provides a framework for integrating bionic systems with human physiology to improve the health, productivity, independence, and quality of life of persons with amputations.

项目概要/摘要 人类有能力精确感知身体部位的位置、速度和扭矩。这种感觉是 称为本体感觉。在创建人机电子交互的许多尝试中，仍然没有 稳健、可重复的方法将本体感受信息从合成设备反映到神经上 系统。该研究提出了一种新颖的双向神经通讯范式——称为激动剂—— 拮抗剂肌神经接口 (AMI) – 用于经胫骨截肢后的肢体功能恢复。 AMI 是一个 神经通讯架构由两块肌肉（主动肌和拮抗肌）组成，通过外科手术 在截肢残骸内串联连接，以便一块肌肉的收缩拉伸另一块肌肉。这 AMI 保留了天然解剖结构中存在的重要动态肌肉关系，从而允许 来自两块肌肉内的机械感受器的本体感觉信号被传送到中枢神经 系统。据推测，手术构建的 AMI 是在肢体手术期间在残渣中产生的 截肢，可以在多角度的情况下提供对关节位置和阻抗的改进的独立控制 自由假肢，同时还将每个假肢关节的本体感觉反映到中央 神经系统。遵循前瞻性病例对照干预模型，我们招募健康、活跃的 接受或不接受新型 AMI 手术干预的胫骨截肢参与者。中的每个科目 干预组有一个由两个 AMI 组成的截肢残肢，使得临床可转化研究成为可能 具有驱动踝关节和距下关节的假肢的肌电控制以及实验演示 闭环假肢关节扭矩控制。具体目标 1 研究 AMI 是否可以改善对 自愿假肢运动。具体目标 2 确定 AMI 是否可以保留非自愿（反射）步态 不规则地形行走时的行为。具体目标 3 探讨 AMI 构造是否可以提供封闭式 具有体位匹配力反馈的环路关节扭矩控制。研究设计包括 收集肌电图、超声、生物力学（运动学和动力学）和心理测量数据。 通过功能性电刺激提供闭环关节扭矩控制。功能范围 AMI 实现的肢体恢复将使用基于指标的性能评估进行评估。通过 该研究提供了一个框架，深入了解通过手术创建的双向神经接口的功能 将仿生系统与人体生理学相结合，以改善健康、生产力、独立性和 截肢者的生活质量。

项目成果

Restoration of bilateral motor coordination from preserved agonist-antagonist coupling in amputation musculature.

• DOI: 10.1186/s12984-021-00829-z
• 发表时间: 2021-02-17
• 期刊: Journal of neuroengineering and rehabilitation
• 影响因子: 5.1
• 作者: Shu T;Huang SS;Shallal C;Herr HM
• 通讯作者: Herr HM

Agonist-antagonist muscle strain in the residual limb preserves motor control and perception after amputation.

• DOI: 10.1038/s43856-022-00162-z
• 发表时间: 2022
• 期刊: COMMUNICATIONS MEDICINE
• 作者: Song, Hyungeun;Israel, Erica A;Gutierrez-Arango, Samantha;Teng, Ashley C;Srinivasan, Shriya S;Freed, Lisa E;Herr, Hugh M
• 通讯作者: Herr, Hugh M

Acquisition of Surface EMG Using Flexible and Low-Profile Electrodes for Lower Extremity Neuroprosthetic Control.

• DOI: 10.1109/tmrb.2021.3098952
• 发表时间: 2021-08
• 期刊: IEEE transactions on medical robotics and bionics
• 作者: Yeon SH;Shu T;Song H;Hsieh TH;Qiao J;Rogers EA;Gutierrez-Arango S;Israel E;Freed LE;Herr HM
• 通讯作者: Herr HM

The Agonist-antagonist Myoneural Interface.

• DOI: 10.1097/bto.0000000000000552
• 发表时间: 2021-12
• 期刊: Techniques in orthopaedics (Rockville, Md.)
• 作者: Herr H;Carty MJ
• 通讯作者: Carty MJ

Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation.

• DOI: 10.1073/pnas.2019555118
• 发表时间: 2021-03-02
• 期刊: Proceedings of the National Academy of Sciences of the United States of America
• 影响因子: 11.1
• 作者: Srinivasan SS;Gutierrez-Arango S;Teng AC;Israel E;Song H;Bailey ZK;Carty MJ;Freed LE;Herr HM
• 通讯作者: Herr HM