Robot-assisted rehabilitation is a crucial approach to restoring motor function in the limb.However,the current training trajectory lacks sufficient theoretical or practical support,and the monotony of single-mode tra...Robot-assisted rehabilitation is a crucial approach to restoring motor function in the limb.However,the current training trajectory lacks sufficient theoretical or practical support,and the monotony of single-mode training is a concern.Tai Chi Pushing Hands,a beneficial and effective daily exercise,has been shown to improve balance function,psychological state,and motor function of the upper extremities in patients recovering from stroke.To address these issues,we propose a new active rehabilitation training that incorporates Tai Chi Pushing Hands movements and yin-yang balance principles.The training trajectory and direction are encoded by the velocity field and consist of two processes:yang(push)and yin(return).During yang,the limb actively pushes the robot to move,while during yin,the limb actively follows the robot’s movement.To provide necessary assistance,an admittance controller with self-adaptive parameters is designed.In addition,we introduce two indexes,the‘Intention Angle’(ϖ)and the time ratio(Γ),to evaluate motion perception performance.Our experiment was conducted on a 4-degree-of-freedom upper limb rehabilitation robot platform,and the subjects were separated into a familiar group and an unfamiliar group.The experiment results show that the training could be completed well no matter whether the subject is familiar with Tai Chi Pushing Hands or not.The parameters and the movement of the robot can be adjusted based on the interactive force to adapt to the ability of the subject.展开更多
背景:当前针对患者骨健康/骨密度相关疾患结局指标的影响,传统太极功法干预仍然存在较大的争议,亟待作进一步探讨。目的:系统评价传统太极功法干预对改善骨密度流失的临床疗效与安全性。方法:通过计算机对中国知网CNKI、万方、维普VIP...背景:当前针对患者骨健康/骨密度相关疾患结局指标的影响,传统太极功法干预仍然存在较大的争议,亟待作进一步探讨。目的:系统评价传统太极功法干预对改善骨密度流失的临床疗效与安全性。方法:通过计算机对中国知网CNKI、万方、维普VIP和中国生物医学文献数据库、以及国外数据库PubMed、MEDLINE、EMbase、CochraneLibrary等进行全面检索;配合对大学图书馆的馆藏期刊进行手工检索,检索时间截于2019年1月;系统搜集传统太极功法(包括太极拳、太极推手、太极柔力球等)干预对骨健康/骨密度相关疾患结局指标影响的随机对照研究(RCT)文献。参考Cochrane系统评价方法进行文献筛选、资料提取以及方法学质量评价;并采用Rev Man 5.3软件进行Meta分析。结果与结论:共纳入14篇文献(16个RCT研究),Meta分析结果表明:接受传统太极功法干预后,脊柱腰椎L2-4骨密度(SMD=0.40,95%CI[0.16,0.65],P=0.001)、以及股骨颈骨密度(SMD=0.75,95%CI [0.27,1.24],P=0.002)改善方面均优于对照组;然而在Ward’s三角骨密度(SMD=0.50,95%CI[-0.10,1.10],P=0.10)、股骨干骨密度(SMD=0.16,95%CI[-0.11,0.44],P=0.25)、股骨近端转子骨密度(SMD=0.54,95%CI[-0.01,1.09],P=0.05)、以及桡骨远端1/3处骨密度(SMD=0.20,95%CI[-0.26,0.66],P=0.040)与对照组比较,组间差异无统计学意义;且传统太极功法干预尚未发现严重不良事件。当前证据发现,传统太极功法干预在特定人群(例如老年人、骨质疏松人群、围绝经期与绝经后妇女)脊柱腰椎、股骨颈等部位的骨密度流失改善方面疗效明确,不良反应较少。鉴于纳入文献数量偏少以及研究本身局限性,有待开展高质量的、设计严谨的临床试验予以进一步验证。展开更多
基金supported by the Foundation of Henan Provincial Science and Technology Research Project in China(212102310890 and 212102310249).
文摘Robot-assisted rehabilitation is a crucial approach to restoring motor function in the limb.However,the current training trajectory lacks sufficient theoretical or practical support,and the monotony of single-mode training is a concern.Tai Chi Pushing Hands,a beneficial and effective daily exercise,has been shown to improve balance function,psychological state,and motor function of the upper extremities in patients recovering from stroke.To address these issues,we propose a new active rehabilitation training that incorporates Tai Chi Pushing Hands movements and yin-yang balance principles.The training trajectory and direction are encoded by the velocity field and consist of two processes:yang(push)and yin(return).During yang,the limb actively pushes the robot to move,while during yin,the limb actively follows the robot’s movement.To provide necessary assistance,an admittance controller with self-adaptive parameters is designed.In addition,we introduce two indexes,the‘Intention Angle’(ϖ)and the time ratio(Γ),to evaluate motion perception performance.Our experiment was conducted on a 4-degree-of-freedom upper limb rehabilitation robot platform,and the subjects were separated into a familiar group and an unfamiliar group.The experiment results show that the training could be completed well no matter whether the subject is familiar with Tai Chi Pushing Hands or not.The parameters and the movement of the robot can be adjusted based on the interactive force to adapt to the ability of the subject.
文摘背景:当前针对患者骨健康/骨密度相关疾患结局指标的影响,传统太极功法干预仍然存在较大的争议,亟待作进一步探讨。目的:系统评价传统太极功法干预对改善骨密度流失的临床疗效与安全性。方法:通过计算机对中国知网CNKI、万方、维普VIP和中国生物医学文献数据库、以及国外数据库PubMed、MEDLINE、EMbase、CochraneLibrary等进行全面检索;配合对大学图书馆的馆藏期刊进行手工检索,检索时间截于2019年1月;系统搜集传统太极功法(包括太极拳、太极推手、太极柔力球等)干预对骨健康/骨密度相关疾患结局指标影响的随机对照研究(RCT)文献。参考Cochrane系统评价方法进行文献筛选、资料提取以及方法学质量评价;并采用Rev Man 5.3软件进行Meta分析。结果与结论:共纳入14篇文献(16个RCT研究),Meta分析结果表明:接受传统太极功法干预后,脊柱腰椎L2-4骨密度(SMD=0.40,95%CI[0.16,0.65],P=0.001)、以及股骨颈骨密度(SMD=0.75,95%CI [0.27,1.24],P=0.002)改善方面均优于对照组;然而在Ward’s三角骨密度(SMD=0.50,95%CI[-0.10,1.10],P=0.10)、股骨干骨密度(SMD=0.16,95%CI[-0.11,0.44],P=0.25)、股骨近端转子骨密度(SMD=0.54,95%CI[-0.01,1.09],P=0.05)、以及桡骨远端1/3处骨密度(SMD=0.20,95%CI[-0.26,0.66],P=0.040)与对照组比较,组间差异无统计学意义;且传统太极功法干预尚未发现严重不良事件。当前证据发现,传统太极功法干预在特定人群(例如老年人、骨质疏松人群、围绝经期与绝经后妇女)脊柱腰椎、股骨颈等部位的骨密度流失改善方面疗效明确,不良反应较少。鉴于纳入文献数量偏少以及研究本身局限性,有待开展高质量的、设计严谨的临床试验予以进一步验证。
