Myoelectric Computer Interface to Reduce Muscle Co-Activation after Stroke

描述(申请人提供)：中风仍然是美国慢性残疾的主要原因，超过一半的中风幸存者尽管接受了传统治疗，但仍有持续性的手臂功能障碍。在这些中风幸存者中，一个重要的原因是 手臂运动受损是指正常情况下不会一起激活的肌肉之间的异常协同激活。这项研究的长期目标是开发一种新的中风疗法，使用一种廉价、易于携带的设备，通过分离异常协同激活的肌肉来改善运动功能。这种疗法是一种肌电计算机接口(MCI)，它将肌肉电活动映射到电脑游戏中光标的运动上。这向用户提供了关于一对肌肉共同激活的直接、详细的反馈。我们的初步结果表明，使用MCI进行训练可以使中风幸存者极大地减少目标手臂肌肉对中的异常共激活，并可能改善功能。这项建议的目标是确定如何优化将分离的肌肉激活转化为功能改善。我们寻求通过比我们的初步研究更多地改善慢性中风幸存者的运动功能，初步研究评估了单一肌肉对的等长MCI训练。我们将测试两种不同剂量的训练对运动功能的影响。我们还将 评估单个肌肉在运动过程中可以分离的程度，这是一种比等长激活更具功能相关性的情况。该建议的具体目标是：1)确定多对肌肉的等长MCI训练改善功能的程度；2)确定基于运动的多对肌肉的MCI训练改善功能的程度。这项拟议的研究具有创新性，因为它应用了对中风后异常共激活的基本见解，开发了一种廉价和便携的新治疗方式。此外，它还测试受伤的中枢神经系统重新获得对特定肌肉对的精确控制的基本能力。重新获得对个别肌肉的精确控制的能力很重要，因为它应该提高将习得的行为转化为功能性任务的能力。这种疗法将广泛影响这一领域，因为它可以让范围广泛的中风幸存者使用。这包括那些有严重运动障碍的人，他们是最需要新疗法的人。实现我们的目标将具有重要意义，因为我们希望这将导致开发一种有效的治疗中风后运动障碍的方法，并为该疗法的初步临床试验奠定基础。我们估计，仅在美国，这种疗法就可以使至少100万中风幸存者受益。

DESCRIPTION (provided by applicant): Stroke remains the leading cause of chronic disability in the U.S., and more than half of stroke survivors have persistent impairment of arm function despite receiving conventional therapy. In these stroke survivors, a significant cause of impaired arm movement is abnormal co-activation between muscles that normally do not activate together. The long-term goal of this research is to develop a new therapy for stroke using an inexpensive, easily portable device to improve motor function by decoupling abnormally co-activating muscles. This therapy, a myoelectric computer interface (MCI), maps electrical muscle activity onto movements of a cursor in a computer game. This provides direct, detailed feedback about the co-activation of a pair of muscles to the user. Our preliminary results suggest that training with the MCI allows stroke survivors to greatly reduce abnormal co-activation in the targeted arm muscle pair and may also improve function. The objective of this proposal is to determine how to optimize translation of the decoupled muscle activations into functional improvement. We seek to improve motor function in chronic stroke survivors by even more than in our preliminary studies, which assessed isometric MCI training of a single muscle pair. We will test the effects of two different doses of training on motor function. We will also assess the extent to which individual muscles can be decoupled during movement, which is a more functionally relevant condition than isometric activation. The specific aims of the proposal are to 1) determine the extent to which isometric MCI training of multiple muscle pairs improves function, and 2) determine the extent to which movement-based MCI training of multiple muscle pairs improves function. The proposed research is innovative because it applies fundamental insight about abnormal co-activation after stroke to develop a novel treatment modality that will be inexpensive and portable. In addition, it tests the fundamental ability of an injured central nervous system to regain precise control over specific pairs of muscles. The ability to regain precise control of individual muscles is important because it should improve the ability to transfer the learned behavior to functional tasks. This therapy will broadly impact the field sinc it can enable use by a wide range of stroke survivors. This includes those with severe motor impairments, who are those most in need of new therapies. Achieving our objective will be significant because we expect it to lead to development of an effective treatment for impaired movement after stroke and set the stage for initial clinical trials of the therapy. We estimate tht this therapy could benefit at least 1 million stroke survivors in the U.S. alone.