New Jersey Institute of Technology, Newark, NJ 07102, USA.
IEEE Trans Neural Syst Rehabil Eng. 2009 Oct;17(5):512-20. doi: 10.1109/TNSRE.2009.2028830. Epub 2009 Aug 7.
Current neuroscience has identified several constructs to increase the effectiveness of upper extremity rehabilitation. One is the use of progressive, skill acquisition-oriented training. Another approach emphasizes the use of bilateral activities. Building on these principles, this paper describes the design and feasibility testing of a robotic/virtual environment system designed to train the arm of persons who have had strokes. The system provides a variety of assistance modes, scalable workspaces and hand-robot interfaces allowing persons with strokes to train multiple joints in three dimensions. The simulations utilize assistance algorithms that adjust task difficulty both online and offline in relation to subject performance. Several distinctive haptic effects have been incorporated into the simulations. An adaptive master-slave relationship between the unimpaired and impaired arm encourages active movement of the subject's hemiparetic arm during a bimanual task. Adaptive anti-gravity support and damping stabilize the arm during virtual reaching and placement tasks. An adaptive virtual spring provides assistance to complete the movement if the subject is unable to complete the task in time. Finally, haptically rendered virtual objects help to shape the movement trajectory during a virtual placement task. A proof of concept study demonstrated this system to be safe, feasible and worthy of further study.
目前的神经科学已经确定了几种方法来提高上肢康复的效果。一种是使用渐进的、以技能获取为导向的训练。另一种方法则强调使用双侧活动。基于这些原则，本文描述了一种机器人/虚拟环境系统的设计和可行性测试，该系统旨在训练中风患者的手臂。该系统提供了多种辅助模式、可扩展的工作空间和手-机器人接口，允许中风患者在三维空间中训练多个关节。模拟使用辅助算法根据受试者的表现在线和离线调整任务难度。已经将几种独特的触觉效果纳入到模拟中。在双手任务中，健全手臂和患病手臂之间的自适应主从关系鼓励患者偏瘫手臂的主动运动。自适应的抗重力支撑和阻尼在虚拟伸展和放置任务中稳定手臂。如果患者无法及时完成任务，自适应虚拟弹簧将提供帮助以完成运动。最后，在虚拟放置任务中，触觉呈现的虚拟物体有助于塑造运动轨迹。一项概念验证研究表明，该系统安全、可行，值得进一步研究。
