Bayón C, Lerma S, Ramírez O, Serrano J I, Del Castillo M D, Raya R, Belda-Lois J M, Martínez I, Rocon E
Neural and Cognitive Engineering group, Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas, Ctra Campo Real km 0.2, Arganda del Rey, Madrid, 28500, Spain.
Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
J Neuroeng Rehabil. 2016 Nov 14;13(1):98. doi: 10.1186/s12984-016-0206-x.
Cerebral Palsy (CP) is a disorder of posture and movement due to a defect in the immature brain. The use of robotic devices as alternative treatment to improve the gait function in patients with CP has increased. Nevertheless, current gait trainers are focused on controlling complete joint trajectories, avoiding postural control and the adaptation of the therapy to a specific patient. This paper presents the applicability of a new robotic platform called CPWalker in children with spastic diplegia.
CPWalker consists of a smart walker with body weight and autonomous locomotion support and an exoskeleton for joint motion support. Likewise, CPWalker enables strategies to improve postural control during walking. The integrated robotic platform provides means for testing novel gait rehabilitation therapies in subjects with CP and similar motor disorders. Patient-tailored therapies were programmed in the device for its evaluation in three children with spastic diplegia for 5 weeks. After ten sessions of personalized training with CPWalker, the children improved the mean velocity (51.94 ± 41.97 %), cadence (29.19 ± 33.36 %) and step length (26.49 ± 19.58 %) in each leg. Post-3D gait assessments provided kinematic outcomes closer to normal values than Pre-3D assessments.
The results show the potential of the novel robotic platform to serve as a rehabilitation tool. The autonomous locomotion and impedance control enhanced the children's participation during therapies. Moreover, participants' postural control was substantially improved, which indicates the usefulness of the approach based on promoting the patient's trunk control while the locomotion therapy is executed. Although results are promising, further studies with bigger sample size are required.
脑性瘫痪(CP)是一种由于未成熟大脑缺陷导致的姿势和运动障碍。使用机器人设备作为改善CP患者步态功能的替代治疗方法的情况日益增多。然而,目前的步态训练器专注于控制完整的关节轨迹,而忽略了姿势控制以及治疗方案对特定患者的适应性。本文介绍了一种名为CPWalker的新型机器人平台在痉挛性双侧瘫儿童中的适用性。
CPWalker由一个具有体重支撑和自主运动支持功能的智能助行器以及一个用于关节运动支持的外骨骼组成。同样,CPWalker还具备在行走过程中改善姿势控制的策略。该集成机器人平台为测试针对CP及类似运动障碍患者的新型步态康复疗法提供了手段。针对三名痉挛性双侧瘫儿童,在该设备中编写了个性化治疗方案,并对其进行了为期5周的评估。在使用CPWalker进行十次个性化训练后,孩子们每条腿的平均速度(提高了51.94 ± 41.97%)、步频(提高了29.19 ± 33.36%)和步长(提高了26.49 ± 19.58%)均有所改善。三维步态评估后的运动学结果比评估前更接近正常值。
结果表明新型机器人平台作为康复工具具有潜力。自主运动和阻抗控制增强了孩子们在治疗过程中的参与度。此外,参与者的姿势控制有了显著改善,这表明在执行运动疗法时促进患者躯干控制的方法是有用的。尽管结果很有前景,但仍需要更大样本量的进一步研究。