Restoring upper limb movement sense to amputees; a move towards natural control o

使截肢者恢复上肢运动感觉；

基本信息

批准号：
8412370
负责人：
Paul D. Marasco
金额：
$ 32.7万
依托单位：
CLEVELAND VA MEDICAL RESEARCH/ED/FDN
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-27 至 2013-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8412370
关键词：
Achievement Address Amputation Amputees Artificial Arm Back Biological Brain Caring Clinical Cognitive Cutaneous Data Devices Elbow Engineering Esthesia Eye Feedback Generations Goals Hand Human Illusions Individual Investigation Investments Joint Prosthesis Joints Kinesthesis Kinesthetic Illusions Limb Development Limb Prosthesis Limb structure Link Location Maps Measures Methods Modeling Motion Motor Movement Muscle Muscle Spindles Nerve Nervous system structure Operative Surgical Procedures Perception Peripheral Peripheral Nerves Play Population Positioning Attribute Process Proprioception Prosthesis Psychophysiology Public Health Research Robot Robotics Role Sensory Sensory Receptors Skin Solutions Structure System Technology Testing Time Tissues Touch sensation Translating United States National Institutes of Health Upper Extremity Upper limb movement Vision Visual Visual attention Work Wrist arm brain machine interface clinical application design innovation insight limb movement motor control novel pressure prevent receptor reinnervation relating to nervous system research study restoration restraint robotic device sensory feedback sensory integration standard of care tool vibration visual tracking

项目摘要

DESCRIPTION (provided by applicant): In recent years there has been a substantial investment in research to create dexterous, multi- functional, prosthetic limbs for restoration of upper limb function following amputation. The focus on prosthetic limb development has, has in many ways, been fueled by advances in clinically operational motor neural- machine-interfaces; such as Targeted Reinnervation, the surgical redirection of amputated nerves for motor control of multifunction limbs, and other brain and peripheral neural-machine-interfaces on the near horizon. Although these motor interfaces provide considerable advantage to the control of the new prosthetic limbs, which are wonders of modern engineering, a fundamental problem still remains. Without natural and intuitive sensory feedback artificial limbs are still just insensate tools. Proprioception is the basic ability to sense where your arm is in space without looking. Amputees lack this sensory feedback, and this is the fundamental challenge in the implementation of advanced prosthetic limbs. Vision confirmation is needed for an amputee to use a prosthesis; from the most basic device to the most advanced. This is the key issue that we seek to address with our research objectives. We propose to attack the problem of prosthetic limbs that lack kinesthetic feedback in 3 Aims focused on developing and implementing approaches to harness and utilize a cognitive illusion of limb movement in human amputees with targeted sensory reinnervation. This research is important to the NIH scientific enterprise because it is highly translational and results directly impact amputee care. We hypothesize that we can stimulate the appropriate sensory receptors in the reinnervated tissue of targeted reinnervation amputees to generate the "kinesthetic illusion" and provide a sense of physiologically relevant limb movement for prosthetic limbs. Aim 1) We will use vibration and pressure to selectively activate the illusion and look at how targeted reinnervation amputees perceive this kinesthetic input. Aim 2) We will develop a small wearable robotic interface to selectively activate the kinesthetic receptors and assign sensations of limb movement to a prosthesis. With this we will look at how the subject interprets joint angle from a neutrally connected but physically unattached prosthesis. We will evaluate limb function with psychophysical examination of internal dynamic models related to constant velocity movements. We will also evaluate function using eye tracking and motion capture to track visual loading during prosthesis use. Aim 3) The prosthetic socket is the physical junction between the prosthesis and the amputee. This junction will need to evolve to reflect implementation restraints of the robot interface. To address this we will develop new socket designs to provide a limb movement feedback system with clinical applicability. PUBLIC HEALTH RELEVANCE: This research is relevant to public health because it is highly translational and the results will likely directly impact standard of care for amputees. As of 2011 there were 770,000 traumatic upper limb amputees in the US; a population that is young and active and will benefit substantially from more functional artificial arms that are neutrally integrated and provide a physiologically relevant sense of limb movement. Furthermore, our lines of investigation into neural interfaces and cognitive mechanisms of sensory feedback could provide far reaching scientific insight into challenges arising from sensory integration issues in many different fields.

描述（由申请人提供）：近年来，在截肢后恢复上肢功能的灵巧，多功能，假肢的研究已经进行了大量投资。在许多方面，人们对肢体肢体发育的关注受到了临床操作运动神经插头的进步的推动。例如靶向增强，截肢神经的手术重定向多功能肢体的运动控制，以及近乎地平线上的其他大脑和周围神经机器间间隙。尽管这些运动界面为新的假肢的控制提供了可观的优势，这些四肢是现代工程的奇迹，但仍然存在一个基本问题。没有天然和直观的感觉反馈，人工四肢仍然只是无意义的工具。本体感受是感知手臂在太空中的位置而不看的基本能力。 amputees缺乏这种感觉反馈，这是实施高级假肢的基本挑战。需要截肢者使用假体的视力确认；从最基本的设备到最高级的设备。这是我们寻求解决研究目标的关键问题。我们建议攻击三种缺乏动感反馈的假肢问题的问题，目的是开发和实施线束和实施方法的方法，并利用人类肢体运动的认知幻觉，并具有针对性的感官增强作用。这项研究对NIH科学企业很重要，因为它具有高度的转化，并且结果直接影响了截肢者的护理。我们假设我们可以刺激靶向重新支配截肢者重新启发的组织中适当的感觉受体，以产生“动力学幻觉”，并为假肢上的生理相关的肢体运动提供一种感知。目的1）我们将使用振动和压力有选择地激活幻觉，并查看靶向增强截肢者如何感知这种动力学输入。目的2）我们将开发一个小的可穿戴机器人界面，以选择性地激活动觉受体，并将肢体运动的感觉分配给假体。这样一来，我们将研究主题如何从中性连接但身体上未附加的假体中解释关节角度。我们将通过心理物理检查与恒定速度运动有关的内部动态模型来评估肢体功能。我们还将使用眼科跟踪和运动捕获来评估功能，以跟踪使用假体期间的视觉负载。目标3）假体是假体和截肢者之间的物理结。该交界处将需要发展以反映机器人接口的实现约束。为了解决这个问题，我们将开发新的插座设计，以提供临床适用性的肢体运动反馈系统。公共卫生相关性：这项研究与公共卫生有关，因为它是高度转化的，结果可能会直接影响截肢者的护理标准。截至2011年美国有770,000个创伤性上肢截肢者；年轻而活跃的人群将从中立整合并提供生理上相关的肢体运动感中受益匪浅。此外，我们对感官反馈的神经界面和认知机制的调查可能会为许多不同领域的感觉整合问题引起的挑战提供遥远的科学见解。