FES and Biomechanics: Treating Movement Disorders

描述（由申请人提供）：本生物医学研究合作项目建议通过我们在特拉华大学新成立的生物医学工程研究中心，结合机械工程和物理治疗教授的资源。该项目的五年目标是通过功能性电刺激（FES）、机器人辅助训练和生物力学建模的结合，帮助中枢神经系统功能障碍患者改善行走模式。在该项目的第一阶段，如本提案所述，重点将放在中风患者表现出偏瘫性腿部损伤。该技术应推广到各种神经损伤。这些人的运动将在四个方面得到改善或“优化”：无风险最大化姿势稳定性，损伤最小化运动过程中的肌肉骨骼损伤（如关节炎），美容发展更自然的步态，能量最小化运动过程中的代谢能量消耗。“NICE”优化方案将通过肌肉骨骼建模、机器人辅助、功能性电刺激和神经肌肉训练来实现。我们将研究的具体任务是在跑步机上的部分体重悬浮步态。这个项目的组织分为三个不同的目标，可以总结如下。目的1：识别偏瘫性中风患者下肢运动模式的损伤，并创建一个优化运动模式的范例（“NICE”优化）。这将通过使用步态分析和肌电图数据的生物力学建模来完成。目标2：开发必要的方法和设备（“NICE”康复系统），以实现卒中患者运动的“NICE”优化。我们将通过使用机器人设备和电刺激系统来实现这一目标。目的3：测试“NICE”康复系统在偏瘫性脑卒中患者中的可行性，并根据患者试验情况对系统进行调整。我们的十年目标是生产一种便携式（可穿戴）FES系统，以帮助患有中枢神经系统功能障碍的患者进行协调运动。

DESCRIPTION (provided by applicant): This Biomedical Research Partnership project proposes to combine resources from professors of Mechanical Engineering and Physical Therapy through our newly organized Center for Biomedical Engineering Research at the University of Delaware. The five-year goal of this project is to assist patients with CNS dysfunction to produce improved walking patterns through a combination of functional electrical stimulation (FES), robotic-assistive training and biomechanical modeling. In the first phase of this project, which is described in this proposal, the focus will be on individuals with stroke exhibiting hemiparetic leg impairment. The technique should be generalizable to a variety of neurological impairments. The movements for these individuals will be improved or "optimized" in four ways: Nonrisk Maximize postural stability, Injury Minimize musculoskeletal injury (e.g., arthritis) during movement, Cosmesis Develop a more natural looking gait, and Energy Minimize metabolic energy consumption during movement. The "NICE" optimization protocol will be realized through musculoskeletal modeling, robotic assistance, functional electrical stimulation, and neuromuscular training. The specific task we will study will be partial body weight suspension gait on a treadmill. The organization of this project has been divided into 3 distinct aims, which may be summarized as follows. Aim 1: Identify impairments in the locomotor patterns of the lower extremity in patients with hemiparetic stroke and create a paradigm to optimize the movement patterns ("NICE" optimization). This will be accomplished through biomechanical modeling using gait analysis and electromyographic data. Aim 2: Develop the methods and equipment ("NICE" rehabilitation system) necessary to implements the "NICE" optimization of locomotion in patients with stroke. We will achieve this through the use of a robotic device and an electrical stimulation system. Aim 3: Test the feasibility of the use of the "NICE" rehabilitation system in patients with hemiparetic stroke and make adjustments to the system based on the patient trials. Our ten-year goal is to produce a portable (wearable) FES system to assist patients with CNS dysfunction in the production of coordinated movements.