Spatial and temporal control of targeted limb movement

该项目的长期目标是开发提高运动残疾患者运动功能的方法。我们改善运动功能的方法是将辅助运动与增强感觉（“艾姆斯”）结合起来，其中获得专利的艾姆斯装置辅助患者移动受影响的肢体，同时它振动延长的肌腱以增强患者的运动感觉。在I期临床试验中，艾姆斯治疗22例低功能慢性卒中患者（14例上肢和14例下肢），约70%的患者的力量、活动范围和功能性运动得到改善。目前艾姆斯中“增强感觉”的方法是第一种方法-以每秒60次脉冲的恒定频率振动延长的肌肉。建议的研究的目的是通过优化感官刺激的方法来加强患者对辅助运动的感知。总体假设是，通过使用艾姆斯疗法优化患者对运动的感知，关节与大脑的对抗性感觉和运动连接之间的连接进一步加强，从而改善运动功能。目标1将确定优化运动过程中动觉放大的心理物理方法。两个实验将解决目标1：实验。1将区分在动觉控制的手部运动的关节，肌肉和皮肤受体之间的贡献;实验。2将调查是否，在精确的自愿关节运动，拮抗肌共同激活，以及是否，作为一个结果，拮抗肌梭的敏感性增强fusimotor驱动。

The long-range goal of this project is to develop methods for enhancing motor function in patients with motor disabilities. Our approach to improving motor function has been to couple assisted movement with enhanced sensation (“AMES”), in which the patented AMES device assists the patient in moving an affected limb while at the same time it vibrates the lengthening tendons to enhance the patient’s sensation of the movement. In a Phase I clinical trial, AMES treatment of 22 low-functioning chronic stroke patients (14 upper and 14 lower extremities) resulted in improved strength, range of motion, and functional movement in about 70% of the patients. The current method of ‘enhancing sensation’ in AMES was a first approach – to vibrate the lengthening muscles at a constant 60 pulses per second. The objective of the proposed research is to intensify the patient’s perception of the assisted movement by optimizing the methods of sensory stimulation. The overall hypothesis is that, by optimizing the patient’s perception of movement with AMES therapy, connections between a joint’s antagonistic sensory and motor connections to the brain are further strengthened, leading to improved motor function. Aim 1 will identify psychophysical methods that optimize kinesthetic amplification during movement. Two experiments will address Aim 1: Exp.1 will differentiate among the contributions of joint, muscle, and skin receptors during a kinesthetically controlled hand movement; Exp.2 will investigate whether, during precise voluntary joint movement, antagonist muscles are co-activated and whether, as a consequence, the sensitivity of antagonist muscle spindles is enhanced by fusimotor drive.