Center for MicroElectroMechanical Systems (CMEMS), Department of Industrial Electronics, School of Engineering, University of Minho, 4800-058 Guimarães, Portugal.
Sensors (Basel). 2020 Oct 17;20(20):5876. doi: 10.3390/s20205876.
The adjunctive use of biofeedback systems with exoskeletons may accelerate post-stroke gait rehabilitation. Wearable patient-oriented human-robot interaction-based biofeedback is proposed to improve patient-exoskeleton compliance regarding the interaction torque's direction (joint motion strategy) and magnitude (user participation strategy) through auditory and vibrotactile cues during assisted gait training, respectively. Parallel physiotherapist-oriented strategies are also proposed such that physiotherapists can follow in real-time a patient's motor performance towards effective involvement during training. A preliminary pre-post controlled study was conducted with eight healthy participants to conclude about the biofeedback's efficacy during gait training driven by an ankle-foot exoskeleton and guided by a technical person. For the study group, performance related to the interaction torque's direction increased during (-value = 0.07) and after (-value = 0.07) joint motion training. Further, the performance regarding the interaction torque's magnitude significantly increased during (-value = 0.03) and after (-value = 68.59×10) user participation training. The experimental group and a technical person reported promising usability of the biofeedback and highlighted the importance of the timely cues from physiotherapist-oriented strategies. Less significant improvements in patient-exoskeleton compliance were observed in the control group. The overall findings suggest that the proposed biofeedback was able to improve the participant-exoskeleton compliance by enhancing human-robot interaction; thus, it may be a powerful tool to accelerate post-stroke ankle-foot deformity recovery.
辅助使用生物反馈系统与外骨骼可能会加速中风后的步态康复。提出了一种基于可穿戴患者导向的人机交互生物反馈方法，通过在辅助步行训练过程中分别使用听觉和振动触觉提示，改善患者-外骨骼在交互扭矩方向（关节运动策略）和大小（用户参与策略）方面的顺应性。还提出了平行的治疗师导向策略，以便治疗师可以实时跟踪患者在训练过程中的电机性能，以实现有效参与。进行了一项初步的前后对照研究，共有 8 名健康参与者参与，以评估由踝足外骨骼驱动并由技术人员指导的步态训练中生物反馈的效果。对于研究组，在关节运动训练期间（-值=0.07）和之后（-值=0.07），与交互扭矩方向相关的性能都有所提高。此外，在用户参与训练期间（-值=0.03）和之后（-值=68.59×10），与交互扭矩大小相关的性能显著提高。实验组和技术人员报告了生物反馈的良好可用性，并强调了治疗师导向策略的及时提示的重要性。对照组中观察到患者-外骨骼顺应性的改善不明显。总体研究结果表明，所提出的生物反馈通过增强人机交互，提高了参与者-外骨骼的顺应性；因此，它可能是加速中风后踝足畸形恢复的有力工具。
