Harnessing the Kohler Effect to Promote Motor Learning During Physically Assisted Rehabilitation

项目摘要：有效的步态康复必须是引人入胜的、紧张的、重复的和专注于 有目的的运动。然而，中风后的患者可能会有神经肌肉或认知障碍， 如果没有身体上的帮助，这一理想是无法实现的。矛盾的是，这种帮助可能会阻碍运动 当患者习惯并减少感觉运动投入时的恢复(运动的主动矫正 错误)。为了对抗习惯性和改善在辅助步态训练中的学习，这个项目新结合了 两个理论框架：一个来自社会心理学，支配着社会压力如何影响动机，以及 另一项来自神经科学的研究将运动学习描述为错误驱动的适应和强化过程 学习。与单独工作相比，团队工作带来的积极社会压力可以增强动力， 这可能会通过加强主动纠错和增加成功的值来改善康复 行为。团队环境中的这种动力增强被称为Köhler效应，并由两个因素调节 机制：向上的社会比较(将自我表现与他人进行比较)和不可缺少(当 成功需要所有团队成员的努力)。尽管这些机制在以下方面具有强大的积极影响 在运动和认知任务中，它们在运动学习中的作用尚不清楚。解决这一差距可能会有所改善 为每年因神经损伤而遭受损害并与之生活在一起的数百万人提供康复护理。这 团契的互补性具体目标是针对每个Köhler机制对运动的影响 康复。目标1调查促进向上的社会比较如何影响感觉运动参与度 和辅助运动中的运动学习，目标2调查了不可缺少的影响。为了增强 科学严谨，使用了一种新的模型系统：健康的参与者在跑步机上行走，并接受标准化的 在摆腿时通过电激活他们的右腿肌群而造成的暂时性神经运动障碍。这 扰动减少了参与者在挥杆过程中的净机械功，缩短了步长。我们的目标是 在查看逐步工作反馈的同时达到目标机械工作。与运动学目标不同，运动学目标 治疗师可以纠正，只有当参与者做出大量贡献时，工作目标才能实现 努力完成康复任务。应显示分开的参与者和治疗师的工作贡献 唤起向上的社会比较。在目标2中，治疗师通过远程机器人系统提供帮助以 重新平衡努力贡献，让治疗师变得更弱，让参与者变得不可或缺。这个项目是 伴随着一项强大的跨学科培训奖学金计划，将神经科学、康复、 社会心理学、工程学和急性中风后护理。重大的理论进步将是一个新的 了解积极的社会压力是如何影响感觉运动参与和运动学习的。 结果将有助于通过改变患者的看法来提高康复干预的有效性， 因此，他们认为自己不是共同康复目标的次要贡献者，而是成功不可或缺的人。

PROJECT SUMMARY: Effective gait rehabilitation must be engaging, intense, repetitive, and focused on purposeful movement. However, patients after stroke can have neuromuscular or cognitive impairments that make this ideal unattainable without physical assistance. Paradoxically, this assistance can hinder motor recovery when patients habituate and reduce their sensorimotor engagement (the active correction of motor errors). To counter habituation and improve learning during assisted gait training, this project newly combines two theoretical frameworks: one from social psychology governing how social pressure impacts motivation, and another from neuroscience describing motor learning as processes of error-driven adaptation and reinforcement learning. Positive social pressure from working in a team can boost motivation compared to working individually, which may improve rehabilitation by enhancing active error correction and increasing the value of successful actions. This motivation enhancement in a team setting is termed the Köhler effect and is moderated by two mechanisms: upward social comparison (comparing self-performance to others) and indispensability (when success requires effort from all team members). Although these mechanisms have robust positive effects in exercise and cognitive tasks, their role in motor learning is unknown. Addressing this gap could improve rehabilitation care for millions who annually acquire and live with impairments from neurological injury. This fellowship’s complementary specific aims target the impact of each Köhler mechanism on locomotor rehabilitation. Aim 1 investigates how promoting upward social comparison affects sensorimotor engagement and motor learning during assisted locomotion and Aim 2 investigates the effects of indispensability. To enhance scientific rigor, a new model system is used: healthy participants walk on a treadmill and receive a standardized, temporary neuromotor impairment by electrically activating their right hamstrings during leg swing. This perturbation decreases participants’ net mechanical work during swing and shortens step length. The goal is to reach a target mechanical work while viewing step-by-step work feedback. Unlike a kinematic target, which a therapist can correct, the work goal can only be achieved if the participant contributes a significant amount of effort to the rehabilitation task. Showing the separated participant and therapist work contributions is expected to evoke upward social comparison. In Aim 2, therapist assistance is provided through a telerobotic system to rebalance effort contributions, making the therapist “weaker” and participants indispensable. This project is accompanied by a robust fellowship plan of interdisciplinary training that bridges neuroscience, rehabilitation, social psychology, engineering, and post-acute stroke care. The major theoretical advancement will be a new understanding of how sensorimotor engagement and motor learning are influenced by positive social pressure. The results will serve to increase the effectiveness of rehabilitation interventions by shifting patient perceptions, so they view themselves not as lesser contributors to a shared rehabilitation goal but as indispensable to success.