脑卒中康复机器人系统iPAM的初步患者测试

A. Jackson, P. Culmer, S. Makower, M. Levesley, R. Richardson, A. Cozens, M. Williams, B. Bhakta
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引用次数: 37

摘要

iPAM是一种双机器人系统,目前正在英国NHS新兴技术应用(NEAT)资助下开发。该系统的目的是为中风后康复提供辅助上肢治疗性锻炼。iPAM具有两个协调的气动机械臂,连接在患者的前臂和上臂上提供帮助,模仿物理治疗师的干预。系统的设计和制造已经完成,机器人安装在当地医院(St Mary’s, Leeds PCT, UK)的一个社区康复单元内。该控制器目前正在开发和“调整”,为机器人提供重力补偿,消除病人手臂上任何潜在的破坏性负荷。通过仿真和机械臂模型验证了该控制方案的安全性。已经进行了两次小规模试验,以评估机器人设计的两个方面;首先,该系统的机械设计不妨碍正常的手臂运动,其次,它能够为患者的手臂提供不同程度的提升,以增加运动范围。前者比较了健康志愿者和中风患者在使用iPAM时的自由手臂运动。机器人被配置为补偿自身的重量,因此人类的上肢被卸下。研究发现,机器人对运动模式没有显著影响。第二组患者试验评估了不同程度的重力辅助操作。患者被要求指向一个目标,并在他们的上臂和下臂上施加不同程度的“抬升”。在那些有明显上肢损伤的患者中,我们发现更高的“抬升”值改善了伸展的范围,但改变了运动模式。试验结果表明,根据患者残疾的严重程度,某些手术模式的适用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Initial patient testing of iPAM - a robotic system for Stroke rehabilitation
iPAM is a dual robotic system currently being developed in the UK under a NHS New and Emerging Applications of Technologies (NEAT) grant. The aim of the system is to provide assistive upper-limb therapeutic excercise for post-stroke rehabilitation. iPAM features two co-ordinated, pneumatically-actuated robotic arms which attach to the patient's forearm and upper-arm to provide assistance, mimicking the intervention of a physiotherapist. The system design and manufacture has been completed and the robot installed at a local hospital (St Mary's, Leeds PCT, UK) inside a community rehabilitation unit. The controller is currently developed and 'tuned' to provide gravity compensation for robots, removing any potentially damaging loads on the patient arm. The control scheme has been tested in simulation and using a mechanical arm model to ensure safe operation. Two small scale trials have been conducted to assess two facets of the robot design; firstly the mechanical design of the system to unimpede normal arm movement and secondly, its ability to provide varying levels of lift to the patient's arm to increase range of movement. The former of these trials compares free arm movement in healthy volunteers and Stroke patients with that when attached to iPAM. The robot was configured to compensate for its own weight, so the human upper-limb was unloaded. It was found that the robot had no significant affect on movement patterns. The second group of patient trials evaluated the operation of various levels of assistance against gravity. Patients were asked to point to a target with varying degrees of 'lift' applied to their upper and lower arm. In those patients with significant upper-limb impairment it was found that higher values of 'lift' improved the extent of reach but altered the movement pattern. Results from the trials demonstrated the suitability of certain modes of operation depending on the severity of patient disability.
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