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ObjectiveTo explore the effects of different intensity of wearable lower limb rehabilitation robot-assisted training on walking function, lower limb motor function, balance function and functional independence of stroke patients. MethodsFrom November, 2021 to December, 2022, 60 stroke patients hospitalized in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), observation group 1 (n = 20) and observation group 2 (n = 20). All the groups received routine rehabilitation, while the control group received routine walking training 30 minutes a day, the observation group 1 received wearable lower limb rehabilitation robot-assisted training 30 minutes a day, and the observation group 2 received wearable lower limb rehabilitation robot-assisted training 60 minutes a day, for four weeks. They were assessed with Functional Ambulation Category scale (FAC), Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Berg Balance Scale (BBS) and Rivermead Mobility Index (RMI) before and after treatment. ResultsOne case in the observation group 1 and three cases in the observation group 2 dropped down. The FAC, FMA-LE, BBS and RMI scores improved in all the three groups after treatment (|Z| > 3.448, |t| > 8.102, P < 0.001), and there was no significant difference in all the indexes among the three groups (|H| < 4.643, F = 1.454, P > 0.05); however, the improvement of BBS score was more in the observation group 1 than in the control group (P < 0.05), and the improvement of all the indexes was more in the observation group 2 than in the control group (P < 0.05). ConclusionThe wearable lower limb rehabilitation robot-assisted training may promote the recovery of walking function, lower limb motor function, balance function and functional independence of stroke patients, and high-intensity training seems to be more effective.
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Objective A 2-PSU/ RR parallel ankle rehabilitation robot was designed, and the biomechanical properties of human muscles were also analyzed, so as to study rehabilitation strategy of the ankle rehabilitation robot. Methods The actual workspace of the robot was obtained by numerical discrete search method, and the effect of structural parameter changes on the height of robot moving platform was explored. Then the human biomechanical responses such as muscle force and muscle mobility were obtained by human biomechanical simulation software AnyBody, so as to investigate the effect of moving platform height changes on muscle behavior. Results The robot could meet the demand of ankle plantarflexion/ dorsiflexion and inversion/ eversion motion. Appropriately increasing the initial inclination angle and decreasing the length of the fixed-length bar enabled the ankle rehabilitation robot to have a lower overall height. The height of the moving platform was decreased by 10 mm in turn, and the muscle force and muscle activity of the human body involved in the movement were decreased to a certain extent. Conclusions This study provides a new design solution for ankle rehabilitation, offers theoretical guidance for motion analysis of the ankle rehabilitation robot, and accelerates rehabilitation of the patients’ ankles by modifying the mechanism parameters.
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ObjectiveTo study the effect of upper limb robot-assisted therapy on upper limb function and cerebral cortex activation in stroke patients using functional near-infrared spectroscopy (fNIRS). MethodsFrom January, 2022 to January, 2023, 32 stroke patients in Zhejiang Rehabilitation Medical Center were randomly divided into control group (n = 16) and experimental group (n = 16). Both groups received routine neurological medication and routine rehabilitation. The control group received routine upper limb exercises, the experimental group received upper limb robot-assisted therapy. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and fNIRS (oxyhemoglobin, deoxyhemoglobin, and total hemoglobin) before and four weeks after treatment. NIRS_SPM was used for activation analysis, Homer2 was used for blood oxygen concentration analysis. ResultsAfter treatment, the score of FMA-UE increased in both groups (|t| > 5.910, P < 0.001), and was higher in the experimental group than in the control group (t = -2.348, P < 0.05). fNIRS activation results showed that, the activation increased in the experimental group after treatment in channel 17 (F = 9.354, P < 0.01), and it was more than that in the control group (F = 5.217, P < 0.05). fNIRS blood oxygen concentration results showed that, the blood oxygen concentration increased in the experimental group after treatment in channel 17 (F = 12.179, P < 0.01), and it was more than that in the control group (F = 4.883, P < 0.05). ConclusionThe upper limb robot-assisted therapy can improve the upper limb motor function and cerebral cortex activation of stroke patients.
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ObjectiveTo investigate the effect of high-definition transcranial direct current stimulation (HD-tDCS) combined with rehabilitation robot on upper limb and hand dysfunction in patients with subacute stroke. MethodsFrom December, 2019 to December, 2021, 50 inpatients with subacute stroke in Zhejiang Provincial People's Hospital were randomly divided into control group (n = 25) and experimental group (n = 25). Both groups received routine rehabilitation therapy, while the control group added sham HD-tDCS combined with rehabilitation robot, and the experimental group added HD-tDCS combined with rehabilitation robot, for four weeks. The upper limb and hand function was assessed with Action Research Arm Test (ARAT), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Motor Assessment Scale (MAS) before and after treatment. ResultsAfter treatment, the scores of ARAT, FMA-UE and MAS increased in the two groups (∣Z∣ > 3.320, t > 6.379, P < 0.01), while the scores of FMA-UE and MAS were higher in the experimental group than in the control group (Z = -2.379, t = 3.181, P < 0.05), as well as the scores of grasping and gross motor of ARAT (∣Z∣ > 2.033, P < 0.05). ConclusionThe combination of HD-tDCS and rehabilitation robot can be more effective on upper limb and hand function in patients with subacute stroke than rehabilitation robot alone.
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Spatiotemporal gait parameters provide important information for the rehabilitation of patients with gait dysfunction. These parameters are often obtained by complex systems such as optical motioncapture system and pressure plates. However, these systems cannot be deployed at the lower-limb rehabilitation robot easily because of high costs, large area occupation and wearable requirements. We present a gait measurement system with a Light Detection And Ranging(LIDAR) laser sensor based on the lower-limb rehabilitation robot. Firstly, to calculate gait parameters, the data are aggregated into left and right legs by the clustering algorithm and the legs contour is fitted with two circles respectively according to the least square method. Then, the spatiotemporal gait parameters are defined based on the time and position of initial contact(IC) and toe off(TO). Finally, to verify the validity of the proposed system, we compared the results of the proposed system with a 3D motion capture system based on a lower-limb rehabilitation robot. Experimental results showed that the gait detection system can measure the parameters within a small range of error that testified the validation of the proposed system. This system proved to be a valid and reliable method for the measurement of gait parameters.
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Humans , Biomechanical Phenomena , Gait , Lasers , Lower Extremity , Motion , RoboticsABSTRACT
Objective:To summarize the methods and results of human motion intention recognition based on the surface electromyography. Methods:Literatures were retrieved and reviewed from the databases of PubMed, Web of Science, CNKI, Wanfang and VIP until December, 2020. The experimental researches about human motion intention recognition based on surface electromyography were summarized. Results:The methods of motion intention recognition were divided into three models: musculoskeletal model, traditional machine learning model and deep learning model. Conclusion:It is difficult to fully estimate human motion intention using surface electromyography in a single way. More researches are needed to develop more accurate and real-time human motion intention recognition methods.
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Flexible variable stiffness actuator is divided into four categories including elastic element, pneumatic element, electric-magnetic element and intelligent material. It is gradually applied in rehabilitation robot. It could adapt the change of patient's impedance in the upper and lower limb rehabilitation robots, ensure the safety of the wearer in the exoskeleton, and improve the biomimetics in the prosthesis. Variable stiffness driving mechanism for rehabilitation robot still has some disadvantages. It is proposed to have compact structure, low power consumption, good stiffness characteristics, high response rate and progressive output torque curve, etc.
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Objective:To solve the problem of leg shaking caused by the sudden change of angular acceleration at the joint of periodic motion during circular gait training of lower limb rehabilitation robot. Methods:A kind of quasi-circular gait was proposed, which divided the periodic motion into three phases: start phase, middle phase and end phase. The time was equal in the start phase and the end phase, and could be adjusted with the parameter ratio. The joint trajectories of the two phases were planned by quintic polynomial, and the middle phase was still the circular gait joint trajectory. The trajectory of the proposed quasi-circular gait was simulated. Results:The angular velocity was continuously differentiable and 0, the angular acceleration was continuous and 0, and the end-effector trajectory became flat with the increase of ratio. The results on the physical prototype of the lower limb rehabilitation robot were principally consistent with the simulation, and the machine worked smoothly. Conclusion:The proposed variable quasi-circular gait had smooth angular acceleration at the junction of periodic motions, which effectively solved the jitter problem when using circular gait for lower limb rehabilitation training and avoided secondary injury to the patients.
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Objective:To develop an automatic adjustment algorithm of bed height of multi-position lower limb rehabilitation robot, to meet the variety of leg lengths and training modes to avoid the collision between robot and ground. Methods:Six mathematical models of robot bed body height were established for six training modes of multi-position lower limb rehabilitation robot, which were described with leg length and bed tilt angle. The influence was analyzed that mechanical clearance and deflection as well as the jitter error of leg bracket during movement. Furthermore, a software related to these models was developed to automatically adjust the bed height for training. Volunteers were recruited to test actually. Results:The test data of bed height are consistent with the theoretical calculation of six mathematical models. Clearance and deflection did not affect the theoretical results of bed height. The end of robot's lower limb was always above the safe height during rehabilitation training. Conclusion:The automatic adjustment algorithm of bed height has been established, which can ensure that the rehabilitation robot runs at a safe height.
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Objective To study the influence of different trajectories of 3-PH/R ankle rehabilitation robot on joints and muscles. Methods The 3-PH/R ankle rehabilitation robot was simplified and imported into biomechanical modeling software by analyzing the kinematics principles. Using the actual motion trajectory of ankle rehabilitation robot as model driving, the joint and muscle forces were compared under three different trajectories, namely, dorsiflexion/plantarflexion, inversion/eversion and nutation. The correlation analysis on three motion trajectories was conducted. Results Nutation could satisfy the function of both plantar dorsiflexion/plantarflexion, and inversion/eversion, and made the ankle muscles fully exercised. The maximum difference in joint force under three different rehabilitation trajectories was 0.3 N. Different muscles had different sensitivity to trajectories. Conclusions The continuous dynamic analysis of muscle force and joint force under three kinds of rehabilitation trajectories was implemented. The results have certain theoretical significance and clinical reference value for the clinical application of ankle rehabilitation robot and the formulation of rehabilitation trajectory.
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OBJECTIVE@#To compare the therapeutic effect between rehabilitation robot rehabilitation training synchronizing acupuncture exercise therapy and simple acupuncture exercise therapy on lower limb function and life activity ability for postoperative patients with hip fracture.@*METHODS@#A total of 50 elderly postoperative patients with hip fracture were randomly divided into an observation group and a control group, 25 cases in each group. Both groups were treated with acupuncture at hip three points of the affected side and lateral line 1 of vertex, anterior oblique parietotemporal line of the healthy side, hip three needles were retained for 30 min. The scalp acupuncture needles were continue retained, the observation group was given acupuncture exercise therapy to synchronize lower limb rehabilitation robot rehabilitation training, and the control group was given acupuncture exercise therapy. The two groups were treated once a day, 7 times as a course of treatment, and totally 4 courses were required. The Harris score, Barthel index score and quadriceps femoris isokinetic muscle strength indexes [peak torque (PT), average power (AP), flexor peak torque/extensor peak torque (F/E)] were compared between the two groups before and after treatment.@*RESULTS@#After treatment, the Harris score, Barthel index score, PT and AP were higher than those before treatment (@*CONCLUSION@#Rehabilitation robot rehabilitation training of lower limbs synchronizing acupuncture exercise therapy could enhance the hip joint activity function and quadriceps muscle group function of elderly postoperative patients with hip fracture, and effectively improve the lower limb function and life activity ability.
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Aged , Humans , Acupuncture Points , Acupuncture Therapy , Exercise Therapy , Robotics , Stroke , Stroke Rehabilitation , Treatment OutcomeABSTRACT
The real physical image of the affected limb, which is difficult to move in the traditional mirror training, can be realized easily by the rehabilitation robots. During this training, the affected limb is often in a passive state. However, with the gradual recovery of the movement ability, active mirror training becomes a better choice. Consequently, this paper took the self-developed shoulder joint rehabilitation robot with an adjustable structure as an experimental platform, and proposed a mirror training system completed by next four parts. First, the motion trajectory of the healthy limb was obtained by the Inertial Measurement Units (IMU). Then the variable universe fuzzy adaptive proportion differentiation (PD) control was adopted for inner loop, meanwhile, the muscle strength of the affected limb was estimated by the surface electromyography (sEMG). The compensation force for an assisted limb of outer loop was calculated. According to the experimental results, the control system can provide real-time assistance compensation according to the recovery of the affected limb, fully exert the training initiative of the affected limb, and make the affected limb achieve better rehabilitation training effect.
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Humans , Electromyography , Movement , Muscle Strength , Robotics , Shoulder Joint , Stroke RehabilitationABSTRACT
Stroke would result in upper-limb dysfunction. Robot-assisted upper limb rehabilitation is applied in the rehabilitation training after stroke, mainly for intensive and repetitive specific task-oriented training to improve muscle strength and promote the isolated movement of upper limbs for the hemiplegics. However, it can do less for spasm and activities of daily living. It may be more effective combining with other therapies. Although the robots have the advantages of no fatigue, quantification, individualization and objective evaluation, there are also some disadvantages, such as incomplete training, inability to correct compensatory action and lack of empathy, etc. There is still a lack of high quality clinical research of large samples about robot-assisted upper limb rehabilitation, and frequency and time of the treatment is unclear.
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Objective:To solve the movement mode adapting to individual differences for the trajectory planning of lower limb rehabilitation robots. Methods:After summarizing the six movement modes of the lower limb rehabilitation robot, according to the multi-rigid body theory of the human body, the exoskeleton of the lower limb rehabilitation robot was simplified into a two-bar linkage mechanism, the inverse kinematics analysis of the motion mode was performed, and the motion pattern solving system was designed based on C#. Results:The motion mode joint angle value calculated based on the C# motion mode solving system was transmitted to the upper computer, and the six motion modes were successfully applied to the lower limb rehabilitation robot. Through the inversion kinematics analysis of the motor model, the C#-designed motion mode solving system could solve the motorized joint angle values that adapted to individual of different leg lengths with lower extremity motor dysfunction. Through physical prototype experiments, the lower limb rehabilitation robot could drive the human body model for rehabilitation training according to the planned exercise mode. The actual joint angle curve and the theoretical joint angle curve were basically coincident, the joint angle error was small. Conclusion:The individual difference motion pattern solution is valid and feasible.
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PURPOSE: This study examined the effects of trunk control rehabilitation robot training (TCRRT) on the dynamic balance, lower extremity strength, gait ability and pain for bipolar hemiarthroplasty. METHODS: Hemiarthroplasty (n=28) patients participated in this study. The subjects were randomized into two groups: trunk control rehabilitation robot training group and control group. RESULTS: The TCRRT group showed significantly more improvement in the MFRT, MMT, 10MWT, TUG, and VAS compared to that before intervention (p<0.05). In addition, all tests were significantly greater in the experimental group than in the control group. CONCLUSION: These results suggest that TCRRT is feasible and effective for improving the dynamic balance, lower extremity strength, gait ability, and pain efficacy after bipolar hemiarthroplasty.
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Humans , Gait , Hemiarthroplasty , Lower Extremity , RehabilitationABSTRACT
Using intelligent rehabilitation robot to intervene hand function after stroke is an important physical treatment. With the development of biomedical engineering and the improvement of clinical demand, the comprehensive intervention of hand-function rehabilitation robot combined with new technologies is gradually emerging. This article summarizes the hand rehabilitation robots based on electromyogram (EMG), the brain-computer interface (BCI) hand rehabilitation robots, the somatosensory hand rehabilitation robots and the hand rehabilitation robots with functional electrostimulation. The advantages and disadvantages of various intervention methods are discussed, and the research trend about comprehensive intervention of hand rehabilitation robot is analyzed.
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Objective:A novel four-degree-of-freedom upper limb rehabilitation robot was designed to overcome the shortcomings of the structure of the most of serial robots. Methods:The shoulder and elbow joint drive system and the information detection system were placed in the base. The synchronous belt drive system and the spiral bevel gear transmission system were designed to transmit power from the base to the shoulder and elbow joint of the arm. The cubic polynomial trajectory planning method based on the joint space was selected to accomplish the trajectory planning of the recovery movements of taking objects and drawing quadrilaterals, and the single-degree-of-freedom motion control experiment and multi-degree-of-freedom trajectory planning experiment were designed to verify the rationality and feasibility of the design. Results:Each joint of the rehabilitation robot reached the designed range of motion at the designed speed, and well completed the planned rehabilitation training movements. Conclusion:This robot can effectively reduce the volume and mass of the mechanical arm, overcome the influence of motor noise and radiation on patients' rehabilitation training, and assist patients to complete a variety of rehabilitation exercises.
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Objective:To observe effects of lower-limb rehabilitation robots on the lower limb spasticity,motor function and ADL of hemiplegic patients after stroke.Method:40 cases of hemiplegic patients were randomly allocated to experiment and control groups (n=20 in each).The experiment group received training assisted by a leg rehabilitation robot LR2 for 30 min once daily for 6 weeks in addition to conventional treatments.The control group was given conventional treatments once daily for 6 weeks.Their lower limbs spasticity,motor function and ADL were assessed with the modified Ashworth rating scale(MAS),Simplified Fugl-Meyer Movement Scale (FMA) and Modified Barthel Index assessment method (MBI) before and after training.Result:After treatment,the lower limb spasticity was significantly lowered (P＜0.05),lower limb motor function and ADL were significantly improved (P＜0.05),and the experimental group was significantly better than the control group (P＜0.05).Conclusion:Leg rehabilitation robot LR2 can lower the spasticity of lower limb muscle and improve lower limb motor function and the ability of daily living in stroke patients,and the short term effect is better than conventional rehabilitation.
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Rehabilitation robot has been gradually popularized in clinical application for adults, but pediatric rehabilitation robot is still in its infancy. The upper limb rehabilitation robot and lower limb rehabilitation robot have achieved good results in the rehabilitation of children with cerebral palsy. The humanoid robot with outstanding interactive performance also brings hope for children with autism. Pediatric rehabilitation robot may need to have more training modes and combine new technologies like virtual reality to meet the needs of children's rehabilitation in the future, and is also facing prob-lems such as high cost and safety.
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According to characteristics of gait-assisted training, exoskeleton-based lower limb rehabilitation robot can be classified into treadmill-based exoskeleton robot and over-ground exoskeleton robot. Both kinds of exoskeleton-based lower limb rehabilitation robot have been applied in stroke rehabilitation, both in subacute and chronic stages, that may do something in gait training, balance improvement and lower limb motor function recovery.