ROBOTIC STEP TRAINING

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 该项目将开发一种机器人步行器，可用于对脊髓损伤患者进行行走再培训。该设备将包括可以控制和响应腿部运动的轻型腿部机器人，以及可以控制和响应肢体负载和躯干运动的体重支持(BWS)系统。这种腿部机器人被称为“Arthur”(行走辅助机器人人类康复工具)。BWS机器人系统由“OS”(头顶支撑)和“PAM”(骨盆辅助机械手)组成。将设计机器人控制算法，为步态提供动力辅助，并根据需要增强对脊髓的感觉输入，以便在跑步机(BWST)上进行体重支持的运动训练期间促进步态再学习。 该设备将在加州大学洛杉矶分校开发，并在加州大学洛杉矶分校的脊髓损伤受试者身上进行测试。UCI的团队负责设计和制造该设备，并在UCI对未受损的受试者进行初步测试。加州大学洛杉矶分校的研究小组将在两项小型先导研究中，在患有脊髓损伤的志愿者中测试该设备。第一项研究将比较患者在机器人设备上进行运动训练和使用BWST进行手动(基于治疗师)运动训练时的肌电模式。第二项研究将确定使用机器人设备进行运动试验是否会导致患者在跑步机上独立行走的能力发生变化。 我们假设，机器人训练在诱导标准肌电模式方面至少与人工训练一样有效，将导致独立跑步机踏步的改善，并将显著减少与运动训练相关的劳动力和成本。如果是这样的话，该项目开发的技术将极大地提高脊髓损伤后步态康复的技术和科学水平。它还将直接惠及数千名患有脊髓损伤的美国公民，并大幅降低与脊髓损伤康复相关的经济成本。 这个项目的科学基础是脊髓具有非凡的学习能力。腰椎脊髓可以站立(Pratt等人)。1994年；De Leon等人。1999 b)和Step(Love等人)。1986年；Barbeau和Rossignol，1987年；洛芙等人。1990年；Edgerton等人。1991年；Hodgson等人。1994年；Belanger等人。1996年；Edgerton等人。1997b；De Leon等人。1998年；De Leon等人。1999a；De Leon等人。C)在没有脊柱上投入的情况下。如果经过适当的训练，脊髓的学习能力对成千上万的脊髓损伤患者来说是一个极其重要的发现，因为这可能意味着被限制在轮椅上或能够站立并采取一些步骤之间的区别。教授脊髓分步治疗本身就有直接的临床应用，也可以在提高其他潜在的脊髓损伤治疗干预措施的疗效方面发挥关键作用，如细胞生长、细胞工程和药物治疗。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This project will develop a robotic step trainer that can be used to retrain individuals with spinal cord injury to walk. The device will consist of lightweight leg robots that can control and respond to leg movement, and a body weight support (BWS) system that can control and respond to limb loading and torso movement. The leg robots are called "ARTHur" (Ambulation-assisting Robotic Tool for Human Rehabilitation). The BWS robotic system is comprised of "OS" (Overhead Support) and "PAM" (Pelvis Assist Manipulator). Robotic control algorithms will be designed that provide power assistance for stepping and enhance sensory input into the spinal cord on an as-needed basis in order to facilitate step relearning during locomotor training with body weight support on a treadmill (BWST). The device will be developed at UCI and tested with spinal cord injured subjects at UCLA. the team at UCI is responsible for designing and building the device, and initial testing with unimpaired subjects at UCI. The team at UCLA will test the device with volunteers with spinal cord injury in two small pilot studies. The first study will compare electromyographic patterns in patients during locomotor training on the robotic device and during manual (therapist-based) locomotor training with BWST. The second study will determine whether locomotor trianing using the robotic device can induce changes in a patient's ability to independently step on a treadmill. We hypothesize that robotic training will be at least as effective as manual training in inducing normative EMG pattern, will induce improvements in independent treadmill stepping and will significantly reduce the labor and costs associated with locomotor training. If so, the technology developed in this project will dramatically improve the state-of-the-art in technology and science for gait rehabilitation following spinal cord injury. It will also directly benefit thousands of U.S. citizens with spinal cord injury, and substantially reduce economic costs associated with rehabilitation from spinal cord injury. The scientific rationale for this project is that the spinal cord has a remarkable capacity to learn. The lumbar spinal cord can lear to stand (Pratt et al. 1994; de Leon et al. 1999b) and to step (Lovely et al. 1986; Barbeau and Rossignol 1987; Lovely et al. 1990; Edgerton et al. 1991; Hodgson et al. 1994; Belanger et al. 1996; Edgerton et al. 1997b; de Leon et al. 1998; de Leon et al. 1999a; de Leon et al. 1999c) in the absence of supraspinal input. The ability of the spinal cord to learn, if appropriately trained, is an extremely important finding for tens of thousands of people with spinal cord injury, as it could mean the difference between being confined to a wheelchair or being able to stand and take some steps. Teaching the spinal cord to step has immediate clinical application in itself and can also play a crucial role in enhancing the efficacy of other potential therapeutic interventions for spinal cord injuries, such as cell growth, cell engineering and pharmacological treatments.