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脑卒中患者使用上肢可穿戴机器人系统进行双侧与单侧康复后的运动学数据分析。

Kinematic data analysis for post-stroke patients following bilateral versus unilateral rehabilitation with an upper limb wearable robotic system.

机构信息

Department of Electrical Engineering, University of California-Santa Cruz, Santa Cruz, CA 95064, USA.

出版信息

IEEE Trans Neural Syst Rehabil Eng. 2013 Mar;21(2):153-64. doi: 10.1109/TNSRE.2012.2207462. Epub 2012 Jul 27.

DOI:10.1109/TNSRE.2012.2207462
PMID:22855233
Abstract

Robot-assisted stroke rehabilitation has become popular as one approach to helping patients recover function post-stroke. Robotic rehabilitation requires four important elements to match the robot to the patient: realistic biomechanical robotic elements, an assistive control scheme enabled through the human-robot interface, a task oriented rehabilitation program based on the principles of plasticity, and objective assessment tools to monitor change. This paper reports on a randomized clinical trial utilizing a complete robot-assisted rehabilitation system for the recovery of upper limb function in patients post-stroke. In this study, a seven degree-of-freedom (DOF) upper limb exoskeleton robot (UL-EXO7) is applied in a rehabilitation clinical trial for patients stable post-stroke (greater than six months). Patients had a Fugl-Meyer Score between 16-39, were mentally alert (> 19 on the VA Mini Mental Status Exam) and were between 27 and 70 years of age. Patients were randomly assigned to three groups: bilateral robotic training, unilateral robotic training, and usual care. This study is concerned with the changes in kinematics in the two robotic groups. Both patient groups played eight therapeutic video games over 12 sessions (90 min, two times a week). In each session, patients intensively played the different combination of video games that directly interacted with UL-EXO7 under the supervision of research assistant. At each session, all of the joint angle data was recorded for the evaluation of therapeutic effects. A new assessment metric is reported along with conventional metrics. The experimental result shows that both groups of patients showed consistent improvement with respect to the proposed and conventional metrics.

摘要

机器人辅助脑卒中康复已经成为帮助脑卒中后患者恢复功能的一种方法。机器人康复需要四个重要元素来使机器人适应患者:逼真的生物力学机器人元素、通过人机接口实现的辅助控制方案、基于可塑性原则的面向任务的康复计划以及用于监测变化的客观评估工具。本文报告了一项利用完整的机器人辅助康复系统恢复脑卒中后患者上肢功能的随机临床试验。在这项研究中,七自由度(DOF)上肢外骨骼机器人(UL-EXO7)应用于脑卒中后稳定期(大于 6 个月)的康复临床试验。患者的 Fugl-Meyer 评分在 16-39 之间,精神警觉(VA Mini Mental Status 测试>19),年龄在 27-70 岁之间。患者被随机分为三组:双侧机器人训练、单侧机器人训练和常规护理。本研究关注两个机器人组的运动学变化。两组患者均在 12 次(90 分钟,每周两次)治疗中玩了 8 个治疗视频游戏。在每次会议中,患者在研究助理的监督下,积极地玩不同的视频游戏组合,这些游戏与 UL-EXO7 直接交互。在每次会议中,都会记录所有关节角度数据,以评估治疗效果。报告了一个新的评估指标以及常规指标。实验结果表明,两组患者在提出的和常规指标方面都表现出一致的改善。

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