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触觉反馈是一种在中低力度水平下训练使用假肢抓握的有效手段。

Tactile feedback is an effective instrument for the training of grasping with a prosthesis at low- and medium-force levels.

作者信息

De Nunzio Alessandro Marco, Dosen Strahinja, Lemling Sabrina, Markovic Marko, Schweisfurth Meike Annika, Ge Nan, Graimann Bernhard, Falla Deborah, Farina Dario

机构信息

Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.

Neurorehabilitation Systems Research Group, Clinics for Trauma, Orthopaedic and Plastic Surgery, University Medical Center Goettingen, Georg-August University, Von-Siebold-Str. 3, 37075, Goettingen, Germany.

出版信息

Exp Brain Res. 2017 Aug;235(8):2547-2559. doi: 10.1007/s00221-017-4991-7. Epub 2017 May 26.

Abstract

Grasping is a complex task routinely performed in an anticipatory (feedforward) manner, where sensory feedback is responsible for learning and updating the internal model of grasp dynamics. This study aims at evaluating whether providing a proportional tactile force feedback during the myoelectric control of a prosthesis facilitates learning a stable internal model of the prosthesis force control. Ten able-bodied subjects controlled a sensorized myoelectric prosthesis performing four blocks of consecutive grasps at three levels of target force (30, 50, and 70%), repeatedly closing the fully opened hand. In the first and third block, the subjects received tactile and visual feedback, respectively, while during the second and fourth block, the feedback was removed. The subjects also performed an additional block with no feedback 1 day after the training (Retest). The median and interquartile range of the generated forces was computed to assess the accuracy and precision of force control. The results demonstrated that the feedback was indeed an effective instrument for the training of prosthesis control. After the training, the subjects were still able to accurately generate the desired force for the low and medium target (30 and 50% of maximum force available in a prosthesis), despite the feedback being removed within the session and during the retest (low target force). However, the training was substantially less successful for high forces (70% of prosthesis maximum force), where subjects exhibited a substantial loss of accuracy as soon as the feedback was removed. The precision of control decreased with higher forces and it was consistent across conditions, determined by an intrinsic variability of repeated myoelectric grasping. This study demonstrated that the subject could rely on the tactile feedback to adjust the motor command to the prosthesis across trials. The subjects adjusted the mean level of muscle activation (accuracy), whereas the precision could not be modulated as it depends on the intrinsic myoelectric variability. They were also able to maintain the feedforward command even after the feedback was removed, demonstrating thereby a stable learning, but the retention depended on the level of the target force. This is an important insight into the role of feedback as an instrument for learning of anticipatory prosthesis force control.

摘要

抓握是一项复杂的任务,通常以预期(前馈)方式执行,其中感觉反馈负责学习和更新抓握动力学的内部模型。本研究旨在评估在假肢的肌电控制过程中提供成比例的触觉力反馈是否有助于学习假肢力控制的稳定内部模型。十名身体健全的受试者控制一个装有传感器的肌电假肢,在三个目标力水平(30%、50%和70%)下连续进行四组抓握,反复闭合完全张开的手。在第一组和第三组中,受试者分别接受触觉和视觉反馈,而在第二组和第四组中,反馈被去除。训练后1天,受试者还进行了一组无反馈的额外测试(重新测试)。计算所产生力的中位数和四分位间距,以评估力控制的准确性和精确性。结果表明,反馈确实是训练假肢控制的有效手段。训练后,尽管在测试过程中和重新测试(低目标力)期间反馈被去除,但受试者仍能够准确地为低和中等目标(假肢可用最大力的30%和50%)产生所需的力。然而,对于高力(假肢最大力的70%),训练的成功率要低得多,一旦反馈被去除,受试者就会出现明显的准确性下降。控制的精确性随着力的增加而降低,并且在不同条件下是一致的,这是由重复肌电抓握的内在变异性决定的。本研究表明,受试者可以依靠触觉反馈在不同试验中调整对假肢的运动指令。受试者调整了肌肉激活的平均水平(准确性),而精确性无法调节,因为它取决于内在的肌电变异性。即使在反馈被去除后,他们也能够维持前馈指令,从而证明了稳定的学习,但记忆依赖于目标力的水平。这为反馈作为预期假肢力控制学习工具的作用提供了重要见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19dc/5502062/f655d10130b6/221_2017_4991_Fig1_HTML.jpg

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