Multi-Joint Sensorimotor Dysfunction of the Stroke Arm

中风臂的多关节感觉运动功能障碍

• 批准号: 7234402
• 负责人: BRIAN D SCHMIT
• 金额: $ 27.43万
• 依托单位: MARQUETTE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7234402
• 关键词: Address; Anesthesia procedures; Articular Range of Motion; Clinical Treatment; Coupling; Distal; Distant; Elbow; Elbow joint structure; Electric Stimulation; Feedback; Fingers; Functional disorder; Hand; Individual; Joints; Lead; Limb structure; Modification; Motion; Motor; Movement; Muscle; Neuromuscular Diseases; Pathway interactions; Positioning Attribute; Posture; Property; Purpose; Range of motion exercise; Reflex action; Rehabilitation therapy; Research; Research Personnel; Sensory; Shoulder; Signal Transduction; Site; Source; Spastic; Stereotyping; Stimulus; Stretching; Stroke; System; Tendon structure; Testing; Torque; Upper Extremity; Upper arm; Wrist; chronic stroke; grasp; improved; improved functioning; motor control; neuroregulation; new technology; novel strategies; post stroke; programs; rehabilitation strategy; response; sensor; sensory feedback; stretch reflex; vibration; volunteer

The purpose of this research partnership is to investigate the functional implications of using sensor feedback to enhance motor control of the arm post-stroke. Two key functional aspects of motor control of the arm will be examined: 1) Reach, which involves coordinated actions of the shoulder and elbow musculature and 2) grasp, which incorporates both finger position and force controls. For each system, we will demonstrate that sensory feedback from nonhomologous joints has a significant effect on motor control. Initially, we will examine the intralimb reflex coupling of wrist/hand sensory feedback on elbow and shoulder musculature and visa versa. For Aim 1 of this study, we will show that motorized stretch of the elbow and fingers produces reflex activity in muscles that are not perturbed. These effects will be compared between post-stroke and neurologically intact individuals using tendon tap perturbations. Sensory manipulations consisting of posture electrical stimulation, vibration and anesthesia will be used to modify the heteronymous reflex responses. Having demonstrated reflex coupling across joints, we will then examine the effects that this reflex coupling may have on motor function. In Aim 2, motor control tasks of the upper arm (e.g. reach) will be tested during sensory manipulations of the fingers and wrist. Similarly, motor tasks of the hand will be tested with modifications of sensory inputs to the elbow and shoulder. These studies will demonstrate that sensory signals from nonhomologous joints can substantialy enhance motor function. The results of this study will suggest a new type of approach for rehabilitation of arm function post-stroke. We postulate that substantial improvements in arm function can be achieved by developing new technologies that provide artificial sensory feedback. In addition, conventional therapies may be applied more efficiently or effectively using the principles that will be demonstrated by this study.

这项研究合作伙伴关系的目的是研究使用传感器反馈来增强手臂冲程后的功能含义。将检查臂的运动控制的两个关键功能方面：1）触及，涉及肩膀和肘部肌肉的协调作用以及2）抓握，其中均包含手指位置和力控制。对于每个系统，我们将证明来自非同源关节的感觉反馈对运动控制有重大影响。最初，我们将检查腕部和肩部肌肉的手腕/手感觉反馈的内部反射耦合，反之亦然。对于本研究的AIM 1，我们将表明肘部和手指的电动拉伸会在不受干扰的肌肉中产生反射活性。使用肌腱TAP扰动，将比较中风后和神经系统完整的个体之间的这些效果。包括姿势电刺激，振动和麻醉的感觉操作将用于修改异义反射反应。在跨关节进行反射耦合后，我们将检查这种反射耦合可能对运动功能具有的影响。在AIM 2中，将在手指和手腕的感觉操纵期间测试上臂的运动控制任务（例如触及到范围）。同样，将通过对肘部和肩膀的感觉输入进行修改测试手的运动任务。这些研究将表明，来自非同源关节的感觉信号可以显着增强运动功能。 这项研究的结果将提出一种新型的恢复手臂功能方法的方法。我们假设，通过开发提供人工感觉反馈的新技术可以实现ARM功能的实质性改进。此外，使用本研究将证明的原理可以更有效地或有效地应用常规疗法。