Evaluation and therapeutic efficacy of a training support system for ambulatory recovery in cerebral hemiplegia patients

我们的研究目的是开发一种脑性偏瘫患者步行功能恢复的训练支持系统，该系统将允许频繁的步行训练，并接收对异常步态的适当反馈。在研制活动训练支持系统的过程中，通过对健康人行走过程中的肢体进行三维分析，观察肢体运动情况，以区分瘫痪肢体的摆动腿时相。结果表明：1.双踝垂直位移可作为反映各腿接触相-摆动相的变量。我们开发了一种使用实时空间测量设备的步行训练支持系统。该系统旨在通过在行走瘫痪肢体摆动阶段提供来自微型振动马达的振动刺激反馈来改善脑性偏瘫患者的瘫痪肢体功能。使用振动刺激作为反馈旨在促进患者主动肢体的运动。在反馈系统中直接使用患者行走腿上的运动信息来改善瘫痪步态，并使用振动刺激作为反馈刺激是该训练系统的鲜明特点。该系统安装在一家专门的康复医院，并进行了临床应用测试。将本研究开发的步行康复训练支持系统应用于偏瘫患者的步行过程中，通过对患肢施加振动刺激反馈，使行走过程中双腿的步幅基本相等；摆动阶段瘫痪腿的抬起高度也有所增加，证明了该系统的有效性。

The object of our research was to develop a training support system for recovery of ambulatory function by cerebral hemiplegia patients which would allow frequent walking training with receipt of appropriate feedback on abnormal gait.1. During development of the ambulatory training support system, three-dimensional analysis of lower limbs during walking by healthy individuals was used to investigate lower limb motion in order to distinguish the swing leg phase of the paralyzed limb. The results showed that the vertical displacement of both ankles could serve as a variable indicating the contact phase-swing phase of each leg.2. We developed an ambulatory training support system employing a real-time spatial measurement device. The system was designed to improve paralyzed lower limb function in cerebral hemiplegia patients by providing vibrating stimulatory feedback from a miniature vibrating motor during the paralyzed limb swing phase of walking. The use of vibratory stimulation as feedback is intended to promote motion of the active limb by the patient. The fact that kinetic information on the walking leg of the patient is used directly in a feedback system to improve paralytic gait, and the use of vibrating stimulation as feedback stimulation are distinctive features of this training system.3. The system was installed in a specialized rehabilitation hospital and tested for clinical application. When the training support system for ambulatory recovery developed in our research was applied in walking by hemiplegia patients, the step duration of both legs was nearly equalized during walking in which vibrating stimulatory feedback was applied to the affected leg; the lift height of the paralyzed leg during the swing phase was also increased, demonstrating the efficacy of the system.