The Resonating Arm Exerciser: design and pilot testing of a mechanically passive rehabilitation device that mimics robotic active assistance.
The Resonating Arm Exerciser: design and pilot testing of a mechanically passive rehabilitation device that mimics robotic active assistance.
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DOI：
10.1186/1743-0003-10-39
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发表时间：
2013-04-18
影响因子：
5.1
通讯作者：
Reinkensmeyer DJ
中科院分区：
文献类型：
--
作者：
Zondervan DK;Palafox L;Hernandez J;Reinkensmeyer DJ
结合驱动辅助的机器人手臂治疗设备可以增强手臂恢复，激励患者练习，并允许治疗师提供半自主训练。然而，由于这种装置通常是复杂的并且主动地施加力，所以它们在康复诊所或家庭中没有实现广泛使用。本文介绍了一个简单的，机械被动设备，提供机器人一样的援助，主动手臂训练使用机械共振的原则的设计和试点测试。共振手臂练习器（RAE）由一个连接到轮椅推缘的杠杆、前臂支撑和一个储存能量的弹性带组成。患者推拉控制杆，使轮椅围绕中立位置前后滚动约20 cm。我们对该器械进行了两项单独的初步研究。在第一，我们测试是否预测的共振性质的RAE放大用户的手臂的流动性，通过比较他或她的主动运动范围（AROM）在一个单一的，持续的推动和拉动期间实现的AROM在摇摆的设备。在旨在测试该器械治疗潜力的第二项初步研究中，8名患有慢性卒中（受伤后35 ± 24个月）且平均、稳定、初始上肢Fugl-Meyer（FM）评分为17 ± 8/66的参与者在3周内使用RAE进行了8次45分钟的锻炼。主要结果测量是在一分钟测试期间用倾斜传感器测量的平均AROM，次要结果测量是FM评分和手臂疼痛的视觉模拟量表。在第一个试点研究中，我们发现中风后有严重运动障碍的人直观地发现了椅子的共振频率，RAE的机械共振将他们的手臂AROM放大了约2倍。在第二项初步研究中，AROM增加了66% ± 20%（p = 0.003）。平均FM评分增加8.5 ± 4例患者（p = 0.009）。受试者没有报告摇晃时手臂疼痛的不适或增加。改善持续了三个月。这些结果表明，一个简单的机械装置，卡在手动轮椅可以使用共振，以协助手臂训练，这种训练显示出潜在的安全增加手臂运动能力的严重慢性偏瘫中风的人。
Robotic arm therapy devices that incorporate actuated assistance can enhance arm recovery, motivate patients to practice, and allow therapists to deliver semi-autonomous training. However, because such devices are often complex and actively apply forces, they have not achieved widespread use in rehabilitation clinics or at home. This paper describes the design and pilot testing of a simple, mechanically passive device that provides robot-like assistance for active arm training using the principle of mechanical resonance. The Resonating Arm Exerciser (RAE) consists of a lever that attaches to the push rim of a wheelchair, a forearm support, and an elastic band that stores energy. Patients push and pull on the lever to roll the wheelchair back and forth by about 20 cm around a neutral position. We performed two separate pilot studies of the device. In the first, we tested whether the predicted resonant properties of RAE amplified a user’s arm mobility by comparing his or her active range of motion (AROM) in the device achieved during a single, sustained push and pull to the AROM achieved during rocking. In a second pilot study designed to test the therapeutic potential of the device, eight participants with chronic stroke (35 ± 24 months since injury) and a mean, stable, initial upper extremity Fugl-Meyer (FM) score of 17 ± 8 / 66 exercised with RAE for eight 45 minute sessions over three weeks. The primary outcome measure was the average AROM measured with a tilt sensor during a one minute test, and the secondary outcome measures were the FM score and the visual analog scale for arm pain. In the first pilot study, we found people with a severe motor impairment after stroke intuitively found the resonant frequency of the chair, and the mechanical resonance of RAE amplified their arm AROM by a factor of about 2. In the second pilot study, AROM increased by 66% ± 20% (p = 0.003). The mean FM score increase was 8.5 ± 4 pts (p = 0.009). Subjects did not report discomfort or an increase in arm pain with rocking. Improvements were sustained at three months. These results demonstrate that a simple mechanical device that snaps onto a manual wheelchair can use resonance to assist arm training, and that such training shows potential for safely increasing arm movement ability for people with severe chronic hemiparetic stroke.
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影响因子：
3.8
作者：
Hawkins, D;Mole, P
通讯作者：
Mole, P
影响因子：
8.3
作者：
Feys, H;De Weerdt, W;Cras, P
通讯作者：
Cras, P
影响因子：
2
作者：
Marchal-Crespo, Laura;McHughen, Stephanie;Reinkensmeyer, David J.
通讯作者：
Reinkensmeyer, David J.
影响因子：
--
作者：
Pearlman, Jon;Cooper, Rory A.;Noon, Jamie
通讯作者：
Noon, Jamie
影响因子：
8.3
作者：
Feys, HM;De Weerdt, WJ;Van Hoydonck, GA
通讯作者：
Van Hoydonck, GA