Unilateral Floor Stiffness Perturbations Systematically Evoke Contralateral Leg Muscle Responses: A New Approach to Robot-Assisted Gait Therapy
Unilateral Floor Stiffness Perturbations Systematically Evoke Contralateral Leg Muscle Responses: A New Approach to Robot-Assisted Gait Therapy
复制标题
单侧地板硬度扰动系统性地引起对侧腿部肌肉反应：机器人辅助步态治疗的新方法
DOI：
10.1109/tnsre.2015.2421822
复制
发表时间：
2016
影响因子：
4.9
通讯作者：
P. Artemiadis
中科院分区：
文献类型：
--
作者：
J. Skidmore;P. Artemiadis
各种机器人康复设备已经被提出用于中风后的步态康复，但与传统的物理疗法相比，只产生了温和的效果。我们提出了一种利用肢体间协调机制进行机器人干预的新方法。为了测试这种方法的可行性，我们通过一种独特的机器人设备施加单侧地板刚度扰动，并观察健康受试者在运动学和肌肉激活方面诱发的对侧腿部反应。地板刚度的实时控制被用来独特地区分力和运动反馈，创造出新的感觉扰动。我们介绍了健康受试者未受干扰的腿的可重复和可扩展的诱发运动学和肌肉反应的结果。此外，我们还提供了腿间协调的基本感觉运动机制的洞察。我们还提出了一个数学模型，准确地描述了僵硬扰动的幅度和诱发的肌肉活动之间的关系，为基于模型的步行者康复策略奠定了基础。与目前的做法相比，这种方法最显著的优势之一是患者的安全性，因为这不需要对受损的腿进行任何直接操作。本文提出的新方法和结果为步态康复机器人干预的范式转换奠定了基础。
A variety of robotic rehabilitation devices have been proposed for gait rehabilitation after stoke, but have only produced moderate results when compared to conventional physiotherapy. We suggest a novel approach to robotic interventions which takes advantage of mechanisms of inter-limb coordination. In order to test the viability of this approach, we apply unilateral floor stiffness perturbations via a unique robotic device and observe evoked contralateral leg responses in kinematics, as well as muscle activations, in healthy subjects. The real-time control of floor stiffness is utilized to uniquely differentiate force and kinematic feedback, creating novel sensory perturbations. We present results of repeatable and scalable evoked kinematic and muscular response of the unperturbed leg in healthy subjects. Moreover, we provide insight into the fundamental sensorimotor mechanisms of inter-leg coordination. We also lay the foundation for model-based rehabilitation strategies for impaired walkers by presenting a mathematical model that accurately describes the relationship between the magnitude of the stiffness perturbation and the evoked muscle activity. One of the most significant advantages of this approach over current practices is the safety of the patient, since this does not require any direct manipulation of the impaired leg. The novel methods and results presented in this paper set the foundation for a paradigm shift in robotic interventions for gait rehabilitation.