Sienko Kathleen H, Seidler Rachael D, Carender Wendy J, Goodworth Adam D, Whitney Susan L, Peterka Robert J
Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, United States.
Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States.
Front Neurol. 2018 Nov 12;9:944. doi: 10.3389/fneur.2018.00944. eCollection 2018.
Numerous studies have demonstrated the real-time use of visual, vibrotactile, auditory, and multimodal sensory augmentation technologies for reducing postural sway during static tasks and improving balance during dynamic tasks. The mechanism by which sensory augmentation information is processed and used by the CNS is not well understood. The dominant hypothesis, which has not been supported by rigorous experimental evidence, posits that observed reductions in postural sway are due to sensory reweighting: feedback of body motion provides the CNS with a correlate to the inputs from its intact sensory channels (e.g., vision, proprioception), so individuals receiving sensory augmentation learn to increasingly depend on these intact systems. Other possible mechanisms for observed postural sway reductions include: cognition (processing of sensory augmentation information is solely cognitive with no selective adjustment of sensory weights by the CNS), "sixth" sense (CNS interprets sensory augmentation information as a new and distinct sensory channel), context-specific adaptation (new sensorimotor program is developed through repeated interaction with the device and accessible only when the device is used), and combined volitional and non-volitional responses. This critical review summarizes the reported sensory augmentation findings spanning postural control models, clinical rehabilitation, laboratory-based real-time usage, and neuroimaging to critically evaluate each of the aforementioned mechanistic theories. Cognition and sensory re-weighting are identified as two mechanisms supported by the existing literature.
众多研究已经证明，视觉、振动触觉、听觉和多模态感官增强技术可实时用于减少静态任务期间的姿势晃动，并改善动态任务期间的平衡。中枢神经系统（CNS）处理和使用感官增强信息的机制尚未得到很好的理解。占主导地位的假设（尚未得到严格实验证据的支持）认为，观察到的姿势晃动减少是由于感官重新加权：身体运动的反馈为中枢神经系统提供了与其完整感官通道（如视觉、本体感觉）输入的相关性，因此接受感官增强的个体学会越来越依赖这些完整的系统。观察到的姿势晃动减少的其他可能机制包括：认知（感官增强信息的处理完全是认知性的，中枢神经系统没有对感官权重进行选择性调整）、“第六感”（中枢神经系统将感官增强信息解释为一个新的、独特的感官通道）、特定情境适应（通过与设备的反复交互开发新的感觉运动程序，并且仅在使用设备时才可用）以及意志和非意志反应的组合。这篇批判性综述总结了在姿势控制模型、临床康复、基于实验室的实时使用和神经成像方面报道的感官增强研究结果，以批判性地评估上述每一种机制理论。认知和感官重新加权被确定为现有文献支持的两种机制。
