Gait & Motion Analysis Laboratory and Center for Robotics in Rehabilitation, MossRehab, Elkins Park, Pennsylvania 19027, USA.
Am J Phys Med Rehabil. 2012 Nov;91(11 Suppl 3):S217-27; quiz S228-31. doi: 10.1097/PHM.0b013e31826bce18.
The past two decades have seen the introduction of and a strong growth in the availability of rehabilitation interventions that are based on the use of robotics. A major driving factor has been the advancement of technology, with faster, more powerful computers, new computational approaches, as well as increased sophistication of motors and other electro mechanical components. These advancements in technology have not been the only factor propelling these new rehabilitation interventions. During the same period, a strong growth in the understanding of neuroplasticity and motor learning has also been witnessed. Although there is still much to learn, comprehension of how new skills are acquired, or old ones are relearned, is evolving at a fast pace. Much of this improved understanding can be linked to the advancement of central nervous system imaging as well as techniques for studying changes at the cellular or molecular level. In this review, the authors present the notion that an ever-advancing understanding of neuroplasticity and motor learning can provide a theoretical basis for the clinical use of rehabilitation robotics as applied to enhancing mobility. Specifically focusing on locomotor training after injury to the central nervous system, these principles can provide guidance to clinicians on how to structure their interventions to potentially promote or accelerate functional recovery in their patients. Several types of existing robotic devices to assist walking that are currently available for use in the clinic, as well as their advantages and limitations, will be discussed.
在过去的二十年中，基于机器人技术的康复干预措施得到了广泛应用并得到了迅猛发展。一个主要的推动因素是技术的进步，包括更快、更强大的计算机、新的计算方法，以及电机和其他机电组件的日益复杂化。这些技术进步并不是推动这些新的康复干预措施的唯一因素。在同一时期，人们对神经可塑性和运动学习的理解也有了很大的提高。尽管还有很多需要学习，但人们对新技能的习得或旧技能的重新学习的理解正在迅速发展。这种理解的提高在很大程度上可以归因于中枢神经系统成像技术的进步以及研究细胞或分子水平变化的技术的进步。在这篇综述中，作者提出了这样一种观点，即对神经可塑性和运动学习的不断深入理解，可以为康复机器人在增强运动能力方面的临床应用提供理论基础。具体来说，该理论聚焦于中枢神经系统损伤后的运动训练，为临床医生提供了如何构建干预措施的指导，以潜在地促进或加速患者的功能恢复。本文还将讨论几种现有的、可用于临床的辅助行走的机器人设备，以及它们的优缺点。
