CAREER: Neuroprostheses for Functional Reaching by Users with High Tetraplegia

功能性电刺激（FES）神经假体是能够恢复因脊髓损伤而瘫痪的人的手和手臂功能的设备。然而，患有全臂瘫痪的个体通常不会从这些类型的神经假体中获得太多益处，因为这些设备还不能复制人类手臂运动的复杂性和运动范围。此外，这些设备必须由专家定期“调整”，以满足佩戴者不断变化的需求。因此，有一个显着的需要，以开发FES神经假体的能力，用于全臂瘫痪的人。这项研究将创造一种方法来协调对佩戴者肩部和手臂肌肉的电刺激与对伸展运动的控制。 它还将为非专家提供一种更新控制的方法，以响应用户肌肉和所需运动的变化。该研究将测试一种假设，即神经假体可以学习每个佩戴者对电刺激的肌肉反应模型，并用于协调肌肉执行伸展运动。将被测试的第二个假设是，护理人员可以在患者的前臂上施加物理暗示，“教”神经假体改进和扩展伸展运动。通过为有抱负的康复工程师创建一个同情心培训计划，将研究和教育融入该项目。工程专业的学生，以及医学，治疗，社会工作和护理专业的学生，将访问残疾人的家园。通过这些家访和课堂教学，工程师们将培养移情技能，如情感分享、自我和他人意识、观点采择和情绪调节。PI的长期职业目标是创造易于使用和广泛使用的神经假体，以恢复四肢瘫痪患者的手臂功能。为了实现这一目标，本项目的研究目标是：（1）创建一个架构，以控制整个手臂达到运动与FES，保留手臂的自然运动和力产生的灵活性和（2）授权非专家轻松地改善和扩展功能的FES神经假体的能力。实验将解决如何控制多关节系统的肌肉动作的方向是状态依赖的问题。PI将在肌肉刺激期间收集力和运动数据，并将数据应用于计划可实现的手部运动，预测移动手臂所需的肩部和肘部扭矩，并选择肌肉刺激命令来产生这些扭矩。此外，PI将研究基于直观的人为干预来训练FES控制器的方法。护理人员将对患者的前臂进行手动校正，以调整系统的控制策略并改进不准确的动作。该研究的结果将是一个灵活的，特定于受试者的FES规划和控制策略，以协调非专家可以轻松调节的多个关节的肌肉，该奖项反映了NSF的法定使命，并通过使用基金会的智力价值和更广泛的影响审查进行评估，被认为值得支持的搜索.

Functional-electrical-stimulation (FES) neuroprostheses are devices capable of restoring hand and arm function to individuals experiencing paralysis resulting from spinal cord injury. However, individuals with whole-arm paralysis typically do not receive much benefit from these types of neuroprotheses because the devices are not yet capable of replicating the complexity and range of motion of human arm movements. Additionally, the devices must be regularly "tuned" by experts to meet the wearer's changing needs. Thus, there is a significant need to develop FES neuroprostheses capabilities for use by people with whole-arm paralysis. This study will create ways to coordinate electrical stimulation of the wearer's shoulder and arm muscles with control of reaching movements. It will also create a way for a non-expert to update control to respond to changes in the user's muscles and desired movements. The study will test the hypothesis that models of muscle response to electrical stimulation, specific to each wearer, can be learned by the neuroprosthesis and used to coordinate muscles to perform reaching movements. A secondary hypothesis that will be tested is that a caregiver can apply physical cues at the patient's forearm, "teaching" the neuroprothesis to refine and expand reaching movements. Research and education are integrated in the project through the creation of an empathy training program for aspiring rehabilitation engineers. Engineering students, alongside medical, therapy, social work, and nursing students, will visit the homes of people with disabilities. Through these home visits and classroom instruction, engineers will develop empathetic skills like affective sharing, self- and other-awareness, perspective taking, and emotional regulation.The PI's long-term career goal is to create easily usable and widely available neuroprostheses to restore arm function to people with high tetraplegia. Toward this goal, the research objectives for this project are to: (1) create an architecture to control whole-arm reaching motions with FES that retains the arm's natural kinematic and force-producing flexibility and (2) empower a non-expert to easily improve and expand the capabilities of an FES neuroprosthesis. Experiments will address the question of how to control a multi-joint system where the direction of muscle action is state dependent. The PI will gather force and motion data during stimulation of muscles and apply the data to plan achievable hand motions, predict shoulder and elbow torques required to move the arm, and choose muscle stimulation commands to produce those torques. Additionally, the PI will investigate approaches to train the FES controller based on intuitive human intervention. Caregivers will apply manual corrections to the patient's forearm to adjust the system's control policy and refine inaccurate movements. The outcome of the study will be a flexible, subject-specific FES planning and control strategy to coordinate muscles across multiple joints that non-experts can easily modulate, which is a significant step toward neuroprostheses that achieve functional tasks like grooming and feeding oneself.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.