Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’bala...Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.展开更多
Background:Robot-assisted gait training(RAGT)is more effective in the range of motion(ROM)and isometric strength in patients with burns than conventional training.However,concerns have been raised about whether RAGT m...Background:Robot-assisted gait training(RAGT)is more effective in the range of motion(ROM)and isometric strength in patients with burns than conventional training.However,concerns have been raised about whether RAGT might negatively affect the scars of patients with burns.Therefore,we investigated the effects of RAGT-induced mechanical load on the biomechanical properties of burn scars.Methods:This was a single-blind,randomized clinical trial conducted on inpatients admitted to the Department of Rehabilitation Medicine between September 2020 and August 2021.RAGT was conducted for 30 min per day,five days a week for 12 weeks and the control group received conventional gait training for 12 weeks.The pre-training ROM of lower extremity joints was evaluated and the levels of melanin,erythema,trans-epidermal water loss,scar distensibility and elasticity were assessed before training and at 4 and 12 weeks after training.Finally,19 patients in the gait assistance robot(GAR)group and 20 patients in the control group completed the 12-week trial and all evaluations.Results:There were no significant differences in the epidemiologic characteristics,pre-training ROM of joints and pre-training biomechanical properties of the burn scar between the groups(p>0.05 for all).None of the patients experienced skin abrasion around the burn scar where the fastening belts were applied or musculoskeletal or cardiovascular adverse events during the training.Scar thickness significantly increased in both groups(p=0.037 and p=0.019)and scar distensibility significantly decreased in the control group(p=0.011)during the training.Hysteresis was significantly decreased in the GAR group during the training(p=0.038).The GAR and control groups showed significant difference in the change in the values of hysteresis between pre-training and 12 weeks after training(p=0.441 and p=0.049).Conclusions:RAGT significantly decreased hysteresis in hypertrophic burn scars and did not cause a significant decrease in skin distensibility.Moreover,no skin complications around the burn scars were detected during RAGT.展开更多
Background: Robot-assisted lower limb rehabilitation training in early stage could improve the limb function among hemiplegic patients caused by ischemic stroke. P300 potential changes have importantly clinical value ...Background: Robot-assisted lower limb rehabilitation training in early stage could improve the limb function among hemiplegic patients caused by ischemic stroke. P300 potential changes have importantly clinical value for evaluating the improvement in nerve function during the training as one of the objective targets. Methods: Sixty hemiplegic patients after stroke were randomly divided into a Lokomat group (30 cases) and a control group (30 cases). The Lokomat group received Lokomat rehabilitation while the control group only received traditional rehabilitation. The gait parameters and the balance ability were evaluated by the K421GAITRite analysis system and the Berg Balance Scale (BBS);ERP components including N100, N200, P200 and P300 potential were evaluated by a muscle electric inducing potentiometer. Results: There were no significant differences in BBS and gait parameters (P > 0.05), as well as in amplitude and incubation periods (IP) (P > 0.05) between the two groups before training. After 8 weeks treatment, the total (48.88 ± 3.68), static (26.40 ± 3.14) and dynamic (22.64 ± 3.68) balance scores improved significantly;the pace (59.22 ± 4.67), stride length (19.04 ± 2.24), feet wide (98.02 ± 7.97) and walking velocity (84.86 ± 9.88) and IP of N200 and P300 shortened obviously and P300 amplitude increased significantly in robot group (P < 0.05). Conclusion: This demonstrated that robot-assisted lower limb rehabilitation training in early stage could improve the limb function among hemiplegic patients caused by ischemic stroke. P300 may be considered as an indicator of neurological function improvement and effective robot-assisted lower limb rehabilitation training.展开更多
Due to the close physical interaction between human and machine in process of gait training, lower limb exoskeletons should be safe, comfortable and able to smoothly transfer desired driving force/moments to the patie...Due to the close physical interaction between human and machine in process of gait training, lower limb exoskeletons should be safe, comfortable and able to smoothly transfer desired driving force/moments to the patients. Correlatively, in kinematics the exoskeletons are required to be compatible with human lower limbs and thereby to avoid the uncontrollable interactional loads at the human-machine interfaces. Such requirement makes the structure design of exoskeletons very difficult because the human-machine closed chains are complicated. In addition, both the axis misalignments and the kinematic character difference between the exoskeleton and human joints should be taken into account. By analyzing the DOF(degree of freedom) of the whole human-machine closed chain, the human-machine kinematic incompatibility of lower limb exoskeletons is studied. An effective method for the structure design of lower limb exoskeletons, which are kinematically compatible with human lower limb, is proposed. Applying this method, the structure synthesis of the lower limb exoskeletons containing only one-DOF revolute and prismatic joints is investigated; the feasible basic structures of exoskeletons are developed and classified into three different categories. With the consideration of quasi-anthropopathic feature, structural simplicity and wearable comfort of lower limb exoskeletons, a joint replacement and structure comparison based approach to select the ideal structures of lower limb exoskeletons is proposed, by which three optimal exoskeleton structures are obtained. This paper indicates that the human-machine closed chain formed by the exoskeleton and human lower limb should be an even-constrained kinematic system in order to avoid the uncontrollable human-machine interactional loads. The presented method for the structure design of lower limb exoskeletons is universal and simple, and hence can be applied to other kinds of wearable exoskeletons.展开更多
Walking is the most basic and essential part of the activities of daily living. To enable the elderly and non-ambulatory gait-impaired patients, the repetitive practice of this task, a novel gait training robot(GTR) w...Walking is the most basic and essential part of the activities of daily living. To enable the elderly and non-ambulatory gait-impaired patients, the repetitive practice of this task, a novel gait training robot(GTR) was designed followed the end-effector principle, and an active partial body weight support(PBWS) system was introduced to facilitate successful gait training. For successful establishment of a walking gait on the GTR with PBWS, the motion laws of the GTR were planned to enable the phase distribution relationships of the cycle step, and the center of gravity(COG) trajectory of the human body during gait training on the GTR was measured. A coordinated control strategy was proposed based on the impedance control principle. A robotic prototype was developed as a platform for evaluating the design concepts and control strategies. Preliminary gait training with a healthy subject was implemented by the robotic-assisted gait training system and the experimental results are encouraging.展开更多
To accommodate the gait and balance disorder of the elderly with age progression and the occurrence of various senile diseases,this paper proposes a novel gait balance training robot(G-Balance)based on a six degree-of...To accommodate the gait and balance disorder of the elderly with age progression and the occurrence of various senile diseases,this paper proposes a novel gait balance training robot(G-Balance)based on a six degree-of-freedom parallel platform.Using the platform movement and IMU wearable sensors,two training modes,i.e.,active and passive,are developed to achieve vestibular stimulation.Virtual reality technology is applied to achieve visual stimulation.In the active training mode,the elderly actively exercises to control the posture change of the platform and the switching of the virtual scene.In the passive training mode,the platform movement is combined with the virtual scene to simulate bumpy environments,such as earthquakes,to enhance the human anti-interference ability.To achieve a smooth switching of the scene,continuous speed and acceleration of the platform motion are required in some scenarios,in which a trajectory planning algorithm is applied.This paper describes the application of the trajectory planning algorithm in the balance training mode and the optimization of jerk(differential of acceleration)based on cubic spline planning,which can reduce impact on the joint and enhance stability.展开更多
Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. How...Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.展开更多
Based on domain specified language mechanism(DSLM),the architecture of the robotic training system for the rehabilitation of children with cerebral palsy(CP)is designed.Application of human-computer interaction(HCI)mo...Based on domain specified language mechanism(DSLM),the architecture of the robotic training system for the rehabilitation of children with cerebral palsy(CP)is designed.Application of human-computer interaction(HCI)motion recognition technology is combined with Kinect to improve the effect of cerebral palsy rehabilitation training.In this system,Kinect's bone recognition method is used to judge the patient's training movements,and the collected bone movement information is judged.The human-computer interaction function is based on the Microsoft foundation classes function of Visual Studio based on DSLM development,which can realize real-time interactive training and evaluation of people and actions,and record the training information of patients.The system combines the designed small game to train the upper limb movement ability and reaction ability of the cerebral palsy patient,and provides key technology for improving the cerebral palsy rehabilitation training system.展开更多
BACKGROUND The results of existing lower extremity robotics studies are conflicting,and few relevant clinical trials have examined short-term efficacy.In addition,most of the outcome indicators in existing studies are...BACKGROUND The results of existing lower extremity robotics studies are conflicting,and few relevant clinical trials have examined short-term efficacy.In addition,most of the outcome indicators in existing studies are scales,which are not objective enough.We used the combination of objective instrument measurement and scale to explore the short-term efficacy of the lower limb A3 robot,to provide a clinical reference.AIM To investigate the improvement of lower limb walking ability and balance in stroke treated by A3 lower limb robot.METHODS Sixty stroke patients were recruited prospectively in a hospital and randomized into the A3 group and the control group.They received 30 min of A3 robotics training and 30 min of floor walking training in addition to 30 min of regular rehabilitation training.The training was performed five times a week,once a day,for 2 wk.The t-test or non-parametric test was used to compare the threedimensional gait parameters and balance between the two groups before and after treatment.RESULTS The scores of basic activities of daily living,Stroke-Specific Quality of Life Scale,FM balance meter,Fugl-Meyer Assessment scores,Rivermead Mobility Index,Stride speed,Stride length,and Time Up and Go test in the two groups were significantly better than before treatment(19.29±12.15 vs 3.52±4.34;22.57±17.99 vs 4.07±2.51;1.21±0.83 vs 0.18±0.40;3.50±3.80 vs 0.96±2.08;2.07±1.21 vs 0.41±0.57;0.89±0.63 vs 0.11±0.32;12.38±9.00 vs 2.80±3.43;18.84±11.24 vs 3.80±10.83;45.12±69.41 vs 8.41±10.20;29.45±16.62 vs 8.68±10.74;P<0.05).All outcome indicators were significantly better in the A3 group than in the control group,except the area of the balance parameter.CONCLUSION For the short-term treatment of patients with subacute stroke,the addition of A3 robotic walking training to conventional physiotherapy appears to be more effective than the addition of ground-based walking training.展开更多
文摘Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.
基金supported by Market Creation Robot Supply Project 2018 through the Ministry of Trade,Industry and Energy of the Republic of Korea and Korea institute for robot industry advancement(Medical and Rehabilitation Robot Pilot Program 2018)Hallym University Research Fund 2018(HURF-2018-065)supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(2020R1l1A3074150).
文摘Background:Robot-assisted gait training(RAGT)is more effective in the range of motion(ROM)and isometric strength in patients with burns than conventional training.However,concerns have been raised about whether RAGT might negatively affect the scars of patients with burns.Therefore,we investigated the effects of RAGT-induced mechanical load on the biomechanical properties of burn scars.Methods:This was a single-blind,randomized clinical trial conducted on inpatients admitted to the Department of Rehabilitation Medicine between September 2020 and August 2021.RAGT was conducted for 30 min per day,five days a week for 12 weeks and the control group received conventional gait training for 12 weeks.The pre-training ROM of lower extremity joints was evaluated and the levels of melanin,erythema,trans-epidermal water loss,scar distensibility and elasticity were assessed before training and at 4 and 12 weeks after training.Finally,19 patients in the gait assistance robot(GAR)group and 20 patients in the control group completed the 12-week trial and all evaluations.Results:There were no significant differences in the epidemiologic characteristics,pre-training ROM of joints and pre-training biomechanical properties of the burn scar between the groups(p>0.05 for all).None of the patients experienced skin abrasion around the burn scar where the fastening belts were applied or musculoskeletal or cardiovascular adverse events during the training.Scar thickness significantly increased in both groups(p=0.037 and p=0.019)and scar distensibility significantly decreased in the control group(p=0.011)during the training.Hysteresis was significantly decreased in the GAR group during the training(p=0.038).The GAR and control groups showed significant difference in the change in the values of hysteresis between pre-training and 12 weeks after training(p=0.441 and p=0.049).Conclusions:RAGT significantly decreased hysteresis in hypertrophic burn scars and did not cause a significant decrease in skin distensibility.Moreover,no skin complications around the burn scars were detected during RAGT.
文摘Background: Robot-assisted lower limb rehabilitation training in early stage could improve the limb function among hemiplegic patients caused by ischemic stroke. P300 potential changes have importantly clinical value for evaluating the improvement in nerve function during the training as one of the objective targets. Methods: Sixty hemiplegic patients after stroke were randomly divided into a Lokomat group (30 cases) and a control group (30 cases). The Lokomat group received Lokomat rehabilitation while the control group only received traditional rehabilitation. The gait parameters and the balance ability were evaluated by the K421GAITRite analysis system and the Berg Balance Scale (BBS);ERP components including N100, N200, P200 and P300 potential were evaluated by a muscle electric inducing potentiometer. Results: There were no significant differences in BBS and gait parameters (P > 0.05), as well as in amplitude and incubation periods (IP) (P > 0.05) between the two groups before training. After 8 weeks treatment, the total (48.88 ± 3.68), static (26.40 ± 3.14) and dynamic (22.64 ± 3.68) balance scores improved significantly;the pace (59.22 ± 4.67), stride length (19.04 ± 2.24), feet wide (98.02 ± 7.97) and walking velocity (84.86 ± 9.88) and IP of N200 and P300 shortened obviously and P300 amplitude increased significantly in robot group (P < 0.05). Conclusion: This demonstrated that robot-assisted lower limb rehabilitation training in early stage could improve the limb function among hemiplegic patients caused by ischemic stroke. P300 may be considered as an indicator of neurological function improvement and effective robot-assisted lower limb rehabilitation training.
基金Supported by National Natural Science Foundation of China(Grant No.61273342)Beijing Municipal Natural Science Foundation of China(Grant Nos.3113026,3132005)
文摘Due to the close physical interaction between human and machine in process of gait training, lower limb exoskeletons should be safe, comfortable and able to smoothly transfer desired driving force/moments to the patients. Correlatively, in kinematics the exoskeletons are required to be compatible with human lower limbs and thereby to avoid the uncontrollable interactional loads at the human-machine interfaces. Such requirement makes the structure design of exoskeletons very difficult because the human-machine closed chains are complicated. In addition, both the axis misalignments and the kinematic character difference between the exoskeleton and human joints should be taken into account. By analyzing the DOF(degree of freedom) of the whole human-machine closed chain, the human-machine kinematic incompatibility of lower limb exoskeletons is studied. An effective method for the structure design of lower limb exoskeletons, which are kinematically compatible with human lower limb, is proposed. Applying this method, the structure synthesis of the lower limb exoskeletons containing only one-DOF revolute and prismatic joints is investigated; the feasible basic structures of exoskeletons are developed and classified into three different categories. With the consideration of quasi-anthropopathic feature, structural simplicity and wearable comfort of lower limb exoskeletons, a joint replacement and structure comparison based approach to select the ideal structures of lower limb exoskeletons is proposed, by which three optimal exoskeleton structures are obtained. This paper indicates that the human-machine closed chain formed by the exoskeleton and human lower limb should be an even-constrained kinematic system in order to avoid the uncontrollable human-machine interactional loads. The presented method for the structure design of lower limb exoskeletons is universal and simple, and hence can be applied to other kinds of wearable exoskeletons.
基金Project(61175128) supported by the National Natural Science Foundation of ChinaProject(2008AA040203) supported by the National High Technology Research and Development Program of China
文摘Walking is the most basic and essential part of the activities of daily living. To enable the elderly and non-ambulatory gait-impaired patients, the repetitive practice of this task, a novel gait training robot(GTR) was designed followed the end-effector principle, and an active partial body weight support(PBWS) system was introduced to facilitate successful gait training. For successful establishment of a walking gait on the GTR with PBWS, the motion laws of the GTR were planned to enable the phase distribution relationships of the cycle step, and the center of gravity(COG) trajectory of the human body during gait training on the GTR was measured. A coordinated control strategy was proposed based on the impedance control principle. A robotic prototype was developed as a platform for evaluating the design concepts and control strategies. Preliminary gait training with a healthy subject was implemented by the robotic-assisted gait training system and the experimental results are encouraging.
基金Supported by National Key R&D Program of China(Grant No.2019YFB1311404)。
文摘To accommodate the gait and balance disorder of the elderly with age progression and the occurrence of various senile diseases,this paper proposes a novel gait balance training robot(G-Balance)based on a six degree-of-freedom parallel platform.Using the platform movement and IMU wearable sensors,two training modes,i.e.,active and passive,are developed to achieve vestibular stimulation.Virtual reality technology is applied to achieve visual stimulation.In the active training mode,the elderly actively exercises to control the posture change of the platform and the switching of the virtual scene.In the passive training mode,the platform movement is combined with the virtual scene to simulate bumpy environments,such as earthquakes,to enhance the human anti-interference ability.To achieve a smooth switching of the scene,continuous speed and acceleration of the platform motion are required in some scenarios,in which a trajectory planning algorithm is applied.This paper describes the application of the trajectory planning algorithm in the balance training mode and the optimization of jerk(differential of acceleration)based on cubic spline planning,which can reduce impact on the joint and enhance stability.
文摘Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.
基金Supported by the China-Slovenia Intergovernmental Science and Technology Cooperation and Exchange Project(2017-21-12-16)China-Serbia Intergovernmental Science and Technology Cooperation and Exchange Project(266-3-1).
文摘Based on domain specified language mechanism(DSLM),the architecture of the robotic training system for the rehabilitation of children with cerebral palsy(CP)is designed.Application of human-computer interaction(HCI)motion recognition technology is combined with Kinect to improve the effect of cerebral palsy rehabilitation training.In this system,Kinect's bone recognition method is used to judge the patient's training movements,and the collected bone movement information is judged.The human-computer interaction function is based on the Microsoft foundation classes function of Visual Studio based on DSLM development,which can realize real-time interactive training and evaluation of people and actions,and record the training information of patients.The system combines the designed small game to train the upper limb movement ability and reaction ability of the cerebral palsy patient,and provides key technology for improving the cerebral palsy rehabilitation training system.
基金Shaoguan Municipal Health Bureau,No.Y22058Shaoguan City Science and Technology Plan Project,No.220517164531600+1 种基金The clinical trial was approved by the Ethics Committee of the Yuebei People's Hospital(No.KY-2021-327)The program was registered online in the Chinese Clinical Trial Registry(Registration No.ChiCTR2100052767)。
文摘BACKGROUND The results of existing lower extremity robotics studies are conflicting,and few relevant clinical trials have examined short-term efficacy.In addition,most of the outcome indicators in existing studies are scales,which are not objective enough.We used the combination of objective instrument measurement and scale to explore the short-term efficacy of the lower limb A3 robot,to provide a clinical reference.AIM To investigate the improvement of lower limb walking ability and balance in stroke treated by A3 lower limb robot.METHODS Sixty stroke patients were recruited prospectively in a hospital and randomized into the A3 group and the control group.They received 30 min of A3 robotics training and 30 min of floor walking training in addition to 30 min of regular rehabilitation training.The training was performed five times a week,once a day,for 2 wk.The t-test or non-parametric test was used to compare the threedimensional gait parameters and balance between the two groups before and after treatment.RESULTS The scores of basic activities of daily living,Stroke-Specific Quality of Life Scale,FM balance meter,Fugl-Meyer Assessment scores,Rivermead Mobility Index,Stride speed,Stride length,and Time Up and Go test in the two groups were significantly better than before treatment(19.29±12.15 vs 3.52±4.34;22.57±17.99 vs 4.07±2.51;1.21±0.83 vs 0.18±0.40;3.50±3.80 vs 0.96±2.08;2.07±1.21 vs 0.41±0.57;0.89±0.63 vs 0.11±0.32;12.38±9.00 vs 2.80±3.43;18.84±11.24 vs 3.80±10.83;45.12±69.41 vs 8.41±10.20;29.45±16.62 vs 8.68±10.74;P<0.05).All outcome indicators were significantly better in the A3 group than in the control group,except the area of the balance parameter.CONCLUSION For the short-term treatment of patients with subacute stroke,the addition of A3 robotic walking training to conventional physiotherapy appears to be more effective than the addition of ground-based walking training.