基于健侧肌肉激活模式的患侧靶向功能电刺激康复方法研究

The restoration of upper limb motor dysfunction is relatively complex and somewhat slow especially for post-stroke hemiplegia patients. Through the activation of motor nerve and muscle, functional electrical stimulation could enable patients to seamlessly achieve multiple degrees of joint movement that promotes the reconstruction and rehabilitation of the brain function. However, the currently applied passive repetitive electrical stimulation therapy lacks active participation of patients and is difficult to achieve precise stimulation of subtle movements. This project proposes an intelligently active rehabilitation strategy for hemiplegic patients based on exploiting the correlation between movement intent of the affected limb and the associated muscle patterns of the contralateral side after electrical stimulation. By detection and analysis of the high-density electromyogram signals from the upper limb, the patient's active movement intention and the corresponding muscle synergy pattern will be obtained while the mapping between the synergy matrix of the muscle and the electrical stimulation parameters will also be done. The development of an array-based stimulation electrode using a flexible fabric is proposed to support a high muscle-selective electrical stimulation. Finally, a rehabilitation training platform that incorporates dynamic control and position adaptive adjustment strategy will be built to ensure that ultimately the affected side complete the same actions as the healthy side by precise electrical stimulation. This project is expected to provide theoretical basis and technical support for active rehabilitation of hemiplegic patients with upper extremity dysfunction after stroke.

脑卒中后偏瘫上肢的运动功能恢复困难且缓慢。功能电刺激可通过激活运动神经和肌肉辅助患者完成关节活动，促进运动功能的恢复。传统的电刺激康复治疗方法由治疗师操控，缺乏患者自主参与；刺激模式简单，难以实现对精细动作的准确刺激。本项目提出从偏瘫患者健侧上肢获取运动意图及对应的肌肉激活模式，通过精准电刺激控制患侧上肢完成相同的动作，实现患侧运动功能的主动康复。采集和分析健侧上肢高密度肌电信号，获取患者运动意图和相应动作的肌肉协同模式，研究肌肉协同矩阵与电刺激参数的映射方式，开发刺激模式动态控制与位置自适应调整技术；开发基于柔性织物的阵列式刺激电极，提高刺激选择性和有效性；最后搭建康复训练平台，通过刺激参数的实时控制和电极位置的动态调整使得患肢完成与健侧肢体相同的动作，帮助患者实现脑卒中后运动功能康复，并评估康复效果。本项目的实施有望为脑卒中后运动功能康复提供理论基础和技术支持。

脑卒中后偏瘫上肢的运动功能恢复困难且缓慢。功能电刺激可通过激活运动神经和肌肉辅助患者完成关节活动，促进运动功能的恢复。传统的电刺激康复治疗方法由治疗师操控，缺乏患者自主参与。本项目提出从偏瘫患者健侧上肢获取运动意图及对应的肌肉激活模式进行刺激控制。研究分别以上肢运动功能健全者和单侧上肢运动功能障碍者为研究对象，通过进行上肢运动状态高密度肌电采集与分析进行运动意图识别与控制方法研究；通过高密度肌电协同提取与分布技术研究上肢运动功能障碍在高密度肌电协同中分布中的表征；设计制作了64通道柔性织物电极；在上述研究基础上搭建了自主肌电控制的康复训练平台。通过项目的展开，我们提出了基于多通道描述符的场特征提取技术，推进运动意图识别技术的发展；获得了上肢运动功能障碍的高密度协同评判指标，有助于运动康复的量化评价；项目研究中采集了多名正常受试和上肢运动功能障碍患者的高密度肌电信号，这些数据可以用来展开运动康复机理和运动控制相关的研究。项目的相关成果和平台有望为脑卒中后运动功能康复提供理论基础和技术支持。