机器人辅助上肢康复训练的量化评价方法研究
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摘要
随着机器人等自动化技术逐步引入到康复医学临床训练中,在康复机器人平台基础上实现对患者肌力的定量评价和提供针对性训练方案已经成为康学医学的研究重点。本文为解决肌力的定量评价问题,提出了同体对侧定量评价方法,完成了患者偏瘫上肢肘关节肌力建模及定量评价,针对偏瘫患者轨迹训练的机理进行了实验研究。本文主要内容如下:
1、在对偏瘫患者上肢定量评价中的存在问题进行分析的基础上,对肌肉肌力定量评价模型及其用于临床可行性进行了讨论;
2、提出了基于同体对侧的评价方法,完成了偏瘫患者健侧和患侧上肢运动学和肌电评价比较实验进行证明,并与健康人组上肢运动过程中的运动学和肌电特征进行对比分析。实验结果表明偏瘫患者的健侧肢体与健康人的生理特征有较高的相关性,而与患侧肢体有明显差异,采用患者健侧上肢生理学参数对患侧上肢进行评价具有可行性;
3、完成了基于肌电信号的肌力模型的理论分析,并提出针对患者患侧肌力评定的改进方法,搭建了实验环境成功解决面临的软硬件问题,完成了初步实验,证明了实验方法和实验平台的可行性,最后讨论了建模的可能误差来源,为将来进一步利用基于肌电信号的肌力模型进行评价打下基础。
4、针对目标轨迹下同体对侧肢体肌群的定量化分析进行了相关研究,在机器人平台的轨迹与临床量表评价对应关系的研究基础上,提出了基于机器人轨迹的评价指标,并完成相关患者实验,实验结果证明轨迹评价指标的可行性。完成了同体对侧上肢在不同轨迹运动下肌电分析,在此基础上提出了同体对侧上肢肌群的定量化评价指标,实验结果表明其与临床量表评价有直接对应关系。
With the introduction of robot automation technology to clinical training in rehabilitation medicine, the quantitative evaluation of muscle strength and targeted training program based on rehabilitation robot platform have became research Highlight in rehabilitation medicine. In order to solve these problems, a quantitative evaluation method for the contralateral limb characteristic provides quantitative assessment of muscle strength, we also conducted experiment for computing the elbow moment and related muscle strength of hemiplegic upper limb modeling in patients, and then we evaluated effect of different training tracks for the mechanism of hemiplegic patients. These main results in this paper are as follows:
1. Including the tendency of rehabilitation industry, demand for clinical practice and basic theoretical research, we firstly introduced the status of rehabilitation medicine and the development in the future, then we analyzed quantitative evaluation model of muscle strength and confirmed the value of clinical application, which are based on problems that are the most frequently mentioned in Rehabilitation research.
2. We proposed a kind of quantitative evaluation method which is based on contralateral limb physiological characteristic; we also have finished kinematics and electromyography evaluation tests on upper limb of clinical hemiplegic patients compared to upper limb movement kinematics and electromyography characteristics of healthy group of in a comprehensive analysis. Experimental results prove that the healthy sides of hemiplegic patients have higher correlation with the physiological characteristics of healthy people which are markedly different from another side of patients. We could get evaluation method in which physiological parameters can be used on the contralateral upper limb.
3. Based on the evaluation method which is based on contralateral limb physiological characteristic, we proposed an EMG-driven musculoskeletal model to estimate muscle forces and elbow joint moments in patients, we made models of affected limb muscles and elbow joint in patients and counted muscle strength and moments by this model. The model adopts physiological measures of contralateral limb in patients to be calculated parameters in order to estimate affected limb muscle strength and moment. This EMG-driven musculoskeletal model will be the effective assessment methods for clinical quantitative evaluation of muscle strength.
4. Using a quantitative relationship between the training track and activation of upper body muscles,we calculated the trajectories and EMG features of patients during the training mission in order to make a scientific, targeted rehabilitation of track design, which could provide different training track to different patients.
In this paper, our research objective is to build the quantitative evaluation based on the robot training platform, we completed theoretical analysis and experiment verification on three related subject, including the evaluation method which is based on contralateral limb physiological characteristic, the quantitative evaluation of residual muscle strength and trajectory analysis, finally formed a complete quantitative evaluation system.
1、在对偏瘫患者上肢定量评价中的存在问题进行分析的基础上,对肌肉肌力定量评价模型及其用于临床可行性进行了讨论;
2、提出了基于同体对侧的评价方法,完成了偏瘫患者健侧和患侧上肢运动学和肌电评价比较实验进行证明,并与健康人组上肢运动过程中的运动学和肌电特征进行对比分析。实验结果表明偏瘫患者的健侧肢体与健康人的生理特征有较高的相关性,而与患侧肢体有明显差异,采用患者健侧上肢生理学参数对患侧上肢进行评价具有可行性;
3、完成了基于肌电信号的肌力模型的理论分析,并提出针对患者患侧肌力评定的改进方法,搭建了实验环境成功解决面临的软硬件问题,完成了初步实验,证明了实验方法和实验平台的可行性,最后讨论了建模的可能误差来源,为将来进一步利用基于肌电信号的肌力模型进行评价打下基础。
4、针对目标轨迹下同体对侧肢体肌群的定量化分析进行了相关研究,在机器人平台的轨迹与临床量表评价对应关系的研究基础上,提出了基于机器人轨迹的评价指标,并完成相关患者实验,实验结果证明轨迹评价指标的可行性。完成了同体对侧上肢在不同轨迹运动下肌电分析,在此基础上提出了同体对侧上肢肌群的定量化评价指标,实验结果表明其与临床量表评价有直接对应关系。
With the introduction of robot automation technology to clinical training in rehabilitation medicine, the quantitative evaluation of muscle strength and targeted training program based on rehabilitation robot platform have became research Highlight in rehabilitation medicine. In order to solve these problems, a quantitative evaluation method for the contralateral limb characteristic provides quantitative assessment of muscle strength, we also conducted experiment for computing the elbow moment and related muscle strength of hemiplegic upper limb modeling in patients, and then we evaluated effect of different training tracks for the mechanism of hemiplegic patients. These main results in this paper are as follows:
1. Including the tendency of rehabilitation industry, demand for clinical practice and basic theoretical research, we firstly introduced the status of rehabilitation medicine and the development in the future, then we analyzed quantitative evaluation model of muscle strength and confirmed the value of clinical application, which are based on problems that are the most frequently mentioned in Rehabilitation research.
2. We proposed a kind of quantitative evaluation method which is based on contralateral limb physiological characteristic; we also have finished kinematics and electromyography evaluation tests on upper limb of clinical hemiplegic patients compared to upper limb movement kinematics and electromyography characteristics of healthy group of in a comprehensive analysis. Experimental results prove that the healthy sides of hemiplegic patients have higher correlation with the physiological characteristics of healthy people which are markedly different from another side of patients. We could get evaluation method in which physiological parameters can be used on the contralateral upper limb.
3. Based on the evaluation method which is based on contralateral limb physiological characteristic, we proposed an EMG-driven musculoskeletal model to estimate muscle forces and elbow joint moments in patients, we made models of affected limb muscles and elbow joint in patients and counted muscle strength and moments by this model. The model adopts physiological measures of contralateral limb in patients to be calculated parameters in order to estimate affected limb muscle strength and moment. This EMG-driven musculoskeletal model will be the effective assessment methods for clinical quantitative evaluation of muscle strength.
4. Using a quantitative relationship between the training track and activation of upper body muscles,we calculated the trajectories and EMG features of patients during the training mission in order to make a scientific, targeted rehabilitation of track design, which could provide different training track to different patients.
In this paper, our research objective is to build the quantitative evaluation based on the robot training platform, we completed theoretical analysis and experiment verification on three related subject, including the evaluation method which is based on contralateral limb physiological characteristic, the quantitative evaluation of residual muscle strength and trajectory analysis, finally formed a complete quantitative evaluation system.
引文
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[3]缪鸿石.中枢神经系统(CNS)损伤后功能恢复的理论.中国康复理论与实践, 1995~1998
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[5] Emanuel Todorov, Michael I.Jordan, Smoothness Maximization Along a Predefined Path Accurately Predicts the Speed Profiles of Complex Arm Movements, The American Physiological Society, 1998
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[13] Krebs H I, Hogan N, Aisen M L, Volpe B T. Robot-aided neurorehabilitation. IEEE Transactions on Rehabilitation Engineering, 1998, 6(1): 75-87
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