A pilot study on the feasibility of robot-aided leg motor training to facilitate active participation.
A pilot study on the feasibility of robot-aided leg motor training to facilitate active participation.
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DOI：
10.1371/journal.pone.0077370
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Rymer WZ
中科院分区：
文献类型：
--
作者：
Krishnan C;Ranganathan R;Dhaher YY;Rymer WZ
机器人辅助步态治疗提供了一种很有前途的方法，可以改善患有神经系统疾病（如中风或脊髓损伤）的个体的步态功能。然而，适当的控制策略的结合是必不可少的积极参与患者的治疗过程。虽然已经提出了几种控制算法（如按需辅助和错误增强），以提高患者的积极参与，我们假设，这些控制算法的治疗效果可以大大提高，如果与运动学习任务相结合，以促进神经重组和运动恢复。在这里，我们描述了一种主动的机器人训练方法（患者合作机器人步态训练结合运动学习任务）使用的Lokomat和试点测试，这种方法是否可以提高患者在训练过程中的积极参与。六名神经系统完整的成年人和三名慢性中风幸存者参加了这项试点可行性研究。参与者在Lokomat中行走，同时执行足部目标跟踪任务，该任务需要在步态的摆动阶段进行更大的髋关节和膝关节屈曲。我们计算了跟踪误差的变化作为运动性能的衡量标准，并计算了肌肉激活的变化作为受试者积极参与的衡量标准。运动学习任务的重复练习导致所有受试者的目标跟踪错误显着减少。与简单地在机器人中行走相比，在主动机器人训练期间肌肉激活也显着更高。中风参与者的数据也显示出与神经系统完整参与者相似的趋势。这些发现提供了一个概念验证的证明，将机器人步态训练与运动学习任务相结合，可以提高主动参与。
Robot-aided gait therapy offers a promising approach towards improving gait function in individuals with neurological disorders such as stroke or spinal cord injury. However, incorporation of appropriate control strategies is essential for actively engaging the patient in the therapeutic process. Although several control algorithms (such as assist-as-needed and error augmentation) have been proposed to improve active patient participation, we hypothesize that the therapeutic benefits of these control algorithms can be greatly enhanced if combined with a motor learning task to facilitate neural reorganization and motor recovery. Here, we describe an active robotic training approach (patient-cooperative robotic gait training combined with a motor learning task) using the Lokomat and pilot-tested whether this approach can enhance active patient participation during training. Six neurologically intact adults and three chronic stroke survivors participated in this pilot feasibility study. Participants walked in a Lokomat while simultaneously performing a foot target-tracking task that necessitated greater hip and knee flexion during the swing phase of the gait. We computed the changes in tracking error as a measure of motor performance and changes in muscle activation as a measure of active subject participation. Repeated practice of the motor-learning task resulted in significant reductions in target-tracking error in all subjects. Muscle activation was also significantly higher during active robotic training compared to simply walking in the robot. The data from stroke participants also showed a trend similar to neurologically intact participants. These findings provide a proof-of-concept demonstration that combining robotic gait training with a motor learning task enhances active participation.
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影响因子：
2.5
作者：
Gribble, PL;Mullin, LI;Mattar, A
通讯作者：
Mattar, A
影响因子：
4.8
作者：
Krakauer, JW
通讯作者：
Krakauer, JW
DOI：
10.1097/npt.0b013e31818e8fc2
发表时间：
2008-12-01
期刊：
Journal of neurologic physical therapy : JNPT
影响因子：
--
作者：
Krishnamoorthy, Vijaya;Hsu, Wei-Li;Scholz, John P
通讯作者：
Scholz, John P
影响因子：
4.2
作者：
Hidler, Joseph;Nichols, Diane;Hornby, T. George
通讯作者：
Hornby, T. George
影响因子：
4.8
作者：
Haenggi, Juergen;Koeneke, Susan;Jaencke, Lutz
通讯作者：
Jaencke, Lutz