Abstract：
Transcutaneous spinal stimulation (TSS) is a promising rehabilitative intervention to restore motor function and coordination for individuals with spinal cord injury (SCI). The effects of TSS are most commonly assessed by evaluating muscle response to stimulation using surface electromyography (sEMG). Given the increasing use of robotic devices to deliver therapy and the emerging potential of hybrid rehabilitation interventions that combine neuromodulation with robotic devices, there is an opportunity to leverage the on-board sensors of the robots to measure kinematic and torque changes of joints in the presence of stimulation. This paper explores the potential for robotic assessment of the effects of TSS delivered to the cervical spinal cord. We used a four degree-of-freedom exoskeleton to measure the torque response of upper limb (UL) joints during stimulation, while simultaneously recording sEMG. We analyzed joint torque and electromyography data generated during TSS delivered over individual sites of the cervical spinal cord in neurologically intact participants. We show that site-specific effects of TSS are manifested not only by modulation of the amplitude of spinally evoked motor potentials in UL muscles, but also by changes in torque generated by individual UL joints. We observed preferential resultant action of proximal muscles and joints with stimulation at the rostral site, and of proximal joints with rostral-lateral stimulation. Robotic assessment can be used to measure the effects of TSS, and could be integrated into complex control algorithms that govern the behavior of hybrid neuromodulation-robotic systems.
摘要：
经皮脊髓刺激（TSS）是一种有前途的康复干预措施，可恢复脊髓损伤（SCI）患者的运动功能和协调性。TSS的效果通常通过使用表面肌电图（sEMG）评估肌肉对刺激的反应来评估。鉴于越来越多地使用机器人设备来提供治疗，以及将神经调节与机器人设备相结合的混合康复干预措施的新兴潜力，在存在刺激的情况下，有机会利用机器人的车载传感器来测量关节的运动学和扭矩变化。本文探讨了机器人评估TSS传递到颈脊髓的效果的潜力。我们使用四自由度外骨骼测量刺激过程中上肢关节的扭矩响应，同时记录sEMG。我们分析了神经系统完整的参与者在TSS传递到颈脊髓各个部位期间产生的关节扭矩和肌电图数据。我们表明，TSS的特定部位效应不仅通过调节上肢（UL）肌肉的脊髓诱发运动电位的幅度来表现，但也由个别UL关节产生的扭矩的变化。我们观察到近端肌肉和关节的优先合成作用，并在头端部位进行刺激，以及带有头端外侧刺激的近端关节。机器人评估可用于测量TSS的效果，并且可以集成到控制混合神经调节机器人系统行为的复杂控制算法中。
