Cusack William F, Thach Scott, Patterson Rebecca, Acker Dan, Kistenberg Robert S, Wheaton Lewis A
Georgia Institute of Technology, Atlanta, GA, USA.
Georgia Institute of Technology, Atlanta, GA, USA
Neurorehabil Neural Repair. 2016 Jul;30(6):573-82. doi: 10.1177/1545968315606992. Epub 2015 Oct 5.
Background Previous studies have demonstrated improved neurobehavioral outcomes when prosthesis users learn task-specific behaviors by imitating movements of prosthesis users (matched limb) compared with intact limbs (mismatched limb). Objective This study is the first to use a unique combination of neurophysiological and task performance methods to investigate prosthetic device training strategies from a cognitive motor control perspective. Intact nonamputated prosthesis users (NAPUs) donned specially adapted prosthetic devices to simulate the wrist and forearm movement that persons with transradial limb loss experience. The hypothesis is that NAPUs trained with matched limb imitation would show greater engagement of parietofrontal regions and reduced movement variability compared with their counterparts trained with a mismatched limb. Methods Training elapsed over 3 days comprised alternating periods of video demonstration observation followed by action imitation. At the beginning and end of the training protocol, participants performed a cued movement paradigm while electroencephalography and electrogoniometry data were collected to track changes in cortical activity and movement variability, respectively. Results Matched limb participants showed greater engagement of motor-related areas while mismatched limb participants showed greater engagement of the parietooccipital system. Matched limb participants also showed lower movement variability. Conclusions These results indicate that the type of limb imitated influences neural and behavioral strategies for novel prosthetic device usage. This finding is important, as customary prosthetic rehabilitation with intact therapists involves mismatched limb imitation that may exacerbate challenges in adapting to new motor patterns demanded by prosthesis use.
背景 先前的研究表明，与健全肢体（不匹配肢体）相比，假肢使用者通过模仿假肢使用者（匹配肢体）的动作来学习特定任务行为时，神经行为结果会得到改善。目的 本研究首次使用神经生理学和任务表现方法的独特组合，从认知运动控制的角度研究假肢设备训练策略。健全的非截肢假肢使用者（NAPUs）佩戴经过特殊改装的假肢设备，以模拟经桡骨截肢者所经历的手腕和前臂运动。假设是，与接受不匹配肢体训练的同伴相比，接受匹配肢体模仿训练的NAPUs将表现出顶叶额叶区域更大的参与度和更低的运动变异性。方法 训练持续3天，包括交替进行视频示范观察期和动作模仿期。在训练方案开始和结束时，参与者执行提示运动范式，同时收集脑电图和角度测量数据，分别跟踪皮层活动和运动变异性的变化。结果 匹配肢体组参与者显示出与运动相关区域更大的参与度，而不匹配肢体组参与者显示出顶枕系统更大的参与度。匹配肢体组参与者的运动变异性也更低。结论 这些结果表明，所模仿肢体的类型会影响新型假肢设备使用的神经和行为策略。这一发现很重要，因为由健全治疗师进行习惯性假肢康复涉及不匹配肢体模仿，这可能会加剧适应假肢使用所需新运动模式的挑战。
