Harris F A
Am J Phys Med. 1979 Aug;58(4):169-84.
A position feedback-controlled head stabilizer has been developed to provide cerebral palsied individuals with resistive exercise to strengthen the neck musculature. This apparatus detects "involuntary" head motion and stabilizes the head by applying opposing forces; it also can be used to facilitate muscular contraction by resisting the subject's voluntary movements. The purpose of the present study was to determine whether voluntary head control in cerebral palsied individuals can be improved through systematic exercise using the stabilizer to strengthen the muscles of the neck and improve their balance of action. The findings support the author's contention that this is possible. The apparatus consists of a helmet and shoulder pads, interconnected so that the head is supported in the helmet by a manipulator arm. At its lower end, the manipulator arm is attached to the shoulder pad mounting frame via a gimbal assembly which allows head movement in two planes of tilt (pitch, or forward-and back, and roll, or side-to-side). Feedback control circuitry is so arranged that any deviation of the head from the desired position leads to actuation of pneumatic cylinders, which apply torques to the manipulator gimbal axes so as to oppose or conteract the incipient head movement. It is particularly significant that none of these patients participating in these experiments were at all apprehensive about or resisted being placed in the apparatus. (Even the youngest subject to use the apparatus--five year old-- did not mind being restrained by the shoulder pads or having his head gripped by helment.) While JG utilized the safety release valve quite often during the first few head control training sessions, he soon became confident enough in the action of the stabilizer that he did not even bother to grip the handle of the release valve. While DA had the action of safety valve explained and demonstrated for her, she never bothered to use it even from the outset of her experience with the stabilizer. Thus, it seems that the football shoulder pads use to stabilize the shoulders and the hockey helmet used to grip and manipulate the head actually make the apparatus attractive to younger patients, while the padding thereby provided makes it comfortable enough to be tolerated well by older individuals. And, the subject's knowing that he has an override control by means of which he can assert command over the entire system appears to be of psychological benefit in establishing confidence in both the apparatus and the investigator.
一种位置反馈控制的头部稳定器已被研发出来，用于为脑瘫患者提供阻力训练，以增强颈部肌肉组织。该装置可检测“非自主”的头部运动，并通过施加反向力来稳定头部；它还可用于通过抵抗受试者的自主运动来促进肌肉收缩。本研究的目的是确定脑瘫患者的自主头部控制能力是否可以通过使用稳定器进行系统训练来增强颈部肌肉并改善其动作平衡而得到提高。研究结果支持了作者的观点，即这是可行的。该装置由一个头盔和肩垫组成，它们相互连接，使得头部由一个机械臂支撑在头盔中。在机械臂的下端，通过一个万向节组件连接到肩垫安装框架，该组件允许头部在两个倾斜平面（俯仰，即前后方向，以及滚动，即左右方向）内移动。反馈控制电路的设置使得头部从期望位置的任何偏差都会导致气压缸的启动，气压缸会向机械臂万向节轴施加扭矩，以对抗或抵消初期的头部运动。特别值得注意的是，参与这些实验的患者中没有一个对被放置在该装置中有丝毫担忧或抵触情绪。（即使是使用该装置的最年幼的受试者——五岁——也不介意被肩垫约束或头部被头盔固定。）虽然JG在最初的几次头部控制训练课程中经常使用安全释放阀，但他很快就对稳定器的作用充满信心，甚至都懒得去抓释放阀的手柄。虽然DA让人向她解释并演示了安全阀的作用，但从她开始使用稳定器起，她就从未费心去使用它。因此，似乎用于稳定肩部的橄榄球肩垫和用于固定和操纵头部的曲棍球头盔实际上使该装置对年轻患者具有吸引力，而由此提供的衬垫使其足够舒适，年长的个体也能很好地耐受。而且，受试者知道他有一个超控控制装置，通过它可以对整个系统进行控制，这在建立对该装置和研究者的信心方面似乎具有心理益处。
