Hussein S, Schmidt H, Volkmar M, Werner C, Helmich I, Piorko F, Krüger J, Hesse S
Rehabilitation Robotics Group (IPK/TU Berlin), Faculty of Mechanical Engineering, Technical University of of Berlin 10587, Germany.
Annu Int Conf IEEE Eng Med Biol Soc. 2008;2008:1961-4. doi: 10.1109/IEMBS.2008.4649572.
The aim of gait rehabilitation is a restoration of an independent gait and improvement of daily life walking functions. Therefore the specific patterns, that are to be relearned, must be practiced to stimulate the learning process of the central nervous system (CNS). The Walking Simulator HapticWalker allows for the training of arbitrary gait trajectories of daily life. To evaluate the quality of the training a total of 9 subjects were investigated during free floor walking and stair climbing and during the same tasks in two different training modes on the HapticWalker: 1) with and 2) without vertical center of mass (CoM) motion. Electromyograms (EMG) of 8 gait relevant muscles were measured and muscle activation was compared for the various training modes. Besides the muscle activation as an indicator for the quality of rehabilitation training the study investigates if a cancellation of the vertical CoM movement by adaption of the footplate trajectory is feasible i.e. the muscle activation patterns for the two training modes on the HapticWalker agree. Results show no significant differences in activation timing between the training modes. This indicates the feasibility of using a passive patient suspension and emulate the vertical CoM motion by trajectory adaption of the footplates. The muscle activation timing during HapticWalker training shows important characteristics observed in physiological free walking though a few differences can still remain.
步态康复的目的是恢复独立步态并改善日常生活中的行走功能。因此,必须练习那些需要重新学习的特定模式,以刺激中枢神经系统(CNS)的学习过程。步行模拟器HapticWalker可用于训练日常生活中的任意步态轨迹。为了评估训练质量,在自由地面行走和爬楼梯期间以及在HapticWalker上的两种不同训练模式下执行相同任务时,共对9名受试者进行了调查:1)有垂直质心(CoM)运动和2)无垂直质心运动。测量了8条与步态相关肌肉的肌电图(EMG),并比较了各种训练模式下的肌肉激活情况。除了将肌肉激活作为康复训练质量的指标外,该研究还调查了通过调整踏板轨迹来消除垂直CoM运动是否可行,即HapticWalker上两种训练模式的肌肉激活模式是否一致。结果表明,训练模式之间的激活时间没有显著差异。这表明使用被动患者悬吊并通过踏板轨迹调整来模拟垂直CoM运动是可行的。尽管仍可能存在一些差异,但HapticWalker训练期间的肌肉激活时间显示出在生理性自由行走中观察到的重要特征。