Laboratory for Bionic Integration, Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH 44195, USA.
Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 East Boulevard 151 W/APT, Cleveland, OH 44106, USA.
Sci Robot. 2021 Sep 8;6(58):eabf3368. doi: 10.1126/scirobotics.abf3368. Epub 2021 Sep 1.
Bionic prostheses have restorative potential. However, the complex interplay between intuitive motor control, proprioception, and touch that represents the hallmark of human upper limb function has not been revealed. Here, we show that the neurorobotic fusion of touch, grip kinesthesia, and intuitive motor control promotes levels of behavioral performance that are stratified toward able-bodied function and away from standard-of-care prosthetic users. This was achieved through targeted motor and sensory reinnervation, a closed-loop neural-machine interface, coupled to a noninvasive robotic architecture. Adding touch to motor control improves the ability to reach intended target grasp forces, find target durometers among distractors, and promote prosthetic ownership. Touch, kinesthesia, and motor control restore balanced decision strategies when identifying target durometers and intrinsic visuomotor behaviors that reduce the need to watch the prosthetic hand during object interactions, which frees the eyes to look ahead to the next planned action. The combination of these three modalities also enhances error correction performance. We applied our unified theoretical, functional, and clinical analyses, enabling us to define the relative contributions of the sensory and motor modalities operating simultaneously in this neural-machine interface. This multiperspective framework provides the necessary evidence to show that bionic prostheses attain more human-like function with effective sensory-motor restoration.
仿生假肢具有恢复潜力。然而，代表人类上肢功能标志的直观运动控制、本体感觉和触觉之间的复杂相互作用尚未被揭示。在这里，我们展示了触觉、抓握运动觉和直观运动控制的神经机器人融合促进了行为表现水平的分层，朝着健全功能的方向发展，远离了标准的假肢使用者。这是通过有针对性的运动和感觉神经再支配、闭环神经机器接口以及与非侵入性机器人结构相结合来实现的。将触觉融入运动控制可以提高达到预期目标抓握力的能力、在干扰物中找到目标硬度计并促进假肢的拥有感。触觉、运动觉和运动控制在识别目标硬度计时恢复平衡的决策策略，并减少在物体交互过程中观看假肢手的需要，从而将眼睛解放出来，以便提前看到下一个计划的动作。这三种模式的结合也提高了错误纠正性能。我们应用了我们的统一的理论、功能和临床分析，使我们能够定义在这个神经机器接口中同时运行的感觉和运动模式的相对贡献。这个多角度框架提供了必要的证据，表明仿生假肢通过有效的感觉-运动恢复实现了更接近人类的功能。
