Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan.
Center for Innovating Medicine and Engineering (CIME), University of Tsukuba Hospital, Tsukuba 305-8573, Ibaraki, Japan.
Medicina (Kaunas). 2022 Mar 7;58(3):395. doi: 10.3390/medicina58030395.
Foot and ankle disabilities (foot drop) due to common peroneal nerve palsy and stroke negatively affect patients' ambulation and activities of daily living. We developed a novel robotics ankle hybrid assistive limb (HAL) for patients with foot drop due to common peroneal nerve palsy or stroke. The ankle HAL is a wearable exoskeleton-type robot that is used to train plantar and dorsiflexion and for voluntary assistive training of the ankle joint of patients with palsy using an actuator, which is placed on the lateral side of the ankle joint and detects bioelectrical signals from the tibialis anterior (TA) and gastrocnemius muscles. Voluntary ankle dorsiflexion training using the new ankle HAL was implemented in a patient with foot drop due to peroneal nerve palsy after lumbar surgery. The time required for ankle HAL training (from wearing to the end of training) was approximately 30 min per session. The muscle activities of the TA on the right were lower than those on the left before and after ankle HAL training. The electromyographic wave of muscle activities of the TA on the right was slightly clearer than that before ankle HAL training in the resting position immediately after ankle dorsiflexion. Voluntary ankle dorsiflexion training using the novel robotics ankle HAL was safe and had no adverse effect in a patient with foot drop due to peroneal nerve palsy.
由于常见的腓总神经麻痹和中风导致的足部和踝关节残疾(足下垂)会严重影响患者的步行和日常生活活动。我们为患有腓总神经麻痹或中风引起的足下垂的患者开发了一种新型的机器人踝关节混合辅助肢体(HAL)。踝关节 HAL 是一种可穿戴的外骨骼型机器人,用于训练跖屈和背屈,并通过放置在踝关节外侧的执行器为瘫痪患者的踝关节提供自愿辅助训练,该执行器可检测来自胫骨前肌(TA)和腓肠肌的生物电信号。在腰椎手术后患有腓总神经麻痹的足下垂患者中实施了使用新型踝关节 HAL 的自愿踝关节背屈训练。每次踝关节 HAL 训练(从穿戴到训练结束)大约需要 30 分钟。在踝关节 HAL 训练前后,右侧 TA 的肌肉活动低于左侧。在踝关节背屈后立即处于休息位置时,右侧 TA 肌肉活动的肌电图波比踝关节 HAL 训练前稍清晰。在患有腓总神经麻痹的足下垂患者中,使用新型机器人踝关节 HAL 进行自愿踝关节背屈训练是安全的,没有不良影响。