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.

项目摘要 在下肢截肢（LLA）的个体中，跌倒和对跌倒的恐惧无处不在 全国人口不断增长。 LLA患者跌倒的事件经常在 需要调整姿势的活动。转移（例如，坐姿）和涉及动态平衡的活动 对照（例如，到达和转弯）导致血管性静止截肢术中的许多跌落。这个证据 强调迫切需要解决平衡和姿势稳定性，以实现日常生活的有效活动 患有LLA的人。 当前的假体技术不允许截肢用户应用典型的姿势控制策略 假体关节，限制姿势稳定性并引起其他健康问题。相反，截肢者经常 使用残留（未吸引）关节和完整的肢体来制定补偿性策略，以控制平衡。这 下肢的主动自由度（例如踝关节和/或膝盖）的丧失显着限制了生物力学 可用于姿势控制的资源。 假体和神经接口技术的最新进步可能会解决需要解决的需求 LLA患者的平衡和姿势稳定性提高；但是，相关研究强调 高效舒适的步行，而不是平衡和姿势控制。作为平衡和姿势控制 基础几乎所有以直立位置进行的活动，使用假体技术直接解决 高度截肢者的平衡稳定性非常需要，但很少在我们的领域进行调查。 该提案的目的是研究使用直接肌电图（DEMG）的训练的影响 控制跨态截肢者（AIM 1）平衡和姿势稳定性的动力假肢脚踝（AIM 2） 与每日规定的被动相比，神经肌肉控制和协调，以及（目标3）认知过程 设备。 该项目具有明显的临床意义，因为它解决了改善平衡和姿势的临床需求 LLA患者的稳定性。使用DEMG控制的动力假肢为用户提供了其他 协助平衡稳定并提高平衡信心的资源，这反过来改善了他们的 社区参与和生活质量。同时，拟议的项目有望做出贡献 对假体技术领域的重要知识，对运动领域做出科学贡献 控制与学习，生物力学和认知运动互动，并受益于物理疗法和截肢者 康复。