脑性瘫痪(cerebral palsy,CP)简称脑瘫,是一组持续存在的中枢性运动和姿势发育障碍、活动受限综合征,这种综合征是由于发育中的胎儿或婴幼儿脑部非进行性损伤所致[1]。全球范围内脑瘫患病率约为0.15%~0.40%[2]。几乎所有脑瘫儿童都伴有...脑性瘫痪(cerebral palsy,CP)简称脑瘫,是一组持续存在的中枢性运动和姿势发育障碍、活动受限综合征,这种综合征是由于发育中的胎儿或婴幼儿脑部非进行性损伤所致[1]。全球范围内脑瘫患病率约为0.15%~0.40%[2]。几乎所有脑瘫儿童都伴有不同程度的运动发育障碍,伴随终生,给儿童及其家庭带来严重影响。根据《国际功能、残疾和健康分类(儿童青少年版)》(international classification of functioning,disability and health children and youth version,ICF-CY)建议,康复治疗不应仅限于身体结构和功能,要将个体与活动、参与等领域联系起来,最终提高儿童的独立性[3]。动态套装矫形器(dynamic suit orthosis,DSO)作为一种补充和替代疗法,利用大脑神经系统的可塑性,通过增加本体感觉输入和病理反射、纠正异常身体姿势建立正确的运动模式[4-5]。根据治疗目的和生产商不同,DSO设计差异很大,包括覆盖全身的矫正衣,矫正裤、矫正手套等较小的矫形器[5]。DSO通常具有两种干预措施:①仅穿戴DSO进行长时程干预;②DSO结合悬吊、滑轮系统等高强度运动项目或神经发育治疗[6]。目前研究表明,DSO种类繁多,价格昂贵,负面影响较大,并且没有标准统一的训练方案,关于其有效性存在较大争议。本文主要阐述DSO的发展现状和临床应用,为临床康复治疗提供参考依据。展开更多
As the conventional reciprocating gait orthosis(RGO)has been deemed incapable of facilitating the patients’passive movement with significant gait discrepancies and distortion,in addition to characteristics such as po...As the conventional reciprocating gait orthosis(RGO)has been deemed incapable of facilitating the patients’passive movement with significant gait discrepancies and distortion,in addition to characteristics such as poor stability,and negligible knee joint rehabilitation,a power assisted reciprocating gait orthosis(PARGO)was designed.Drive devices were added to the hip and knee joints of the RGO.Through efficient implementation of structural components,the number of the required motors was reduced,therefore decreasing the weight of the orthosis.The PARGO knee joint’s structural principle was analyzed to characterize the effect of the PARGO’s single-axis knee joint design on wear comfort,thereby providing a basis for the wear of the PARGO.By analyzing the sagittal movement patterns of the hip and knee joints during normal human gait,kinematic analysis was carried out to obtain the input patterns of the PARGO hip and knee joint drive motors,enabling the patients to more accurately reproduce the normal gaits of hip and knee joints during the rehabilitation training with the aid of the PARGO,and the control process of the PARGO was studied.Finally,a prototype of the PARGO was developed,and experimentation was carried out to demonstrate the feasibility of the improved orthosis.展开更多
文摘脑性瘫痪(cerebral palsy,CP)简称脑瘫,是一组持续存在的中枢性运动和姿势发育障碍、活动受限综合征,这种综合征是由于发育中的胎儿或婴幼儿脑部非进行性损伤所致[1]。全球范围内脑瘫患病率约为0.15%~0.40%[2]。几乎所有脑瘫儿童都伴有不同程度的运动发育障碍,伴随终生,给儿童及其家庭带来严重影响。根据《国际功能、残疾和健康分类(儿童青少年版)》(international classification of functioning,disability and health children and youth version,ICF-CY)建议,康复治疗不应仅限于身体结构和功能,要将个体与活动、参与等领域联系起来,最终提高儿童的独立性[3]。动态套装矫形器(dynamic suit orthosis,DSO)作为一种补充和替代疗法,利用大脑神经系统的可塑性,通过增加本体感觉输入和病理反射、纠正异常身体姿势建立正确的运动模式[4-5]。根据治疗目的和生产商不同,DSO设计差异很大,包括覆盖全身的矫正衣,矫正裤、矫正手套等较小的矫形器[5]。DSO通常具有两种干预措施:①仅穿戴DSO进行长时程干预;②DSO结合悬吊、滑轮系统等高强度运动项目或神经发育治疗[6]。目前研究表明,DSO种类繁多,价格昂贵,负面影响较大,并且没有标准统一的训练方案,关于其有效性存在较大争议。本文主要阐述DSO的发展现状和临床应用,为临床康复治疗提供参考依据。
基金The Research Foundation for Key Program of Beijing(Grant No.D141100003614001)
文摘As the conventional reciprocating gait orthosis(RGO)has been deemed incapable of facilitating the patients’passive movement with significant gait discrepancies and distortion,in addition to characteristics such as poor stability,and negligible knee joint rehabilitation,a power assisted reciprocating gait orthosis(PARGO)was designed.Drive devices were added to the hip and knee joints of the RGO.Through efficient implementation of structural components,the number of the required motors was reduced,therefore decreasing the weight of the orthosis.The PARGO knee joint’s structural principle was analyzed to characterize the effect of the PARGO’s single-axis knee joint design on wear comfort,thereby providing a basis for the wear of the PARGO.By analyzing the sagittal movement patterns of the hip and knee joints during normal human gait,kinematic analysis was carried out to obtain the input patterns of the PARGO hip and knee joint drive motors,enabling the patients to more accurately reproduce the normal gaits of hip and knee joints during the rehabilitation training with the aid of the PARGO,and the control process of the PARGO was studied.Finally,a prototype of the PARGO was developed,and experimentation was carried out to demonstrate the feasibility of the improved orthosis.
