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Biomedical subjects

David J Reinkensmeyer

Publications and source records attributed to David J Reinkensmeyer.

At least 19 recordsLinked to original sources

Motor adaptation to a small force field superimposed on a large background force.

The human motor system adapts to novel force field perturbations during reaching by forming an internal model of the external dynamics and by modulating arm impedance. We studied whether it uses similar strategies when the perturbation is superimposed on a much larger background force. Consistent with the Weber-Fechner law for force perception, subjects had greater difficulty consciously perceiving the force field perturbation when it was superimposed on the large background force. However, they still adapted to the perturbation, decreasing trajectory distortion with repeated reaching and demonstrating kinematic after effects when the perturbation was unexpectedly removed. They also adapted by increasing their arm impedance when the background force was not present, but did not vary the arm impedance when the background force was present. The identified parameters of a previously proposed mathematical model of motor adaptation changed significantly with the presence of the background force. These results indicate that the motor system maintains its sensitivity for internal model formation even when there are large background forces that mask perception. Further, the motor system modulates arm impedance differently in response to the same perturbation depending on the background force onto which that perturbation is superimposed. Finally, these results suggest that computational models of motor adaptation will likely need to include force-dependent parameters to accurately predict errors.

Adaptation, Physiological↗

Robot-assisted hindlimb extension increases the probability of swing initiation during treadmill walking by spinal cord contused rats.

Training and evaluation of locomotion in animals with spinal cord injury will likely be improved with the development of techniques that increase stepping activity. We hypothesized that robot-assisted extension of the hindlimbs of spinal cord injured rats during stance would increase the probability that the swing phase of gait would be initiated. Thirty-three adult, Sprague-Dawley rats received a contusion injury to the mid-thoracic spinal cord. The animals' hindlimbs were pulled into extension using small robotic arms to pull at the ankle, as the rat stepped on either a reciprocating, robotic paw platform or a conventional treadmill belt. The animals demonstrated an increase in the probability of swing initiation with spontaneous recovery during the first 4 weeks following injury (p < 0.0001). The probability of swing initiation was found to be greater with the use of robot-assisted extension versus no extension force at the ankle (75+/-16.9% versus 38.9+/-16.6%, p < 0.001). Swing initiation occurred most frequently at a particular distance of hindlimb extension (50 mm caudal from the neutral position at stance), but was broadly tuned about this distance. These results indicate that a greater amount of stepping activity can be elicited by robot-assisted extension, thereby providing possible benefits to evaluation and training of gait following SCI.

Algorithms↗

Robot-assisted reaching exercise promotes arm movement recovery in chronic hemiparetic stroke: a randomized controlled pilot study.

BACKGROUND AND PURPOSE: Providing active assistance to complete desired arm movements is a common technique in upper extremity rehabilitation after stroke. Such active assistance may improve recovery by affecting somatosensory input, motor planning, spasticity or soft tissue properties, but it is labor intensive and has not been validated in controlled trials. The purpose of this study was to investigate the effects of robotically administered active-assistive exercise and compare those with free reaching voluntary exercise in improving arm movement ability after chronic stroke. METHODS: Nineteen individuals at least one year post-stroke were randomized into one of two groups. One group performed 24 sessions of active-assistive reaching exercise with a simple robotic device, while a second group performed a task-matched amount of unassisted reaching. The main outcome measures were range and speed of supported arm movement, range, straightness and smoothness of unsupported reaching, and the Rancho Los Amigos Functional Test of Upper Extremity Function. RESULTS AND DISCUSSION: There were significant improvements with training for range of motion and velocity of supported reaching, straightness of unsupported reaching, and functional movement ability. These improvements were not significantly different between the two training groups. The group that performed unassisted reaching exercise improved the smoothness of their reaching movements more than the robot-assisted group. CONCLUSION: Improvements with both forms of exercise confirmed that repeated, task-related voluntary activation of the damaged motor system is a key stimulus to motor recovery following chronic stroke. Robotically assisting in reaching successfully improved arm movement ability, although it did not provide any detectable, additional value beyond the movement practice that occurred concurrently with it. The inability to detect any additional value of robot-assisted reaching may have been due to this pilot study's limited sample size, the specific diagnoses of the participants, or the inclusion of only individuals with chronic stroke.

Journal Article↗

Robotic gait analysis of bipedal treadmill stepping by spinal contused rats: characterization of intrinsic recovery and comparison with BBB.

There is a critical need to develop objective, quantitative techniques to assess motor function after spinal cord injury. Here, we assess the ability of a recently developed robotic device (the "rat stepper") to characterize locomotor impairment following contusion injury in rats. In particular, we analyzed how the kinematic features of hindlimb movement during bipedal, weight-supported treadmill stepping change following contusion, and whether these changes correlate with the recovery of open field locomotion. Female, Sprague-Dawley rats (n=29, 8 weeks of age) received mid thoracic contusion injuries of differing severities (11 mild, nine moderate, nine severe, and four sham). In a first experiment, 16 of the animals were evaluated weekly for 12 weeks using the robotic stepping device. In a second experiment, 17 of the animals were evaluated every other day for 4 weeks. The contused animals recovered open field locomotion based on the Basso, Beattie, and Bresnahan Scale (BBB) analysis, with most of the recovery occurring by 4 weeks post-injury. Analysis of 14 robotic measures of stepping revealed that several measures improved significantly during the same 4 weeks: swing velocity, step height, step length, hindlimb coordination, and the ability to support body weight. These measures were also significantly correlated with the BBB score. The number of steps taken during testing was not directly related to intrinsic recovery or correlated to the BBB score. These results suggest that it is the quality of weight-supported steps, rather than the quantity, that best reflects locomotor recovery after contusion injury, and that the quality of these steps is determined by the integrity of extensor, flexor, and bilateral coordination pathways. Thus, by measuring only a few weight-supported steps with motion capture, a sensitive, valid measure of locomotor recovery following contusion injury can be obtained across a broad range of impairment levels.

Animals↗

Automating arm movement training following severe stroke: functional exercises with quantitative feedback in a gravity-reduced environment.

An important goal in rehabilitation engineering is to develop technology that allows individuals with severe motor impairment to practice arm movement without continuous supervision from a rehabilitation therapist. This paper describes the development of such a system, called Therapy WREX or ("T-WREX"). The system consists of an orthosis that assists in arm movement across a large workspace, a grip sensor that detects hand grip pressure, and software that simulates functional activities. The arm orthosis is an instrumented, adult-sized version of the Wilmington Robotic Exoskeleton (WREX), which is a five degrees-of-freedom mechanism that passively counterbalances the weight of the arm using elastic bands. After providing a detailed design description of T-WREX, this paper describes two pilot studies of the system's capabilities. The first study demonstrated that individuals with chronic stroke whose arm function is compromised in a normal gravity environment can perform reaching and drawing movements while using T-WREX. The second study demonstrated that exercising the affected arm of five people with chronic stroke with T-WREX over an eight week period improved unassisted movement ability (mean change in Fugl-Meyer score was 5 points +/- 2 SD; mean change in range of motion of reaching was 10%, p < 0.001). These results demonstrate the feasibility of automating upper-extremity rehabilitation therapy for people with severe stroke using passive gravity assistance, a grip sensor, and simple virtual reality software.

Adult↗

Impaired motor control in patients with benign focal epilepsy of childhood.

Upper extremity motor function was quantitatively assessed in 6 children (age 7-11 years) treated with antiepileptic drugs for benign focal epilepsies of childhood and compared with that of 30 age-matched normal children. Both motor performance and adaptation to perturbing mechanical constraints imposed by a robotic device were significantly impaired in children with benign focal epilepsies of childhood. Our findings thus question whether certain "benign" epilepsies are truly benign and whether pharmacologic treatment might contribute to motor impairment.

Anticonvulsants↗

Spinal cord-transected mice learn to step in response to quipazine treatment and robotic training.

In the present study, concurrent treatment with robotic step training and a serotonin agonist, quipazine, generated significant recovery of locomotor function in complete spinal cord-transected mice (T7-T9) that otherwise could not step. The extent of recovery achieved when these treatments were combined exceeded that obtained when either treatment was applied independently. We quantitatively analyzed the stepping characteristics of spinal mice after alternatively administering no training, manual training, robotic training, quipazine treatment, or a combination of robotic training with quipazine treatment, to examine the mechanisms by which training and quipazine treatment promote functional recovery. Using fast Fourier transform and principal components analysis, significant improvements in the step rhythm, step shape consistency, and number of weight-bearing steps were observed in robotically trained compared with manually trained or nontrained mice. In contrast, manual training had no effect on stepping performance, yielding no improvement compared with nontrained mice. Daily bolus quipazine treatment acutely improved the step shape consistency and number of steps executed by both robotically trained and nontrained mice, but these improvements did not persist after quipazine was withdrawn. At the dosage used (0.5 mg/kg body weight), quipazine appeared to facilitate, rather than directly generate, stepping, by enabling the spinal cord neural circuitry to process specific patterns of sensory information associated with weight-bearing stepping. Via this mechanism, quipazine treatment enhanced kinematically appropriate robotic training. When administered intermittently during an extended period of robotic training, quipazine revealed training-induced stepping improvements that were masked in the absence of the pharmacological treatment.

Animals↗

Effect of muscle fatigue on internal model formation and retention during reaching with the arm.

The motor system adapts to novel dynamic environments by forming internal models that predict the muscle forces needed to move skillfully. The goal of this study was to determine how muscle fatigue affects internal model formation during arm movement and whether an internal model acquired while fatigued could be recalled accurately after rest. Twelve subjects adapted to a viscous force field applied by a lightweight robot as they reached to a target. They then reached while being resisted by elastic bands until they could no longer touch the target. This protocol reduced the strength of the muscles used to resist the force field by approximately 20%. The bands were removed, and subjects adapted again to the viscous force field. Their adaptive ability, quantified by the amount and time constant of adaptation, was not significantly impaired following fatigue. The subjects then rested, recovering approximately 70% of their lost force-generation ability. When they reached in the force field again, their prediction of the force field strength was different than in a nonfatigued state. This alteration was consistent with the use of a higher level of effort than normally used to counteract the force field. These results suggest that recovery from fatigue can affect recall of an internal model, even when the fatigue did not substantially affect the motor system's ability to form the model. Recovery from fatigue apparently affects recall because the motor system represents internal models as a mapping between effort and movement and relies on practice to recalibrate this mapping.

Adaptation, Physiological↗

Hindlimb loading determines stepping quantity and quality following spinal cord transection.

We compared the bipedal hindlimb stepping ability of untrained and trained (step-trained 6 min/day) spinal rats (mid-thoracic spinal cord transection at post-natal day 5) at different levels of body weight support on a treadmill over a 40-day period, starting at 69 days of age. A robotic device provided precise levels of body weight support and recorded hindlimb movement. We assessed stepping ability using: (1) step quantity determined from the measured hindlimb movement, (2) ordinal scales of paw placement, weight-bearing, and limb flexion, and (3) the lowest level of body weight support at which stepping was maintained. Stepping quantity and quality depended strongly on the level of support provided. Stepping ability improved with time, but only at the higher levels of weight-bearing, and independently of training. Increasing limb loading by gradually decreasing body weight support altered the spatiotemporal properties of the steps, resulting in an increase in step length and stance duration and a decrease in swing and step cycle duration. The rats progressively improved their ability to support more load before collapsing from a maximum of about 42 g ( approximately 25% of body weight) at Day 1 to 73 g ( approximately 35% of body weight) at Day 40. We conclude that the level of hindlimb loading provided to a spinally transected rat strongly influences the quantity and quality of stepping. Furthermore, the relationship between stepping ability and loading conditions changes with time after spinal cord transection and is unaltered by small amounts of step training. Finally, load-bearing failure point can be a quantitative measure of locomotor recovery following spinal cord injury, especially for severely impaired animals that cannot step unassisted.

Animals↗

Robot-enhanced motor learning: accelerating internal model formation during locomotion by transient dynamic amplification.

When adapting to novel dynamic environments the nervous system learns to anticipate the imposed forces by forming an internal model of the environmental dynamics in a process driven by movement error reduction. Here, we tested the hypothesis that motor learning could be accelerated by transiently amplifying the environmental dynamics. A novel dynamic environment was created during treadmill stepping by applying a perpendicular viscous force field to the leg through a robotic device. The environmental dynamics were amplified by an amount determined by a computational learning model fit on a per-subject basis. On average, subjects significantly reduced the time required to predict the applied force field by approximately 26% when the field was transiently amplified. However, this reduction was not as great as that predicted by the model, likely due to nonstationarities in the learning parameters. We conclude that motor learning of a novel dynamic environment can be accelerated by exploiting the error-based learning mechanism of internal model formation, but that nonlinearities in adaptive response may limit the feasible acceleration. These results support an approach to movement training devices that amplify rather than reduce movement errors, and provide a computational framework for both implementing the approach and understanding its limitations.

Adaptation, Physiological↗

Dynamic motion planning for the design of robotic gait rehabilitation.

In this paper we examine a method to control the stepping motion of a paralyzed person suspended over a treadmill using a robot attached to the pelvis. A leg swing motion is created by moving the pelvis without contact with the legs. The problem is formulated as an optimal control problem for an underactuated articulated chain. The optimal control problem is converted into a discrete parameter optimization and an efficient gradient-based algorithm is used to solve it. Motion capture data from an unimpaired human subject is compared to the simulation results from the dynamic motion optimization. Our results suggest that it is feasible to drive repetitive stepping on a treadmill by a paralyzed person by assisting in torso movement alone. The optimized, pelvic motion strategies are comparable to "hip-hiking" gait strategies used by people with lower limb prostheses or hemiparesis. The resulting motions can be found at the web site http://ww.eng.uci.edu/-chwang/project/stepper/stepper.html.

Computer Simulation↗

Robotics, motor learning, and neurologic recovery.

Robotic devices are helping shed light on human motor control in health and injury. By using robots to apply novel force fields to the arm, investigators are gaining insight into how the nervous system models its external dynamic environment. The nervous system builds internal models gradually by experience and uses them in combination with impedance and feedback control strategies. Internal models are robust to environmental and neural noise, generalized across space, implemented in multiple brain regions, and developed in childhood. Robots are also being used to assist in repetitive movement practice following neurologic injury, providing insight into movement recovery. Robots can haptically assess sensorimotor performance, administer training, quantify amount of training, and improve motor recovery. In addition to providing insight into motor control, robotic paradigms may eventually enhance motor learning and rehabilitation beyond the levels possible with conventional training techniques.

Algorithms↗

Hemiparetic stroke impairs anticipatory control of arm movement.

Internal models are sensory motor mappings used by the nervous system to anticipate the force requirements of movement tasks. The ability to use internal models likely underlies the development of skillful control of the arm throughout life. It is currently unknown to what extent individuals with hemiparetic stroke can form and implement such internal models. To examine this issue, we measured whether such individuals could learn to anticipate forces applied to their arms by a lightweight robotic device as they practiced reaching to a target. Thirteen subjects with post-stroke hemiparesis were tested. Forces were applied to the arm, which curved the hand path in either the medial or lateral direction, as the subjects reached repeatedly towards a target located in front of them at their workspace boundary. The subjects exhibited a decreased ability to adapt to the perturbing forces with their hemiparetic arms. That is, they did not straighten their reaching path as well, compared to their ipsilesional arms, and they exhibited smaller aftereffects when the perturbing force was unexpectedly removed. The ability to adapt to the force improved significantly with decreasing impairment severity, as quantified using both clinical scales and quantitative strength measurements. Some subjects with strength reductions as severe as 60% were able to adapt to the fields, generating significant aftereffects. We conclude that hemiparetic stroke impairs the ability to implement internal models used for anticipatory control of arm movement, although even some severely weakened subjects retain at least a partial ability to form and use internal models. Finding ways to fully restore this adaptive ability, or to make use of what adaptive ability remains during rehabilitation, is an important goal for improving functional motor recovery.

Adult↗

Neuromotor noise limits motor performance, but not motor adaptation, in children.

Children do not typically appear to move with the same skill and dexterity as adults, although they can still improve their motor performance in specific tasks with practice. One possible explanation is that their motor performance is limited by an inherently higher level of movement variability, but that their motor adaptive ability is robust to this variability. To test this hypothesis, we examined motor adaptation of 43 children (ages 6-17) and 12 adults as they reached while holding the tip of a lightweight robot. The robot applied either a predictable, velocity-dependent field (the "mean field") or a similar field that incorporated stochastic variation (the "noise field"), thereby further enhancing the variability of the subjects' movements. We found that children exhibited greater initial trial-to-trial variability in their unperturbed movements but were still able to adapt comparably to adults in both the mean and noise fields. Furthermore, the youngest children (ages 6-8) were able to reduce their variability with practice to levels comparable to the remaining children groups although not as low as adults. These results indicate that children as young as age 6 possess adult-like neural systems for motor adaptation and internal model formation that allow them to adapt to novel dynamic environments as well as adults on average despite increased neuromotor or environmental noise. Performance after adaptation is still more variable than adults, however, indicating that movement inconsistency, not motor adaptation inability, ultimately limits motor performance by children and may thus account for their appearance of incoordination and more frequent motor accidents (e.g., spilling, tripping). The results of this study also suggest that movement variability in young children may arise from two sources--a relatively constant, intrinsic source related to fundamental physiological constraints of the developing motor system and a more rapidly modifiable source that is modulated depending on the current motor context.

Adaptation, Physiological↗

Modeling reaching impairment after stroke using a population vector model of movement control that incorporates neural firing-rate variability.

The directional control of reaching after stroke was simulated by including cell death and firing-rate noise in a population vector model of movement control. In this model, cortical activity was assumed to cause the hand to move in the direction of a population vector, defined by a summation of responses from neurons with cosine directional tuning. Two types of directional error were analyzed: the between-target variability, defined as the standard deviation of the directional error across a wide range of target directions, and the within-target variability, defined as the standard deviation of the directional error for many reaches to a single target. Both between- and within-target variability increased with increasing cell death. The increase in between-target variability arose because cell death caused a nonuniform distribution of preferred directions. The increase in within-target variability arose because the magnitude of the population vector decreased more quickly than its standard deviation for increasing cell death, provided appropriate levels of firing-rate noise were present. Comparisons to reaching data from 29 stroke subjects revealed similar increases in between- and within-target variability as clinical impairment severity increased. Relationships between simulated cell death and impairment severity were derived using the between- and within-target variability results. For both relationships, impairment severity increased similarly with decreasing percentage of surviving cells, consistent with results from previous imaging studies. These results demonstrate that a population vector model of movement control that incorporates cosine tuning, linear summation of unitary responses, firing-rate noise, and random cell death can account for some features of impaired arm movement after stroke.

Action Potentials↗

Directional control of reaching is preserved following mild/moderate stroke and stochastically constrained following severe stroke.

Recent evidence suggests that brain injury can impair the ability to independently activate shoulder and elbow muscles. We hypothesized that if muscle activation patterns are constrained, then brain-injured subjects should not be able to accurately grade initial hand movement direction during reaching toward a broad range of target directions. To test this hypothesis, we measured hand trajectories during reaching in three-space by 16 hemiparetic stroke subjects to an array of 75 targets distributed throughout the workspace. Contrary to our hypothesis, we found that the ability to grade movement direction was largely preserved following mild and moderate stroke. However, the most severely impaired subjects exhibited a degradation of directional control consistent with a loss of independent muscle control. Initial and final hand movement directions for these subjects were grouped roughly in two opposing directions, in a plane parallel with the coronal plane of the body, rather than distributed across the normal range. Selection between the two movement directions appeared partially random, in that subjects initiated over 50% of movements in the direction generally opposite the intended target, for targets to one side of the body. These results suggest that individuals with severe stroke are constrained to use only two gross, stereotypical muscle coactivation patterns for reaching control, and that selection between these patterns is stochastically influenced as the actual direction of motion is not strictly predictable given the desired direction.

Adult↗

Use of robotics in assessing the adaptive capacity of the rat lumbar spinal cord.

We have developed a robotic device that can record the trajectory of the hindlimb movements in rats. The robotic device can also impose programmed forces on the limbs during stepping. In the present paper we describe experiments using this robotic device, i.e. the rat stepper, to determine whether step training improves the locomotor capacity of adult rats that received complete spinal cord transections as neonates. We also determined to what extent the locomotor patterns can be maintained when the step cycle is physically perturbed by the robotic device. The results of the present study demonstrate that a robotic device can be used effectively to quantify the improvements in the locomotor capacity of spinal transected rats that occurs over a period of step training. The present results also demonstrate that when an external force is imposed to disrupt the step cycle, the spinal cord has the neural control elements necessary to normalize the kinematics over a number of steps, in the face of the disrupted forces.

Animals↗