CAREER: Interlimb Neural Coupling to Enhance Gait Rehabilitation

流动性问题影响着许多人的一生。由于衰老或神经系统疾病（如中风和帕金森病）而导致行走问题的人经常参加步态训练疗法，以提高他们的行走能力。目前的步态训练方法主要集中在改善腿部运动，忽视了手臂运动的作用，即使许多人没有表现出适当的手臂摆动。步行是一项复杂的技能，需要高度协调的腿部和手臂运动。手臂摆动是行走的重要组成部分，影响稳定性，平衡和能量效率。为了改善行走，应该采用全身方法，即利用四肢在步态产生中的协同作用。这个早期职业发展计划（CAREER）项目将建立一个新的框架，在步态训练中使用适当的手臂摆动，为行走困难的人创造更有效的方法，并获得持久的改善。该项目的目标将通过量化正常手臂摆动，同时考虑年龄和步行速度等因素，然后使用可穿戴机器人设备创建新的方法来诱导步行过程中的正常手臂摆动。这些机器人设备的使用将增强步态康复，对社会产生重大影响，因为行走能力对于日常生活活动至关重要，并且许多人由于各种原因难以有效行走。该教育计划将吸引在科学和工程领域人数不足的残疾学生。他们参与使用辅助机器人设备的研究将鼓励他们在这一领域继续深造和职业生涯，并帮助学生留住。这项建议的研究目标是通过诱导步行过程中的全身反应来建立一种有效的步态训练方法。 本研究旨在从根本上了解如何利用肢体间神经耦合和利用手臂摆动来增强步态康复。将适当的手臂摆动步态训练的两个主要方法进行调查，以确定如何interlimb耦合可以用来改善关键参数，如协调，对称性，可变性，和步行速度。在一种方法中，由使用大腿和小腿运动学数据的新型模型实时生成的手臂摆动模式将用于可穿戴机器人设备。这些设备将尝试在记录步态参数的同时，以各种步行速度诱导与腿部运动协调的正确手臂运动。在第二种方法中，手臂摆动将由机器人设备改变，以调节腿部运动的幅度和频率，从而改善步态参数。两种新型的可穿戴机器人设备将被创建为研究工具，以研究触觉和动觉力反馈方法如何在用户以自选速度行走时激发和改变手臂摆动。每种方法中的肢体间耦合将通过使用肌间连贯性分析等技术分析肌肉活动来量化。这些研究的参与者将包括健康的年轻人和老年人，步态缓慢的老年人，以及中风和行走困难但能够在没有辅助设备的情况下行走的人。该研究项目将采用耦合上肢和下肢的内在趋势，以创建一种高效的步态康复方法，该方法将对各种步态缺陷的个体显着有益。该项目的教育计划将在残疾学生、农村地区的K-12学生、该项目由残疾和康复工程计划以及刺激竞争力研究的既定计划（EPSCoR）共同资助。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Mobility issues affect many people across the lifespan. People with walking problems due to aging or neurological disorders such as stroke and Parkinson's disease often participate in gait training therapy to improve their walking ability. Current gait training methods primarily focus on improving leg movements and overlook the role of arm movement, even though many people do not demonstrate appropriate arm swing. Walking is a complex skill requiring highly coordinated leg and arm movements. Arm swing then is an essential component of walking that impacts stability, balance, and energy efficiency. To improve walking, a whole-body approach should be adopted, one that takes advantage of how all four limbs work together in gait production. This Early Career Development Program (CAREER) project will establish a novel framework for employing appropriate arm swing in gait training to create more effective methods with enduring improvements for people with walking difficulties. The objective of this project will be accomplished by quantifying normal arm swing while considering factors such as age and walking speed, and then creating novel approaches using wearable robotic devices to induce normal arm swing during walking. The use of these robotic devices will enhance gait rehabilitation providing a significant impact on society given that the ability to walk is crucial for daily living activities, and many individuals, for a variety of reasons, have difficulty in walking efficiently. The education plan will engage students with disabilities, who are underrepresented in science and engineering. Their involvement in research using assistive robotic devices will encourage them to pursue further education and careers in this field and help with student retention.The research goal of this proposal is to establish an effective gait training approach by inducing whole-body responses during walking. This project seeks to fundamentally understand how to exploit interlimb neural coupling and utilize arm swing to enhance gait rehabilitation. Two major approaches for incorporating appropriate arm swing into gait training will be investigated to determine how interlimb coupling can be used to improve key parameters such as coordination, symmetry, variability, and walking speed. In one approach, arm-swing patterns generated in real-time by a novel model using thigh and shank kinematic data will be utilized in wearable robotic devices. These devices will attempt to induce correct arm movement in coordination with leg movements at various walking speeds while gait parameters are recorded. In the second approach, arm swing will be altered by robotic devices to modulate the amplitude and frequency of leg movements to improve gait parameters. Two novel wearable robotic devices will be created as research tools to examine how tactile and kinesthetic force feedback methods can instigate and alter arm swing in users during walking at self-selected speeds. The interlimb coupling in each approach will be quantified by analyzing muscle activity using techniques such as intermuscular coherence analysis. Participants in these studies will include healthy young and older adults, older adults with slow gait speed, and individuals who have suffered a stroke and walk with difficulty but are able to walk without an assistive device. This research project will employ the intrinsic tendency to couple upper and lower extremities in creating a highly effective gait rehabilitation approach that will be significantly beneficial for a wide variety of individuals with gait deficits. The project’s education plan will promote teaching and training assistive robotics among students with disabilities, K-12 students in rural areas, and groups underrepresented in mechanical engineering including female students.This project is jointly funded by the Disability and Rehabilitation Engineering Program and the Established Program to Stimulate Competitive Research (EPSCoR).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.