Reinkensmeyer David J, Maier Marc A, Guigon Emmanuel, Chan Vicky, Akoner O, Wolbrecht Eric T, Cramer Steven C, Bobrow James E
Department of Mechanical and Aerospace Engineering, University of California, Irvine, CA 92697, USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2009;2009:2439-41. doi: 10.1109/IEMBS.2009.5335353.
Different dose-matched, upper extremity rehabilitation training techniques, including robotic and non-robotic techniques, can result in similar improvement in movement ability after stroke, suggesting they may elicit a common drive for recovery. Here we report experimental results that support the hypothesis of a common drive, and develop a computational model of a putative neural mechanism for the common drive. We compared weekly motor control recovery during robotic and unassisted movement training techniques after chronic stroke (n = 27), as assessed with quantitative measures of strength, speed, and coordination. The results showed that recovery in both groups followed an exponential time course with a time constant of about 4-5 weeks. Despite the greater range and speed of movement practiced by the robot group, motor recovery was very similar between the groups. The premise of the computational model is that improvements in motor control are caused by improvements in the ability to activate spared portions of the damaged corticospinal system, as learned by a biologically plausible search algorithm. Robot-assisted and unassisted training would in theory equally drive this search process.
不同剂量匹配的上肢康复训练技术，包括机器人辅助和非机器人辅助技术，在中风后可使运动能力得到相似程度的改善，这表明它们可能引发了共同的恢复驱动机制。在此，我们报告了支持共同驱动假说的实验结果，并建立了一种关于共同驱动假定神经机制的计算模型。我们比较了慢性中风患者（n = 27）在机器人辅助运动训练技术和无辅助运动训练技术期间每周的运动控制恢复情况，通过力量、速度和协调性的定量测量进行评估。结果表明，两组的恢复均遵循指数时间进程，时间常数约为4 - 5周。尽管机器人组练习的运动范围和速度更大，但两组之间的运动恢复非常相似。该计算模型的前提是，运动控制的改善是由激活受损皮质脊髓系统备用部分的能力提高所导致的，这是通过一种生物学上合理的搜索算法学习到的。理论上，机器人辅助训练和无辅助训练将同样推动这一搜索过程。
