Vermillion Billy C, Heidner Gustavo Sandri
Annu Int Conf IEEE Eng Med Biol Soc. 2017 Jul;2017:1138-1141. doi: 10.1109/EMBC.2017.8037030.
Significant impairment in hand function is found prevalent among stroke survivors, but its effective restoration is challenging due to the complexity of the functional tasks of the hand. In this study, we proposed a novel approach to improve functionality of the hand post-stroke by providing subject-specific' patterns of targeted assistance to impaired musculotendon of the hand during functional task performance. Eleven chronic stroke survivors participated in the experiment in which a biomimetic device provided targeted assistance to the impaired hand musculotendons. The proposed subject-specific approach was found to restore proper mechanics of two functional tasks, hand open and palmar pinch, as quantified by the joint kinematics and fingertip force direction. The range of motion and joint coordination was improved for the hand open task, and the fingertip force was directed towards normal direction by the targeted assistance of impaired muscles. The assistance pattern was significantly different across subjects, indicating significant between-subject variability in the impairment characteristics that affect task performance. The proposed method could enable an effective subject-specific' training method that restores proper mechanics of functional hand tasks for stroke survivors.
手部功能的显著受损在中风幸存者中很常见,但由于手部功能任务的复杂性,其有效恢复具有挑战性。在本研究中,我们提出了一种新方法,通过在功能任务执行期间为手部受损的肌腱提供“特定于个体”的靶向辅助模式,来改善中风后手的功能。11名慢性中风幸存者参与了实验,实验中一个仿生装置为受损的手部肌腱提供靶向辅助。通过关节运动学和指尖力方向量化发现,所提出的特定于个体的方法恢复了两项功能任务(手张开和掌侧捏取)的正常力学机制。对于手张开任务,运动范围和关节协调性得到改善,并且通过对受损肌肉的靶向辅助,指尖力指向正常方向。不同受试者之间的辅助模式有显著差异,表明影响任务表现的损伤特征存在显著的个体间变异性。所提出的方法能够实现一种有效的“特定于个体”的训练方法,为中风幸存者恢复手部功能任务的正常力学机制。