Exploiting Selective Recruitment to Prolong Standing after SCI

利用选择性招募来延长 SCI 后的资格

• 批准号: 9525331
• 负责人: RONALD J TRIOLO
• 金额: --
• 依托单位: LOUIS STOKES CLEVELAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2018-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9525331
• 关键词: Animal Model; Animals; Biomechanics; Chronic; Clinical; Clinical assessments; Devices; Discontinuous Capillary; Electrodes; Ensure; Equilibrium; Evaluation; Extensor; Fatigue; Fiber; Frequencies; Generations; Goals; Hand; Hip region structure; Human; Human Volunteers; Implant; Individual; Joints; Knee; Lower Extremity; Manuals; Methodology; Methods; Muscle; Muscle Fibers; Nerve; Outcome; Output; Paralysed; Performance; Peripheral Nerves; Phase; Physiologic pulse; Population; Process; Production; Property; Recruitment Activity; Reporting; Scheme; Series; Shapes; Spinal cord injury; Stimulus; Sum; System; Technology; Testing; Time; Training; base; clinical application; design; exhaustion; femoral nerve; functional outcomes; human subject; implantation; improved; innovation; neurophysiology; neuroprosthesis; novel; novel strategies; operation; relating to nervous system; research clinical testing; response; translational study

DESCRIPTION (provided by applicant): The goal of this project is to integrate several demonstrated technologies for restoring lower limb function after paralysis from spinal cord injury (SCI), and examine novel stimulation schemes designed to minimize fatigue of the knee extensor musculature during standing. All existing stimulation systems for standing after SCI rely on continuous activation of the knee extensors, which results in rapid fatigue that limits their functionality and clinical utility. The primary objective of this translational study is to improve the performance of neuroprostheses for standing by developing and implementing advanced stimulation paradigms that exploit the selectivity of multi- contact peripheral nerve electrodes to prolong standing duration. Strategie for exploiting the selective activation of multiple synergistic muscle fiber populations include alternating between independent groups to reduce stimulus duty cycle, interleaving stimulus pulses to reduce local stimulus frequency, and a previously unexplored paradigm in which the oscillations of sinusoidal forces generated by each population produce a constant net output that exceeds any individual contribution. There has yet to be a successful critical evaluation of any of these methods chronically in humans, which still require rigorous bench testing. Stable and selective peripheral nerve interfaces (multi-contact spiral cuff electrodes) have recently become available for chronic human implantation and will enable the clinical assessment of advanced stimulation paradigms in individuals with SCI. We will implement each paradigm in recipients of implanted standing neuroprostheses and determine their relative benefits in terms of knee extension moment, endurance, robustness and elapsed standing duration. The numerous parameters that need to be adjusted for each muscle fiber population are currently selected ad hoc in a time consuming trial-and-error process. We will perform a series of chronic animal studies to develop and test automated methods for tuning each stimulation paradigm and selecting optimal parameters to maximize performance and generalize them to other neural interface technologies. The resulting tuning and optimization methods resulting from these studies will be verified clinically with users of a variety of implanted neuroprostheses, and will ultimately be suitable for transfer to other clinical applications.

描述（由申请人提供）： 该项目的目的是整合脊髓损伤（SCI）麻痹后恢复下肢功能的几种证明的技术，并检查旨在最大程度地减少站立膝盖伸肌肌肉疲劳的新型刺激方案。 SCI之后的所有现有刺激系统都依赖于膝关节伸肌的连续激活，从而导致迅速疲劳，从而限制了其功能性和临床实用性。这 这项翻译研究的主要目的是通过开发和实施高级刺激范式来提高神经ph虫的表现，从而利用多接触外周神经电极的选择性来延长站立持续时间。 用于利用多种协同肌肉纤维种群选择性激活的策略包括在独立组之间交替以减少刺激占空比，从而相互交流刺激脉冲以降低局部刺激频率，并且先前未开发的范式，其中由每个人群产生的正弦力的振荡产生了恒定的网络输出产生任何个人贡献。 在人类中，尚未成功对任何这些方法进行成功​​的批判性评估，这仍然需要严格的基准测试。稳定和选择性的外围神经界面（多接触式螺旋袖电极）最近已用于慢性人植入，并将能够对SCI患者的晚期刺激范式进行临床评估。我们将在植入的站立神经植物的接受者中实施每个范式，并在膝盖伸展力矩，耐力，健壮性和经过的站立持续时间方面确定其相对好处。目前，在耗时的试验过程中，目前选择了需要针对每个肌肉纤维人群进行调整的众多参数。 我们将进行一系列慢性动物研究，以开发和测试自动化方法，以调整每个刺激范式并选择最佳参数，以最大程度地提高性能并将其推广到其他神经界面技术。 这些研究产生的调整和优化方法将通过各种植入神经植物的使用者进行临床验证，并最终适合转移到其他临床应用中。