医疗康复机器人研究进展及趋势

State of the Art of Medical and Rehabilitation Robotics and Their Perspective

随着人们对医疗健康手段和过程提出的精准、微创、高效及低成本等方面的更高需求,医疗康复机器人技术也获得了各国的极大关注,并得到了日新月异的发展。目前医疗康复机器人主要用于外科手术、功能康复及辅助护理等方面,但随着重要技术的突破和进展,未来机器人技术有可能会应用到医疗健康的各个领域。医疗康复领域越来越倾向于人与机器自然、精准的交互,近年来,以人的智能和机器智能结合及人机交互为代表的技术突破使得人与机器之间的结合越来越紧密,借助人机交互技术和方法,将人的智能和机器智能结合起来,使二者优势互补、协同工作,并将在医疗康复方面孕育出重大的理论创新和技术方法突破。社会需求、技术革新和人机智能融合极大的促进了医疗康复机器人的发展。医疗康复机器人涉及人类生命健康的特殊领域,存在潜在的经济市场,已被多个国家列为战略性新兴产业,我国也需进一步大力开展医疗康复机器人的研发,推动该战略新兴产业的发展,以应对我国国民对健康服务的需求(医疗、康复及老龄化)。

Currently, robots have been developed and used across the various areas such as manufacturing, services, healthcare/medical, defense, and space. While the manufacturing robotics have been widely accepted by industries and have been achieving many successes, the medical and healthy robots have been paid close attention to by researchers and clinicians. The robots may be used in various divisions of medical and healthy procedures, but now they are majorly developed and successfully applied in the fields of surgery, rehabilitation, and assistance. With the assistance of medical robotics, existing surgical medical procedures could be greatly iraproved with less invasive and fewer side effects, which result in faster recovery times and in substantially improving both risk-benefit and cost-benefit ratios. Currently, the major successful areas of applying a medical robotics include prostate surgery, cardiac surgery, brain neural surgery, and spinal-cord surgery. In the healthy applications of robots, another successful area is rehabilitation in which both multifunctional prostheses and exercising robots have been developed and used for limb amputees and paralyzed patients, respectively. The intelligent prostheses are used to help the amputees restore some limb functions in their daily life. The paralyzed people can use a rehabilitation robot to do limb exercise for recovery of the lost functions of their arm and leg locomotion. In addition, with the fast-growing elderly population, some robots also have been developed and used as assistive equipment in their daily activities for increasing locomotion and mitigating occurrence of dementia and as a companion at home for reducing isolation and depression. In this review paper we first summarized the state of the art of the robots developed for surgeries and rehabilitations. Then the up-to-date most interesting and popular research fields related to the medical and rehabilitation robots were introduced. Recently, a number of medical and rehabilitation robotics were designed and introduced into the clinical applications. Some minimally invasive surgery robotic systems such as the da Vinci Surgical System（Da Vinci Surgery）have been commercially available and are successfully utilized to perform clinical cardiac surgeries in many countries. And robotic systems such as MIT-Manus （commercially, InMotion）and Lokomat （Hocoma）are also successfully delivering physical and occupational therapy. Although many great processes of medical and rehabilitation robotic technologies and systems have been made, there are still some limitations and issues of current robotics technologies and systems. For example, the current medical surgery robots are lack of natural and precise interactions between the robotics and doctors, which would limit the performance and safety of medical robotics. And most of the rehabilitation and assistive robots are passively operated by the users. Thus the efficiency of these robots in the recovery of limb functions is limited. In order to further improve the performance of the current medical and rehabilitation robots, the precise interaction and synergy between robots and human would be very important and critical for making use of robotics in healthy fields since one of major characteristics of healthy robots is that they will work in a human-machine-interaction environment. The natural and precise interactions between robots and human will be able to be realized by the fusion of human-machine-intelligence synergy that would make use of the cognitive abilities of human brains and the computing capacities of a computer. Finally, this paper made a perspective of the medical and rehabilitation robots briefly. It can be predicted that robotic systems will have a large number of potential application niches from youth to the elderly, and from able-bodied to disabled. In the future, medical and rehabilitation robots will be able to have the ability to capture human state and behavior（aided with wearable sensors）in controlled environments such as physical therapy sessions and working places of a doctor or paramedic Thus the medical and rehabilitation robotics will finally have an ability to realize the natural and precise interactions between human （ such as patients and doctors ） and machine （robots）