Motor Learning in a Customized Body-Machine Interface for Persons with Paralysis

描述（由申请人提供）：这些研究的目标是使脊髓损伤（SCI）瘫痪的人能够驾驶电动轮椅，并通过利用和适应其剩余上半身运动能力的界面与计算机交互。这被称为“身体-机器接口”，因为它以最佳方式将可穿戴传感器检测到的上半身（手臂和肩膀）的运动映射到设备控制信号的空间。通过这种方式，由于缺乏手的移动性而不能操作操纵杆控制器的瘫痪者可以有效地使用他们的整个上半身作为虚拟操纵杆装置。所提出的方法的一个重要特点是，它包含了一个互动的学习过程，在该过程中，接口适应主体的流动性和主体学会通过接口采取行动。本研究的目的是开发和测试这个界面的定制一组脊髓损伤参与者四肢瘫痪，导致高水平的颈部损伤。所提出的研究被组织在三个具体的目标：（目标1）开发新的功能能力的人与脊髓损伤定制的身体-机器接口，以他们的个人上半身的流动性。在将界面与每个受试者的剩余动作相匹配后，参与者将练习旨在训练两类控制动作的计算机游戏：操作虚拟操纵杆和操作虚拟键盘。本研究将测试受试者使用模拟轮椅进行熟练操作的能力。(Aim 2.）为了验证这一假设，练习个性化界面的上身控制导致脊髓损伤后显着的身体和心理上的好处。继发性并发症的康复治疗是脊髓损伤的重要环节。一项研究将通过常规临床方法和测量受试者产生协调的上身运动和施加等长力的能力，评估和量化练习功能性上身运动对肩部和手臂活动性的影响。在这一目标下的其他研究将评估操作身体-机器接口对肌肉骨骼疼痛以及参与者的情绪和精神状态的影响。(Aim 3）训练脊髓损伤幸存者熟练地使用他们增强的上肢运动技能和定制的界面参数来操作电动轮椅。本研究的目的是将在虚拟环境中学习的技能转移到实际的电动轮椅的控制上。在模拟轮椅中达到稳定性能后，受试者将在安全的测试环境中通过相同的身体-机器接口练习对物理轮椅的控制。如果成功的话，这项研究将导致电动轮椅使用定制的界面，适应其用户的剩余运动能力的有效操作。身体和心理上的好处预计将来自持续和协调的活动与使用这种身体-机器接口 公共卫生相关性：四肢瘫痪的人通常保留一定程度的上半身活动能力。拟议的研究将开发个性化的界面，利用这种剩余的移动性，使瘫痪的人能够控制计算机，轮椅和其他辅助设备。如果成功，该项目将导致建立一个基于可穿戴传感器的新的人机界面系列，这些传感器将根据用户的能力调整其功能。

DESCRIPTION (provided by applicant): The goal of these studies is to enable persons paralyzed by spinal cord injury (SCI) to drive powered wheelchairs and interact with computers by acting through an interface that utilizes and adapts to their residual upper-body motor capabilities. This is called a "body-machine interface" because it maps the motions of the upper body -detected by wearable sensors- (arms and shoulders) to the space of device control signals in an optimal way. In this way, paralyzed persons who cannot operate a joystick controller because of lack of hand mobility can effectively use their whole upper body as virtual joystick device. An important characteristic of the proposed approach is that it incorporates an interactive learning process, in which the interface adapts to the subject's mobility and the subject learns to act through the interface. This study aims at developing and testing the customization of this interface to a group of SCI participants with tetraplegia, resulting from hig-level cervical injury. The proposed research is organized in three specific aims: (Aim 1) To develop new functional capabilities in persons with spinal cord injury by customizing a body- machine interface to their individual upper body mobility. After fitting the interface to the residal movements of each subject, participants will practice computer games aimed at training two classes of control actions: operating a virtual joystick and operating a virtual keyboard. This study will test the ability of the subjects to perform skilled maneuvers with a simulated wheelchair. (Aim 2.) To test the hypothesis that practicing the upper-body control of personalized interfaces results in significant physical and psychological benefits after spinal-cord injury. Rehabilitation of secondary complications is important in SCI. A study will evaluate and quantify the impact of the practicing functional upper-body motions on the mobility of the shoulder and arms by conventional clinical methods and by measuring the subjects' ability to generate coordinated upper body movements and to apply isometric forces. Other studies under this aim will evaluate the effects of operating the body-machine interface on musculoskeletal pain and on the mood and mental state of the participants. (Aim 3) To train spinal-cord injury survivors to skillfully operate a powered wheelchair using their enhanced upper body motor skills and customized interface parameters. The goal of this study is to transfer the skills learne in the virtual environment to the control of an actual powered wheelchair. After reaching stable performance in the simulated wheelchair, subjects will practice the control of the physical wheelchair via the same body-machine interface within safe a testing environment. If successful, this study will lead to effective operation of powered wheelchairs using a customized interface that adapts to the residual motor capability of its users. Physical and psychological benefits are expected to derive from the sustained and coordinated activity associated with the use of this body-machine interface PUBLIC HEALTH RELEVANCE: People with tetraplegia often retain some level of mobility of the upper body. The proposed study will develop personalized interfaces, which utilize this residual mobility to enable paralyzed persons to control computers, wheelchairs and other assistive devices. If successful the project will result into the establishment of a new family of human-machine interfaces based on wearable sensors that adapt their functions to their users' abilities.