Annu Int Conf IEEE Eng Med Biol Soc. 2017 Jul;2017:4243-4246. doi: 10.1109/EMBC.2017.8037793.
The paper suggests a therapeutic device for hemiparesis that combines robot-assisted rehabilitation and mirror therapy. The robot, which consists of a motor, a position sensor, and a torque sensor, is provided not only to the paralyzed wrist, but also to the unaffected wrist to induce a symmetric movement between the joints. As a user rotates his healthy wrist to the direction of either flexion or extension, the motor on the damaged side rotates and reflects the motion of the normal side to the symmetric angular position. To verify performance of the device, five stroke patients joined a clinical experiment to practice a 10-minute mirroring exercise. Subjects on Brunnstrom stage 3 had shown relatively high repulsive torques due to severe spasticity toward their neutral wrist positions with a maximum magnitude of 0.300kgfm, which was reduced to 0.161kgfm after the exercise. Subjects on stage 5 practiced active bilateral exercises using both wrists with a small repulsive torque of 0.052kgfm only at the extreme extensional angle. The range of motion of affected wrist increased as a result of decrease in spasticity. The therapeutic device not only guided a voluntary exercise to loose spasticity and increase ROM of affected wrist, but also helped distinguish patients with different Brunnstrom stages according to the size of repulsive torque and phase difference between the torque and the wrist position.
本文提出了一种用于偏瘫的治疗设备，该设备结合了机器人辅助康复和镜像疗法。该机器人由一个电机、一个位置传感器和一个扭矩传感器组成，不仅安装在瘫痪的手腕上，也安装在未受影响的手腕上，以诱导关节之间的对称运动。当用户将其健康手腕向屈曲或伸展方向旋转时，受损侧的电机旋转并将正常侧的运动反映到对称的角度位置。为了验证该设备的性能，五名中风患者参加了一项临床实验，进行了10分钟的镜像练习。处于Brunnstrom 3期的受试者由于对其手腕中立位置的严重痉挛而表现出相对较高的排斥扭矩，最大幅度为0.300kgfm，练习后降至0.161kgfm。处于5期的受试者使用两只手腕进行主动双侧练习，仅在极端伸展角度时具有0.052kgfm的小排斥扭矩。由于痉挛程度降低，受影响手腕的运动范围增加。该治疗设备不仅引导了自愿运动以放松痉挛并增加受影响手腕的关节活动度，还根据排斥扭矩的大小以及扭矩与手腕位置之间的相位差，帮助区分不同Brunnstrom阶段的患者。
