Robotic Orthoses for Gait Rehabilitation

用于步态康复的机器人矫形器

• 批准号: 7447037
• 负责人: Daniel P Ferris
• 金额: $ 19.26万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-01 至 2010-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7447037
• 关键词: Algorithms; Ankle; Asia; Braces-Orthopedic appliances; Computers; Data; Electromyography; Feedback; Flexor; Gait; H-Reflex; Human; Impairment; Individual; Joints; Kinetics; Lead; Leg; Lesion; Limb structure; Link; Locomotion; Lower Extremity; Measures; Mechanics; Metabolic; Motion; Motor; Muscle; Nervous system structure; Neurologic; Orthotic Devices; Patients; Pattern; Phase; Public Health; Randomized Clinical Trials; Reflex action; Rehabilitation device; Rehabilitation therapy; Robotics; Shapes; Soleus Muscle; Source; Speed; Spinal cord injury; Stimulus; Stroke; Therapeutic Effect; Time; Torque; Training; Walking; Water; Week; ankle joint; cost; design; disability; foot; improved; innovation; kinematics; response; robot assistance; stretch reflex

DESCRIPTION (provided by applicant): We have developed a powered ankle-foot orthosis that can assist human walking. The ankle-foot orthosis has an artificial pneumatic muscle providing plantar flexor torque in response to soleus muscle activation (i.e. proportional myoelectric control). We focus on robotic assistance for the ankle because plantar flexion during stance is a major source of mechanical power during walking and is directly related to walking ability in individuals with neurological disability. Neurologically intact subjects wearing the orthoses rapidly adapt their muscle activation patterns to compensate for the added mechanical power provided by the orthoses. We propose to determine if subjects with incomplete spinal cord injury benefit from practice walking with the powered orthoses. Our preliminary data suggest that proportional myoelectric control provides a powerful stimulus for re-shaping muscle activation patterns in subjects with incomplete spinal cord injury. The orthosis effectively makes the muscle stronger. This provides the nervous system with enhanced proprioceptive feedback linking muscle recruitment to joint motion. This innovative approach is unique as other robotic rehabilitation devices rely on an external agent (i.e. a computer) to control the timing and magnitude of mechanical assistance rather than the patient's own nervous system as we propose. We will measure H-reflexes, electromyography, kinematics, kinetics, and metabolic cost in individuals with incomplete spinal cord injury before and after eight weeks of practice walking with the orthoses. The results will provide sufficient data to design an extended randomized clinical trial of the powered orthosis. PUBLIC HEALTH RELEVANCE: We will study people with incomplete spinal cord injury walking with robotic braces on their legs to determine if the braces can improve their walking ability. The results may lead to new robotic therapies for improving rehabilitation after spinal cord injury or stroke.

描述（由申请人提供）：我们开发了一种可以辅助人类行走的动力踝足矫形器。踝足矫形器具有人造气动肌肉，响应比目鱼肌激活（即比例肌电控制）提供跖屈肌扭矩。我们专注于踝关节的机器人辅助，因为站立期间的跖屈是行走过程中机械动力的主要来源，并且与神经障碍患者的行走能力直接相关。佩戴矫形器的神经系统完好的受试者会快速调整其肌肉激活模式，以补偿矫形器提供的额外机械动力。我们建议确定不完全脊髓损伤的受试者是否可以从使用动力矫形器练习行走中受益。我们的初步数据表明，比例肌电控制为重塑不完全脊髓损伤受试者的肌肉激活模式提供了强大的刺激。矫形器有效地使肌肉变得更强壮。这为神经系统提供了增强的本体感觉反馈，将肌肉募集与关节运动联系起来。这种创新方法是独一无二的，因为其他机器人康复设备依赖外部代理（即计算机）来控制机械辅助的时间和幅度，而不是我们建议的患者自己的神经系统。我们将测量不完全脊髓损伤个体在使用矫形器练习行走八周之前和之后的 H 反射、肌电图、运动学、动力学和代谢成本。结果将为设计动力矫形器的扩展随机临床试验提供足够的数据。公共健康相关性：我们将研究患有不完全脊髓损伤的人在腿部佩戴机器人支架行走，以确定支架是否可以提高他们的行走能力。研究结果可能会带来新的机器人疗法，以改善脊髓损伤或中风后的康复。