肩外展负荷影响慢性卒中患者的运动协调，为有针对性的康复提供信息
Shoulder abduction loading affects motor coordination in individuals with chronic stroke, informing targeted rehabilitation
摘要：
中风后个体经历运动障碍，例如丧失独立关节控制，导致手臂功能的整体降低。他们的动作变得更慢，更不协调，很难完成对时间敏感的任务，比如平衡一杯水或端着一个碗，碗里有一个球。了解中风引起的运动障碍如何相互作用，可以帮助设计辅助训练方案，以改善恢复。在这项研究中，我们调查的影响异常关节耦合模式引起的屈曲协同对时间敏感的运动协调麻痹上肢。我们设计了一个虚拟的球在碗中的任务，需要快速运动的最佳性能和实现它的机器人系统，能够提供不同程度的外展负荷在肩膀上。我们招募了12名参与者（6名慢性中风患者和6名未受损的对照组），并在3个负荷水平下评估他们的任务技能，由机器人末端执行器施加的垂直力定义。我们的研究结果表明，对于中风患者，负荷对他们产生快速协调运动的能力有显着影响。随着负载的增加，他们的整体任务性能下降，他们是不太能够补偿球动力学-他们的运动频率分析表明，外展负载削弱了他们的能力，以产生动态任务的共振频率的运动。这种效应可能是由于中风后个体对低分辨率间接运动通路的依赖增加。考虑到负荷和动态任务表现的相互依赖性，我们可以创建有针对性的机器人辅助训练方案，专注于改善时间敏感的运动控制，类似于现有的渐进式负荷疗法，这些疗法已显示出扩大中风后可达工作空间的功效。
英文摘要：
Individuals post stroke experience motor impairments, such as loss of independent joint control, leading to an overall reduction in arm function. Their motion becomes slower and more discoordinated, making it difficult to complete timing-sensitive tasks, such as balancing a glass of water or carrying a bowl with a ball inside it. Understanding how the stroke-induced motor impairments interact with each other can help design assisted training regimens for improved recovery. In this study, we investigate the effects of abnormal joint coupling patterns induced by flexion synergy on timing-sensitive motor coordination in the paretic upper limb. We design a virtual ball-in-bowl task that requires fast movements for optimal performance and implement it on a robotic system, capable of providing varying levels of abduction loading at the shoulder. We recruit 12 participants (6 individuals with chronic stroke and 6 unimpaired controls) and assess their skill at the task at 3 levels of loading, defined by the vertical force applied at the robot end-effector. Our results show that, for individuals with stroke, loading has a significant effect on their ability to generate quick coordinated motion. With increases in loading, their overall task performance decreases and they are less able to compensate for ball dynamics---frequency analysis of their motion indicates that abduction loading weakens their ability to generate movements at the resonant frequency of the dynamic task. This effect is likely due to an increased reliance on lower resolution indirect motor pathways in individuals post stroke. Given the inter-dependency of loading and dynamic task performance, we can create targeted robot-aided training protocols focused on improving timing-sensitive motor control, similar to existing progressive loading therapies, which have shown efficacy for expanding reachable workspace post stroke.
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