Department of Human Performance, Division of Physical Therapy, School of Medicine West Virginia University, Morgantown, West Virginia.
Rockefeller Neuroscience Institute, Department of Neuroscience, West Virginia University, Morgantown, West Virginia.
J Neurophysiol. 2021 Aug 1;126(2):591-606. doi: 10.1152/jn.00149.2021. Epub 2021 Jun 30.
The whole repertoire of complex human motion is enabled by forces applied by our muscles and controlled by the nervous system. The impact of stroke on the complex multijoint motor control is difficult to quantify in a meaningful way that informs about the underlying deficit in the active motor control and intersegmental coordination. We tested whether poststroke deficit can be quantified with high sensitivity using motion capture and inverse modeling of a broad range of reaching movements. Our hypothesis is that muscle moments estimated based on active joint torques provide a more sensitive measure of poststroke motor deficits than joint angles. The motion of 22 participants was captured while performing reaching movements in a center-out task, presented in virtual reality. We used inverse dynamic analysis to derive active joint torques that were the result of muscle contractions, termed muscle torques, that caused the recorded multijoint motion. We then applied a novel analysis to separate the component of muscle torque related to gravity compensation from that related to intersegmental dynamics. Our results show that muscle torques characterize individual reaching movements with higher information content than joint angles do. Moreover, muscle torques enable distinguishing the individual motor deficits caused by aging or stroke from the typical differences in reaching between healthy individuals. Similar results were obtained using metrics derived from joint accelerations. This novel quantitative assessment method may be used in conjunction with home-based gaming motion capture technology for remote monitoring of motor deficits and inform the development of evidence-based robotic therapy interventions. Functional deficits seen in task performance have biomechanical underpinnings, seen only through the analysis of forces. Our study has shown that estimating muscle moments can quantify with high-sensitivity poststroke deficits in intersegmental coordination. An assessment developed based on this method could help quantify less observable deficits in mildly affected stroke patients. It may also bridge the gap between evidence from studies of constrained or robotically manipulated movements and research with functional and unconstrained movements.
人体运动的全部表现都是由肌肉施加的力和神经系统控制的。中风对复杂多关节运动控制的影响很难以有意义的方式量化,无法了解主动运动控制和节段间协调的潜在缺陷。我们测试了使用运动捕捉和广泛的伸手运动的逆模型是否可以高度敏感地量化中风后的缺陷。我们的假设是,基于主动关节转矩估计的肌肉力矩比关节角度提供了一种更敏感的中风后运动缺陷测量方法。在虚拟现实中呈现的中心外任务中,对 22 名参与者的运动进行了捕捉。我们使用逆动力学分析来推导出导致记录的多关节运动的肌肉收缩的主动关节转矩,称为肌肉转矩。然后,我们应用一种新的分析方法将与重力补偿相关的肌肉转矩分量与与节段间动力学相关的肌肉转矩分量分开。我们的结果表明,肌肉转矩比关节角度更能描述个体的伸手运动,具有更高的信息量。此外,肌肉转矩能够区分由衰老或中风引起的个体运动缺陷与健康个体之间典型的伸手差异。使用从关节加速度得出的指标也得到了类似的结果。这种新的定量评估方法可与基于家庭的游戏运动捕捉技术结合使用,用于远程监测运动缺陷,并为基于证据的机器人治疗干预措施的发展提供信息。在任务表现中看到的功能缺陷有其生物力学基础,只有通过对力的分析才能看到。我们的研究表明,估计肌肉力矩可以高度敏感地量化节段间协调的中风后缺陷。基于这种方法开发的评估方法可以帮助量化轻度中风患者中不易察觉的缺陷。它还可以弥合受约束或机器人操作运动研究与功能和不受约束运动研究之间的差距。