Development of a Functional Recovery Training Assistant System of Hemiplegic Lower Limb; Motion Evaluation and Training System for the Hemiplegic Lower Limb and Its Clinical Application in Rehabilitation

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For the functional recovery of hemiplegic lower limbs (HLL), it is very important to repeat voluntary motions isolated from synergy. The purpose of this study is to design a Functional Recovery Training Assistant System for Hemiplegic Lower Limb (FRTASHLL) and evaluate its clinical benefits in rehabilitation.1. FRTASHLL is designed to assist the intensive exercise therapy free from synergy and evaluate the quantification and rehabilitation of physical impairment. The system achieves a visual feedback loop, providing the real-time position marker of the trainee's foot and the desired foot trajectory of a voluntary motion of HLL for the visual display terminal of the system computer. Accuracy and reproducibility of the motion of HLL are examined in relation to a locus pattern of the foot movement and the dynamic force of the lower limb at the foot. Testing and exercising data can be compiled and analyzed by using the system computer. FRTASHLL can calculate various characteristics values … More of rehabilitation, e.g. a time integral of the distance (Position Trajectory Errors, PT-Errors: cm s/cycle) between a desired trajectory of the foot and the position marker of a trainee's foot.2. The clinical application of FRTASHLL was evaluated in 10 hemiplegic patients and 13 normal controls. Fine movements of unaffected lower limb were measured with FRTASHLL PT-Errors of stroke patients were significantly bigger than those of normal controls in both 8-figure motion patterns and mirrored 8-figure motion patterns (foot marker displayed at mirror-image position). PT-Errors in the 8-figure motion pattern and the mirrored 8-figure motion pattern did not correlate. Except correlation between PT-Errors in mirrored 8-figure motion pattern and a degree of hemiplegia, PT-Errors in a normal or mirrored 8-figure motion pattern did not correlate with sensation of unaffected lower limb, hemineglect, finger tapping, construction ability, or site of lesion.Training with FRTASHLL by tracing an 8-figure motion pattern with HLL 50 trails daily for 4 days significantly decreased PT-Errors.FRTASHLL is effective to evaluate and train HLL with visual feedback. It also reveals impairment in the unaffected lower limb of hemiplegic patients and improves HLL function with training. Less