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首页> 美国卫生研究院文献>Journal of NeuroEngineering and Rehabilitation >Robotic quantification of upper extremity loss of independent joint control or flexion synergy in individuals with hemiparetic stroke: a review of paradigms addressing the effects of shoulder abduction loading
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Robotic quantification of upper extremity loss of independent joint control or flexion synergy in individuals with hemiparetic stroke: a review of paradigms addressing the effects of shoulder abduction loading

机译：偏瘫患者中独立关节控制或屈曲协同作用的上肢丧失的机器人量化：应对肩外展负重影响的范例的综述

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Unsupported or “against-gravity” reaching and hand opening movements are greatly impaired in individuals with hemiparetic stroke. The reduction in reaching excursion and hand opening is thought to be primarily limited by abnormal muscle co-activation of shoulder abductors with distal limb flexors, known as flexion synergy, that results in a loss of independent joint control or joint individuation. Our laboratory employs several methods for quantifying this movement impairment, however the most documented techniques are sophisticated and laboratory-based. Here a series of robotic methods that vary in complexity from comprehensive (laboratory-based) to focused (clinically relevant) are outlined in detail in order to facilitate translation and make recommendations for utilization across the translational spectrum as part of Journal of NeuroEngineering and Rehabilitation thematic series, “Technically-advanced assessments in sensory motor rehabilitation.” While these methods focus on our published work utilizing the device, ACT3D, these methods can be duplicated using any mechatronic device with the appropriate characteristics. The common thread and most important aspect of the methods described is addressing the deleterious effects of abduction loading. Distal upper extremity joint performance is directly and monotonically modulated by proximal (shoulder abduction) joint demands. The employment of robotic metrics is the best tool for selectively manipulating shoulder abduction task requirements spanning the individual’s full range of shoulder abduction strength. From the series of methods and the concluding recommendations, scientists and clinicians can determine the ideal robotic quantification method for the measurement of the impact of loss of independent joint control on reaching and hand function.
机译：偏瘫性中风患者的无支撑或“反重力”伸手动作会大大受损。人们认为，到达偏移和手张开的减少主要受到肩外展肌与远端四肢屈肌的异常肌肉共激活（称为屈曲协同作用）的限制，这导致失去独立的关节控制或关节个性。我们的实验室采用多种方法来量化这种运动障碍，但是，记录最丰富的技术是基于实验室的复杂技术。这里详细概述了一系列机器人方法，这些方法的复杂程度从全面的（基于实验室的）到重点的（临床相关的）不等，以方便翻译并提出建议，以作为《神经工程与康复杂志》主题的一部分在整个翻译领域中加以利用系列，“感觉运动康复的技术先进评估”。虽然这些方法专注于我们使用ACT 3D 设备发表的工作，但是可以使用任何具有适当特性的机电设备来复制这些方法。所述方法的共同点和最重要的方面是解决绑架负荷的有害影响。上肢远端关节的性能直接受近端（肩外展）关节要求的影响。机器人指标的使用是有选择地操纵跨肩绑架强度范围内的所有任务的最佳工具。通过一系列方法和结论建议，科学家和临床医生可以确定理想的机器人量化方法，用于测量独立关节控制丧失对伸手和手部功能的影响。

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