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Based on the biomechanical mechanism of human upper limb, the disadvantages of traditional rehabilitation training and the current status of upper limb rehabilitation robot, a six degree of freedom, flexible adjustment, wearable upper limb rehabilitation exoskeleton design scheme is proposed. Firstly, the mechanics of each joint of the upper limb is analyzed, and the virtual prototype design of the whole mechanical structure of the upper limb rehabilitation wearable exoskeleton is carried out by using CATIA three-dimensional software. The tooth transmission of the forearm and the upper arm single row four point contact ball bearing with internal/external rotation and the shoulder flexible passive adjustment mechanism (viscoelastic damper) are innovatively designed. Then, the joints of the upper limb rehabilitation exoskeleton are analyzed, theoretical analysis and calculation of the driving torque, the selection of the motor and gearbox of each driving joint are carried out. Finally, the whole finite element analysis of the upper limb exoskeleton is carried out. The research and experimental results showed that the design scheme of the upper limb exoskeleton assist structure is highly feasible, which can help the patients with upper limb paralysis and motor dysfunction self-rehabilitation.
Subject(s)
Humans , Biomechanical Phenomena , Exoskeleton Device , Robotics , Stroke Rehabilitation , Torque , Upper Extremity , Wearable Electronic DevicesABSTRACT
This paper introduced the application of pneumatic artificial muscles in rehabilitation medical equipment at home and abroad, and emphatically analyzed the application of pneumatic artificial muscle in upper limb rehabilitation instruments and lower limb rehabilitation instruments in recent years, among which upper limb rehabilitation instruments included hand, wrist and arm, and lower limb rehabilitation instruments included leg, knee and ankle. The working characteristics and application scope of the application examples were introduced, and a comparative analysis of the same functional rehabilitation equipment was made.
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Objective To assess the intervention effect of upper limb rehabilitation exercise video on life quality in patients after modified radical mastectomy. Methods A total of 160 breast cancer patients received modified radical mastectomy were from Shanghai Jiading District Maternal and Child Health Hospital from June 2017 to June 2019.They were randomly divided into control group and observation group with 80 cases in each group.The patients in the control group were trained with routine upper limb rehabilitation exercise, and the patients in the observation group were given video training for upper limb rehabilitation exercise.Quality of life (QOL), anxiety scale and depression scale were used for corresponding evaluations.Satisfaction and compliance scales were also used for evaluation. Results Before intervention, there was no significant difference in each index between the two groups (P>0.05).After intervention, the quality of life in the observation group was better than that in the control group, including life status (21.43±4.83), functional status (19.69±4.72), emotional status (19.83±4.36), social/family status (19.59±3.62) and additional attention (24.73±3.27).There was no statistically significant difference in these parameters before and after intervention in the control group (P>0.05).The scores of anxiety (36.37±5.64) and depression (37.28±4.47) in the observation group were lower than those in the control group, and the differences were statistically significant.The nursing satisfaction of patients in the observation group was much higher than that in the control group (91.25% vs 77.50%), and the proportion of compliance was higher than that in the control group (97.50% vs 68.75%). Conclusion In breast cancer patients received radical mastectomy, video-guided rehabilitation training can improve the quality of life and nursing satisfaction, compliance of rehabilitation, and condition of anxiety and depression.
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Robot rehabilitation has been a primary therapy method for the urgent rehabilitation demands of paralyzed patients after a stroke. The parameters in rehabilitation training such as the range of the training, which should be adjustable according to each participant's functional ability, are the key factors influencing the effectiveness of rehabilitation therapy. Therapists design rehabilitation projects based on the semiquantitative functional assessment scales and their experience. But these therapies based on therapists' experience cannot be implemented in robot rehabilitation therapy. This paper modeled the global human-robot by Simulink in order to analyze the relationship between the parameters in robot rehabilitation therapy and the patients' movement functional abilities. We compared the shoulder and elbow angles calculated by simulation with the angles recorded by motion capture system while the healthy subjects completed the simulated action. Results showed there was a remarkable correlation between the simulation data and the experiment data, which verified the validity of the human-robot global Simulink model. Besides, the relationship between the circle radius in the drawing tasks in robot rehabilitation training and the active movement degrees of shoulder as well as elbow was also matched by a linear, which also had a remarkable fitting coefficient. The matched linear can be a quantitative reference for the robot rehabilitation training parameters.
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With the aging of the society, the number of stroke patients has been increasing year by year. Compared with the traditional rehabilitation therapy, the application of upper limb rehabilitation robot has higher efficiency and better rehabilitation effect, and has become an important development direction in the field of rehabilitation. In view of the current development status and the deficiency of upper limb rehabilitation robot system, combined with the development trend of all kinds of products of the upper limb rehabilitation robot, this paper designed a center-driven upper limb rehabilitation training robot for cable transmission which can help the patients complete 6 degrees of freedom (3 are driven, 3 are underactuated) training. Combined the structure of robot with more joints rehabilitation training, the paper choosed a cubic polynomial trajectory planning method in the joint space planning to design two trajectories of eating and lifting arm. According to the trajectory equation, the movement trajectory of each joint of the robot was drawn in MATLAB. It laid a foundation for scientific and effective rehabilitation training. Finally, the experimental prototype is built, and the mechanical structure and design trajectories are verified.
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The upper limb dysfunction after stroke has a high incidence,and is difficult to recovery,which seriously affects the patients' activities of daily living and the quality of life.Scholars have been exploring new and effective rehabilitation strategies for upper limb dysfunction after stroke.Transcranial direct current stimulation (tDCS),a typical form of non-invasive brain stimulation,is widely used in upper limb function rehabilitation by modulating the excitability of the cerebral cortex to improve motion performance.Some results showed that tDCS combined with repetitive rehabilitation training can significantly improve the motion function of stroke patients.Robotic therapy (RT) provides high-intensity,repetitive motion therapy that meets the training needs of patients at different levels.Therefore,tDCS combined with RT can effectively enhance the upper limb function rehabilitation effect of stroke patients.In this paper,the research status of tDCS combined with RT in the treatment of upper limb function after stroke were reviewed such as target patients,treatment methods,rehabilitation effects,combination methods,etc.The research trends and future development ideas in this field were discussed.
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@#Objective To observe the effect of repetitive focal muscle stimulation on recovery of upper limb function after stroke.Methods From October, 2016 to February, 2018, 46 stroke patients at early stage were recruited and divided into control group (n=23) and observation group (n=23). Both groups received basic rehabilitation training. The observation group accepted additional repetitive focal muscle stimulation on palms, forearm extensor carpi radialis, biceps brachii and muscles around scapula. The control group received sound stimulation as placebo treatment. The treatment was implemented once a day, five days a week for four weeks totally. The scores of Fugl-Meyer Assessment -Upper Extremities (FMA-UE), the Motricity Index of Upper Extremities (MI-UE) and the Hong Kong version of Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK) were compared before and four weeks after treatment. Results After treatment, the scores of FMA-UE, MI-UE and FTHUE-HK improved in both groups (F>2.577, P<0.05), and were higher in the observation group than in the control group (t>2.153, P<0.05).Conclusion Repetitive focal muscle stimulation could facilitate to recover the function of upper limb in early-stage stroke patients.
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The paper overviewed the research progress of the upper limb rehabilitation training system based on virtual reality technolo-gy, introduced some kinds of rehabilitation system, especially the software design, and the application of virtual scene, virtual object and net-work remote in the upper limb rehabilitation, and summarized the problem of applications of virtual reality in the rehabilitation and put for-ward the prospects about it.
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This paper discussed the application of upper extremity rehabilitation devices in rehabilitation evaluation after stroke, fo-cused on some typical kinds of upper extremity rehabilitation systems. It was analyzed that the way to obtain multiple parameter and evalua-tion indices during the progress of upper extremity rehabilitation evaluation, and viewed the development and application of upper extremity rehabilitation evaluation technology.
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@#The upper limb rehabilitation robot can be divided into two types, exoskeleton and traction, according to the mechanisms.This paper reviewed mechanisms of upper limb rehabilitation robot and summarized the main problems.
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@#Hemiplegia is a common type of physical disability in children with brain damage. For many kinds of reasons, the outcome of rehabilitation of the affected upper limb is not good enough, especially in the affected hand. Recently, many studies engaged in the modified Constraint-induced Movement Therapy (mCIMT) to explore the child-friendly way of restraint to improve hand function in hemiplegic children, and were summarized in this paper.
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@#Objective To explore the associated factors influencing the prognosis of upper limb function and ability of activities daily living(ADL)in stroke patients with left side hemiplegia.Methods 64 stroke patients with left side hemiplegia were treated regularly last for 1 month.At admission,the assessment procedure for cognitive function were performed with scales of Mini-Mental State Examination(MMSE),Loewenstein Occupational Therapy Cognitive Assessment(LOTCA),Motor Impersistence(MI),Schenkenberg Line Bisection Test.Brunnstrom stage,Modified Barthel Index(MBI),Ueda,Bin Hemiplegic Finger Function Assessment Scale,Upper Limb Function Assessment Scale were graded for the upper limb function and ADL ability before and after training.The multinominal logistic regression analysis was used to analyze the relationship between those factors and the upper limb function and ADL ability.Results The extent of resumption of upper limb function of patients was positively correlated with the ability of formal operational thinking(P<0.01)in LOTCA score before training.However,the extent of resumption of hand was negatively correlated with MI score before training(P<0.01).The extent of resumption of the hand practicability was positively correlated with the ability of operational thinking and score of ADL in LOTCA before training(P<0.01).The extent of the resumption of ADL was positively correlated with the ability score of operational thinking in LOTCA and diseased region.It was negatively correlated with the score of Schenkenberg line bisection(P<0.01).Conclusion The ability of operational thinking in LOTCA before training and the scores of Schenkenberg line bisection,ADL and MI are helpful in prognosis for the upper limb function in stroke patients with left side hemiplegia.
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@#ObjectiveTo explore the effect of the rehabilitation therapy founded by ourself.Methods46 children with hemiplegia were divided into rehabilitation group and control group.Fugl-Meyer Measure was used before and after rehabilitation. ResultsThere were significant difference between two groups in all the index(P<0.05).ConclusionThe rehabilitation therapy founded by ourself is effective on hemiplegia.