Toward Restoration of Normative Postural Control and Stability using Neural Control of Powered Prosthetic Ankles

使用动力假肢踝关节的神经控制恢复规范的姿势控制和稳定性

• 批准号: 10745442
• 负责人: He Huang
• 金额: $ 62.3万
• 依托单位: NORTH CAROLINA STATE UNIVERSITY RALEIGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-07 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10745442
• 关键词: Activities of Daily Living; Address; Amputees; Ankle; Biological; Biomechanics; Clinical; Cognitive; Community Participation; Devices; Effectiveness; Electromyography; Equilibrium; Freedom; Future; Goals; Health; Incidence; Individual; Joint Prosthesis; Joints; Knee; Knowledge; Lead; Limb Prosthesis; Limb structure; Locomotion; Lower Extremity; Mechanics; Mission; Motor; Muscle; Musculoskeletal Equilibrium; Neuromechanics; Outcome; Participant; Pattern; Periodicity; Physical therapy; Population; Positioning Attribute; Posture; Production; Prosthesis; Public Health; Quality of life; Randomized, Controlled Trials; Rehabilitation therapy; Reporting; Research; Residual state; Resources; Risk Reduction; Robotics; Single-Blind Study; Structure; Technology; Time; Training; United States National Institutes of Health; Walking; active lifestyle; ankle prosthesis; clinically significant; cognitive load; cognitive process; design; fall risk; falls; fear of falling; improved; innovation; limb amputation; motor control; motor function improvement; motor learning; neural; neural prosthesis; neuromuscular; neuroregulation; neurotransmission; novel; operation; powered prosthesis; prevent; programs; prosthesis control; restoration; success

PROJECT SUMMARY Falling and fear of falling are pervasive amongst individuals with lower limb amputation (LLA), a large and growing population in the nation. The incidence of falls in individuals with LLA has been often reported during activities requiring adjustments in posture. Transfers (e.g., sit-to-stand) and activities involving dynamic balance control (e.g., reaching and turning) lead to many of the falls in dysvascular transtibial amputees. This evidence highlights the urgent need to address balance and postural stability to enable effective activities of daily living for individuals with LLA. Current prosthesis technology does not allow the amputee users to apply typical postural control strategies at prosthetic joints, limiting postural stability and yielding additional health concerns. Instead, amputees often develop compensatory strategies with the residual (unamputated) joints and intact limb to control balance. The loss of active degrees of freedom (e.g., ankle and/or knee) in the lower limb significantly limits the biomechanical resources available for postural control. Recent advancements in prosthesis and neural interfacing technologies potentially can address the need for improved balance and postural stability in individuals with LLA; however, the related research emphasizes efficient and comfortable walking, rather than balance and postural control. As balance and postural control underly almost all activities performed in an upright position, using prosthesis technologies to directly address the balance stability of amputees is highly needed but rarely investigated in our field. The objective of this proposal is to investigate the effects of training to use direct electromyographic (dEMG) control of a powered prosthetic ankle on transtibial amputees’ (Aim 1) balance and postural stability, (Aim 2) neuromuscular control and coordination, and (Aim 3) cognitive processes, compared to daily prescribed passive devices. This project has clear clinical significance since it addresses the clinical need for improved balance and postural stability in individuals with LLA. Use of dEMG-controlled powered prostheses provides users with additional resources to assist with balance stability and improve balance confidence, which, in turn, improves their community participation and quality of life. At the same time, the proposed project is expected to contribute important knowledge to the field of prosthesis technology, make scientific contributions to the fields of motor control and learning, biomechanics, and cognitive-motor interaction, and benefit physical therapy and amputee rehabilitation.

项目概要 跌倒和对跌倒的恐惧在下肢截肢 (LLA) 患者中普遍存在，下肢截肢是一种大而常见的疾病。 全国人口不断增长期间，经常有 LLA 患者跌倒的报道。 需要调整姿势的活动（例如从坐到站）和涉及动态平衡的活动。 控制（例如，伸手和转身）导致许多血管障碍性胫骨截肢者跌倒。 强调迫切需要解决平衡和姿势稳定性问题，以实现有效的日常生活活动 患有 LLA 的个人。 当前的假肢技术不允许截肢者在以下情况下应用典型的姿势控制策略： 假肢关节，限制了姿势稳定性并产生额外的健康问题。 制定利用残余（未截肢）关节和完整肢体的补偿策略来控制平衡。 下肢主动自由度（例如踝关节和/或膝关节）的丧失显着限制了生物力学 可用于姿势控制的资源。 假肢和神经接口技术的最新进展可能可以满足以下需求： 然而，相关研究强调，LLA 患者的平衡和姿势稳定性得到改善； 作为高效舒适的行走平衡和姿势控制，而不是平衡和姿势控制。 在几乎所有以直立姿势进行的活动的基础上，使用假肢技术直接解决 截肢者的平衡稳定性是非常需要的，但在我们的领域很少进行研究。 该提案的目的是调查使用直接肌电图 (dEMG) 进行训练的效果 动力假肢踝关节对小腿截肢者（目标 1）平衡和姿势稳定性的控制，（目标 2） 与每日规定的被动治疗相比，神经肌肉控制和协调以及（目标 3）认知过程 设备。 该项目具有明确的临床意义，因为它解决了改善平衡和姿势的临床需求 使用 dEMG 控制的动力假肢为 LLA 患者提供了额外的稳定性。 帮助平衡稳定性和提高平衡信心的资源，从而提高他们 同时，拟议项目预计将有助于社区参与和生活质量。 掌握假肢技术领域的重要知识，为运动领域做出科学贡献 控制和学习、生物力学和认知运动相互作用，并有益于物理治疗和截肢者 康复。