Spatial and temporal control of targeted limb movement

该项目的长期目标是开发增强运动障碍患者运动功能的方法。我们改善运动功能的方法是将辅助运动与增强感觉（“AMES”）结合起来，其中获得专利的AMES设备帮助患者移动受影响的肢体，同时它振动延长的肌腱以增强患者的运动感觉。在一项I期临床试验中，对22名低功能慢性中风患者（14名上肢和14名下肢）进行AMES治疗，约70%的患者的力量、活动范围和功能运动得到改善。目前在AMES中“增强感觉”的方法是第一种方法——以每秒60次脉冲的速度振动延长肌肉。本研究的目的是通过优化感觉刺激的方法来增强患者对辅助运动的感知。总的假设是，通过AMES疗法优化患者对运动的感知，关节的拮抗感觉和与大脑的运动连接之间的联系得到进一步加强，从而改善运动功能。目的1将确定优化运动过程中动觉放大的心理物理方法。两个实验将解决目标1:Exp.1将区分关节、肌肉和皮肤受体在动觉控制的手部运动中的作用；ex2将研究在精确的随意关节运动中，拮抗剂肌肉是否被共同激活，以及拮抗剂肌肉纺锤体的敏感性是否因此被梭形运动驱动增强。

The long-range goal of this project is to develop methods for enhancing motor function in patients with motor disabilities. Our approach to improving motor function has been to couple assisted movement with enhanced sensation (“AMES”), in which the patented AMES device assists the patient in moving an affected limb while at the same time it vibrates the lengthening tendons to enhance the patient’s sensation of the movement. In a Phase I clinical trial, AMES treatment of 22 low-functioning chronic stroke patients (14 upper and 14 lower extremities) resulted in improved strength, range of motion, and functional movement in about 70% of the patients. The current method of ‘enhancing sensation’ in AMES was a first approach – to vibrate the lengthening muscles at a constant 60 pulses per second. The objective of the proposed research is to intensify the patient’s perception of the assisted movement by optimizing the methods of sensory stimulation. The overall hypothesis is that, by optimizing the patient’s perception of movement with AMES therapy, connections between a joint’s antagonistic sensory and motor connections to the brain are further strengthened, leading to improved motor function. Aim 1 will identify psychophysical methods that optimize kinesthetic amplification during movement. Two experiments will address Aim 1: Exp.1 will differentiate among the contributions of joint, muscle, and skin receptors during a kinesthetically controlled hand movement; Exp.2 will investigate whether, during precise voluntary joint movement, antagonist muscles are co-activated and whether, as a consequence, the sensitivity of antagonist muscle spindles is enhanced by fusimotor drive.