Lower limb rehabilitation exoskeleton robots integrate sensing, control, and other technologies and exhibit the characteristics of bionics, robotics, information and control science, medicine, and other interdisciplin...Lower limb rehabilitation exoskeleton robots integrate sensing, control, and other technologies and exhibit the characteristics of bionics, robotics, information and control science, medicine, and other interdisciplinary areas. In this review, the typical products and prototypes of lower limb exoskeleton rehabilitation robots are introduced and stateof-the-art techniques are analyzed and summarized. Because the goal of rehabilitation training is to recover patients’ sporting ability to the normal level, studying the human gait is the foundation of lower limb exoskeleton rehabilitation robot research. Therefore, this review critically evaluates research progress in human gait analysis and systematically summarizes developments in the mechanical design and control of lower limb rehabilitation exoskeleton robots. From the performance of typical prototypes, it can be deduced that these robots can be connected to human limbs as wearable forms;further, it is possible to control robot movement at each joint to simulate normal gait and drive the patient’s limb to realize robot-assisted rehabilitation training. Therefore human–robot integration is one of the most important research directions, and in this context, rigid-flexible-soft hybrid structure design, customized personalized gait generation, and multimodal information fusion are three key technologies.展开更多
Many patients with spinal injures are confined to wheelchairs, leading to a sedentary lifestyle with secondary pathologies and increased dependence on a carer. Increasing evidence has shown that locomotor training red...Many patients with spinal injures are confined to wheelchairs, leading to a sedentary lifestyle with secondary pathologies and increased dependence on a carer. Increasing evidence has shown that locomotor training reduces the incidence of these secondary pathologies, but the physical effort involved in this training is such that there is poor compliance. This paper reports on the design and control of a new ＂human friendly＂ orthosis （exoskeleton）, powered by high power pneumatic Muscle Actuators （pMAs）. The combination of a highly compliant actuation system, with an intelligent embedded control mechanism which senses hip, knee, and ankle positions, velocity, acceleration and force, produces powerful yet inherently safe operation for paraplegic patients. This paper analyzes the motion of ankle, knee, and hip joints under zero loading, and loads which simulate human limb mass, showing that the use of ＂soft＂ actuators can provide a smooth user friendly motion. The application of this technology will greatly improve the rehabilitative protocols for paraplegic patients.展开更多
Robotic exoskeletons have emerged as rehabilitation tool that may ameliorate several of the existing healthrelated consequences after spinal cord injury(SCI).However,evidence to support its clinical application is sti...Robotic exoskeletons have emerged as rehabilitation tool that may ameliorate several of the existing healthrelated consequences after spinal cord injury(SCI).However,evidence to support its clinical application is still lacking considering their prohibitive cost.The current mini-review is written to highlight the main limitations and potential benefits of using exoskeletons in the rehabilitation of persons with SCI.We have recognized two main areas relevant to the design of exoskeletons and to their applications on major health consequences after SCI.The design prospective refers to safety concerns,fitting time and speed of exoskeletons.The health prospective refers to factors similar to body weight,physical activity,pressure injuries and bone health.Clinical trials are currently underway to address some of these limitations and to maximize the benefits in rehabilitation settings.Future directions highlight the need to use exoskeletons in conjunction with other existing and emerging technologies similar to functional electrical stimulation and brain-computer interface to address major limitations.Exoskeletons have the potential to revolutionize rehabilitation following SCI;however,it is still premature to make solid recommendations about their clinical use after SCI.展开更多
Purpose–Pediatric disorders,such as cerebral palsy and stroke,can result in thumb-in-palm deformity greatly limiting hand function.This not only limits children’s ability to perform activities of daily living but al...Purpose–Pediatric disorders,such as cerebral palsy and stroke,can result in thumb-in-palm deformity greatly limiting hand function.This not only limits children’s ability to perform activities of daily living but also limits important motor skill development.Specifically,the isolated orthosis for thumb actuation(IOTA)is 2 degrees of freedom(DOF)thumb exoskeleton that can actuate the carpometacarpal(CMC)and metacarpophalangeal(MCP)joints through ranges of motion required for activities of daily living.The paper aims to discuss these issues.Design/methodology/approach–IOTA consists of a lightweight hand-mounted mechanism that can be secured and aligned to individual wearers.The mechanism is actuated via flexible cables that connect to a portable control box.Embedded encoders and bend sensors monitor the 2 DOF of the thumb and flexion/extension of the wrist.A linear force characterization was performed to test the mechanical efficiency of the cable-drive transmission and the output torque at the exoskeletal CMC and MCP joints was measured.Findings–Using this platform,a number of control modes can be implemented that will enable the device to be controlled by a patient to assist with opposition grasp and fine motor control.Linear force and torque studies showed a maximum efficiency of 44 percent,resulting in a torque of 2.3971.06 in.-lbf and 0.6970.31 in.-lbf at the CMC and MCP joints,respectively.Practical implications–The authors envision this at-home device augmenting the current in-clinic and at-home therapy,enabling telerehabilitation protocols.Originality/value–This paper presents the design and characterization of a novel device specifically designed for pediatric grasp telerehabilitation to facilitate improved functionality and somatosensory learning。展开更多
目的:运用Meta分析方法系统评价康复外骨骼机器人对脑卒中患者下肢运动功能的康复疗效,并比较不同下肢外骨骼机器人的疗效差异,为脑卒中下肢运动功能障碍患者选择适合的外骨骼机器人提供科学理论依据。方法:计算机检索Cochrane Library...目的:运用Meta分析方法系统评价康复外骨骼机器人对脑卒中患者下肢运动功能的康复疗效,并比较不同下肢外骨骼机器人的疗效差异,为脑卒中下肢运动功能障碍患者选择适合的外骨骼机器人提供科学理论依据。方法:计算机检索Cochrane Library、PubMed、Web of Science、Embase、中国知网、维普和万方数据库的相关文献,收集从建库至2022年11月发表的关于探讨下肢康复外骨骼机器人改善脑卒中患者下肢运动功能的随机对照临床试验。由2名研究人员进行文献检索与筛选,使用Cochrane 5.1.0偏倚风险评估工具和Jadad量表对纳入文献进行质量评价。采用RevMan 5.4和Stata 17.0软件对结局指标进行Meta分析。结果:①最终纳入22篇文献,Jadad评分显示均为高质量文献,共865例患者,试验组436例、对照组429例。②Meta分析结果显示,与对照组相比,外骨骼机器人可显著提高脑卒中患者下肢运动功能(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)评分(MD=2.63,95%CI:1.87-3.38,P<0.05)、平衡功能(Berg Balance Scale,BBS)评分(MD=3.62,95%CI:1.21-6.03,P<0.05)、站起-走测试量表(Timed Up and Go,TUG)评分(MD=-2.77,95%CI:-4.48至-1.05,P<0.05)和步频(MD=3.15,95%CI:1.57-4.72,P<0.05),但对功能性步行量表(Functional Ambulation Category Scale,FAC)评分(MD=0.30,95%CI:-0.01-0.61,P>0.05)和6 min步行测试(6-minute walk test,6MWT)评分(MD=3.77,95%CI:-6.60-14.14,P>0.05)的提高不明显。③网状Meta分析结果显示,FMA-LE评分:平地行走式外骨骼(MD=10.23,95%CI:3.81-27.49,P<0.05)和减重式外骨骼(MD=33.66,95%CI:11.49-98.54,P<0.05)与常规康复治疗相比均能改善FMA-LE评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;BBS评分:减重式外骨骼(MD=79.86,95%CI:2.34-2725.99,P<0.05)与常规康复治疗相比能显著改善BBS评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;FAC评分:平地行走式外骨骼(MD=1.38,95%CI:1.00-1.90,P<0.05)与常规康复治疗相比能显著改善FAC评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗;TUG评分:减重式外骨骼与常规康复治疗相比(MD=0.07,95%CI:0.01-0.51,P<0.05)能显著改善TUG评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗。结论:康复外骨骼机器人可以改善脑卒中患者平衡、步行以及日常生活活动能力,其中减重式外骨骼在提高下肢运动功能和平衡功能方面疗效更优,平地行走式外骨骼在提高功能性步行和转移能力方面疗效更佳。展开更多
Exoskeleton robots have demonstrated the potential to rehabilitate stroke dyskinesia.Unfortunately,poor human-machine physiological coupling causes unexpected damage to human of muscles and joints.Moreover,inferior hu...Exoskeleton robots have demonstrated the potential to rehabilitate stroke dyskinesia.Unfortunately,poor human-machine physiological coupling causes unexpected damage to human of muscles and joints.Moreover,inferior humanoid kinematics control would restrict human natural kinematics.Failing to deal with these problems results in bottlenecks and hinders its application.In this paper,the simplified muscle model and muscle-liked kinematics model were proposed,based on which a soft wrist exoskeleton was established to realize natural human interaction.Firstly,we simplified the redundant muscular system related to the wrist joint from ten muscles to four,so as to realize the human-robot physiological coupling.Then,according to the above human-like musculoskeletal model,the humanoid distributed kinematics control was established to achieve the two DOFs coupling kinematics of the wrist.The results show that the wearer of an exoskeleton could reduce muscle activation and joint force by 43.3%and 35.6%,respectively.Additionally,the humanoid motion trajectories similarity of the robot reached 91.5%.Stroke patients could recover 90.3%of natural motion ability to satisfy for most daily activities.This work provides a fundamental understanding on human-machine physiological coupling and humanoid kinematics control of the exoskeleton robots for reducing the post-stroke complications.展开更多
基金Supported by National Key R&D Program of China(Grant No.2016YFE0105000)National Natural Science Foundation of China(Grant No.91848104)
文摘Lower limb rehabilitation exoskeleton robots integrate sensing, control, and other technologies and exhibit the characteristics of bionics, robotics, information and control science, medicine, and other interdisciplinary areas. In this review, the typical products and prototypes of lower limb exoskeleton rehabilitation robots are introduced and stateof-the-art techniques are analyzed and summarized. Because the goal of rehabilitation training is to recover patients’ sporting ability to the normal level, studying the human gait is the foundation of lower limb exoskeleton rehabilitation robot research. Therefore, this review critically evaluates research progress in human gait analysis and systematically summarizes developments in the mechanical design and control of lower limb rehabilitation exoskeleton robots. From the performance of typical prototypes, it can be deduced that these robots can be connected to human limbs as wearable forms;further, it is possible to control robot movement at each joint to simulate normal gait and drive the patient’s limb to realize robot-assisted rehabilitation training. Therefore human–robot integration is one of the most important research directions, and in this context, rigid-flexible-soft hybrid structure design, customized personalized gait generation, and multimodal information fusion are three key technologies.
文摘Many patients with spinal injures are confined to wheelchairs, leading to a sedentary lifestyle with secondary pathologies and increased dependence on a carer. Increasing evidence has shown that locomotor training reduces the incidence of these secondary pathologies, but the physical effort involved in this training is such that there is poor compliance. This paper reports on the design and control of a new ＂human friendly＂ orthosis （exoskeleton）, powered by high power pneumatic Muscle Actuators （pMAs）. The combination of a highly compliant actuation system, with an intelligent embedded control mechanism which senses hip, knee, and ankle positions, velocity, acceleration and force, produces powerful yet inherently safe operation for paraplegic patients. This paper analyzes the motion of ankle, knee, and hip joints under zero loading, and loads which simulate human limb mass, showing that the use of ＂soft＂ actuators can provide a smooth user friendly motion. The application of this technology will greatly improve the rehabilitative protocols for paraplegic patients.
文摘Robotic exoskeletons have emerged as rehabilitation tool that may ameliorate several of the existing healthrelated consequences after spinal cord injury(SCI).However,evidence to support its clinical application is still lacking considering their prohibitive cost.The current mini-review is written to highlight the main limitations and potential benefits of using exoskeletons in the rehabilitation of persons with SCI.We have recognized two main areas relevant to the design of exoskeletons and to their applications on major health consequences after SCI.The design prospective refers to safety concerns,fitting time and speed of exoskeletons.The health prospective refers to factors similar to body weight,physical activity,pressure injuries and bone health.Clinical trials are currently underway to address some of these limitations and to maximize the benefits in rehabilitation settings.Future directions highlight the need to use exoskeletons in conjunction with other existing and emerging technologies similar to functional electrical stimulation and brain-computer interface to address major limitations.Exoskeletons have the potential to revolutionize rehabilitation following SCI;however,it is still premature to make solid recommendations about their clinical use after SCI.
文摘Purpose–Pediatric disorders,such as cerebral palsy and stroke,can result in thumb-in-palm deformity greatly limiting hand function.This not only limits children’s ability to perform activities of daily living but also limits important motor skill development.Specifically,the isolated orthosis for thumb actuation(IOTA)is 2 degrees of freedom(DOF)thumb exoskeleton that can actuate the carpometacarpal(CMC)and metacarpophalangeal(MCP)joints through ranges of motion required for activities of daily living.The paper aims to discuss these issues.Design/methodology/approach–IOTA consists of a lightweight hand-mounted mechanism that can be secured and aligned to individual wearers.The mechanism is actuated via flexible cables that connect to a portable control box.Embedded encoders and bend sensors monitor the 2 DOF of the thumb and flexion/extension of the wrist.A linear force characterization was performed to test the mechanical efficiency of the cable-drive transmission and the output torque at the exoskeletal CMC and MCP joints was measured.Findings–Using this platform,a number of control modes can be implemented that will enable the device to be controlled by a patient to assist with opposition grasp and fine motor control.Linear force and torque studies showed a maximum efficiency of 44 percent,resulting in a torque of 2.3971.06 in.-lbf and 0.6970.31 in.-lbf at the CMC and MCP joints,respectively.Practical implications–The authors envision this at-home device augmenting the current in-clinic and at-home therapy,enabling telerehabilitation protocols.Originality/value–This paper presents the design and characterization of a novel device specifically designed for pediatric grasp telerehabilitation to facilitate improved functionality and somatosensory learning。
文摘目的:运用Meta分析方法系统评价康复外骨骼机器人对脑卒中患者下肢运动功能的康复疗效,并比较不同下肢外骨骼机器人的疗效差异,为脑卒中下肢运动功能障碍患者选择适合的外骨骼机器人提供科学理论依据。方法:计算机检索Cochrane Library、PubMed、Web of Science、Embase、中国知网、维普和万方数据库的相关文献,收集从建库至2022年11月发表的关于探讨下肢康复外骨骼机器人改善脑卒中患者下肢运动功能的随机对照临床试验。由2名研究人员进行文献检索与筛选,使用Cochrane 5.1.0偏倚风险评估工具和Jadad量表对纳入文献进行质量评价。采用RevMan 5.4和Stata 17.0软件对结局指标进行Meta分析。结果:①最终纳入22篇文献,Jadad评分显示均为高质量文献,共865例患者,试验组436例、对照组429例。②Meta分析结果显示,与对照组相比,外骨骼机器人可显著提高脑卒中患者下肢运动功能(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)评分(MD=2.63,95%CI:1.87-3.38,P<0.05)、平衡功能(Berg Balance Scale,BBS)评分(MD=3.62,95%CI:1.21-6.03,P<0.05)、站起-走测试量表(Timed Up and Go,TUG)评分(MD=-2.77,95%CI:-4.48至-1.05,P<0.05)和步频(MD=3.15,95%CI:1.57-4.72,P<0.05),但对功能性步行量表(Functional Ambulation Category Scale,FAC)评分(MD=0.30,95%CI:-0.01-0.61,P>0.05)和6 min步行测试(6-minute walk test,6MWT)评分(MD=3.77,95%CI:-6.60-14.14,P>0.05)的提高不明显。③网状Meta分析结果显示,FMA-LE评分:平地行走式外骨骼(MD=10.23,95%CI:3.81-27.49,P<0.05)和减重式外骨骼(MD=33.66,95%CI:11.49-98.54,P<0.05)与常规康复治疗相比均能改善FMA-LE评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;BBS评分:减重式外骨骼(MD=79.86,95%CI:2.34-2725.99,P<0.05)与常规康复治疗相比能显著改善BBS评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;FAC评分:平地行走式外骨骼(MD=1.38,95%CI:1.00-1.90,P<0.05)与常规康复治疗相比能显著改善FAC评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗;TUG评分:减重式外骨骼与常规康复治疗相比(MD=0.07,95%CI:0.01-0.51,P<0.05)能显著改善TUG评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗。结论:康复外骨骼机器人可以改善脑卒中患者平衡、步行以及日常生活活动能力,其中减重式外骨骼在提高下肢运动功能和平衡功能方面疗效更优,平地行走式外骨骼在提高功能性步行和转移能力方面疗效更佳。
基金supported by National Key R&D Program of China(Grant No.2016YFE0206200)the National Natural Science of China(Grant Nos.61821005,61703395,and 61727811)+2 种基金the Sichuan Science and Technology Program(Grant No.20SYSX0276)Natural Science Foundation of Liaoning Province of China(Grant No.20180520035)Youth Innovation Promotion Association of the Chinese Academy of Sciences(Grant No.2019205).
文摘Exoskeleton robots have demonstrated the potential to rehabilitate stroke dyskinesia.Unfortunately,poor human-machine physiological coupling causes unexpected damage to human of muscles and joints.Moreover,inferior humanoid kinematics control would restrict human natural kinematics.Failing to deal with these problems results in bottlenecks and hinders its application.In this paper,the simplified muscle model and muscle-liked kinematics model were proposed,based on which a soft wrist exoskeleton was established to realize natural human interaction.Firstly,we simplified the redundant muscular system related to the wrist joint from ten muscles to four,so as to realize the human-robot physiological coupling.Then,according to the above human-like musculoskeletal model,the humanoid distributed kinematics control was established to achieve the two DOFs coupling kinematics of the wrist.The results show that the wearer of an exoskeleton could reduce muscle activation and joint force by 43.3%and 35.6%,respectively.Additionally,the humanoid motion trajectories similarity of the robot reached 91.5%.Stroke patients could recover 90.3%of natural motion ability to satisfy for most daily activities.This work provides a fundamental understanding on human-machine physiological coupling and humanoid kinematics control of the exoskeleton robots for reducing the post-stroke complications.
