Increasing productivity and quality of care: robot-aided neuro-rehabilitation.
Increasing productivity and quality of care: robot-aided neuro-rehabilitation.
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发表时间：
2000-11
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通讯作者：
H. Krebs;B. Volpe;M. Aisen;N. Hogan
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作者：
H. Krebs;B. Volpe;M. Aisen;N. Hogan
本文综述了我们在机器人辅助脑卒中神经康复和恢复方面的研究。在这项研究开始时，我们必须正视（并解决！）一个关键的问题：如果解剖学是命运，我们能影响它吗？在过去的五年里，我们的努力一直集中在回答这个问题上，我们将展示我们对76名中风患者进行的2,000多小时机器人辅助治疗的一些临床结果。为了确定运动疗法是否影响中风后大脑的可塑性和恢复，我们需要适当的“显微镜”，使我们能够同时控制向患者提供的治疗量，同时客观地测量患者的表现。可反向驱动的机器人是关键的使能技术。迄今为止，我们使用常见临床量表的结果表明，机器人辅助感觉运动训练确实对减少损伤和重组成人大脑有真正的积极影响。然而，尽管临床量表可以帮助我们检查神经恢复过程中的影响，但它们的粗糙性质需要大量耗时的试验，最重要的是，它们无法向我们展示优化治疗的重要细节。另一种基于机器人的秤提供了新的更精细的测量的潜在好处，并更深入地了解神经损伤的恢复过程。我们还计划利用现有技术来建立临床医生监督，机器人管理的治疗，包括课堂治疗的实用性和经济可行性。我们非常乐观地认为，在不久的将来，进展将大大加快，使我们能够将这项技术从研究领域转移到中风幸存者的日常治疗中。
This paper presents an overview of our research in robot-aided stroke neuro-rehabilitation and recovery. At the onset of this research we had to confront squarely (and solve!) a critical question: If anatomy is destiny, can we influence it? Our efforts over the last five years have been focused on answering this question and we will present a few of our clinical results from over 2,000 hours of robot-aided therapy with 76 stroke patients. To determine if exercise therapy influences plasticity and recovery of the brain following a stroke, we needed the appropriate "microscope" that would allow us to concomitantly control the amount of therapy delivered to a patient, while objectively measuring patient's performance. Back-driveable robots are the key enabling technology. Our results to date using common clinical scales suggest that robot-aided sensorimotor training does have a genuinely positive effect on reduction of impairment and the reorganization of the adult brain. Yet while clinical scales can help us to examine the impact in the neuro-recovery process, their coarse nature requires extensive and time-consuming trials, and on top of that they fail to show us details important for optimizing therapy. Alternative, robot-based scales offer the potential benefit of new finer measurements-and deeper insight into the process of recovery from neurological injury. We also plan to use present technology to establish the practicality and economic feasibility of clinician-supervised, robot-administered therapy, including classroom therapy. We feel quite optimistic that the march of progress will accelerate substantially in the near future and allow us to transfer this technology from the research realm to the everyday treatment of stroke survivors.