Intensive Training Therapy with Functional Electrical Stimulation for Recovery of Walking Function in Hemiplegics

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The purpose of this study is to develop the intensive training therapy with the assists of functional electrical stimulation to help the recovery of walking function in hemiplegic patients. To realize the purpose, we developed a walking training station which consists of 1) a split-belt walking machine that can enable perturbed walking, 2) a support frame that could allow the patients to do safe training, 3) a functional electrical stimulation system that could not only assist the normal walking for hemiplegic patients, but also improve the balance maintenance of patients by artificial reflexes, 4) a set of measurement devices to monitoring the patients' walking.Besides, we also developed a neuro-musculo-skeletal model which could be used to compare and analyze both the normal walking and perturbed walking.Using the walking training station and simulation, a series of gait experiment and computer simulation experiment were carried out. The followings are the results and discussion.1) T … More he reflexive responses are phase-dependent. That is, different phase of perturbation occurrence would cause difference reflexive responses. Especially, the phase difference resulted in the amplitude difference of muscle activity, rather than the difference of response latency. The walking assist should also take the perturbation occurrence into consideration.2) The simulator with a reflexive pathway which was implemented by using the EMG profiles acquired and processed in gait experiments with slip perturbation, could respond to the slip perturbation and recover from the perturbed gait to keep walking. That is, the reflexive pathway could improve the perturbation-resistance for walking.3) When constructing the control system for assistive devices, time varying and individual dependent users characteristics should be taken into consideration, so that, the users could be appropriately assisted. An interaction based learning method was proposed and applied to acquire not only the control mechanism of FES, but also the perturbation occurrence detection system adaptively.4) Patients received training on the walking training station. With the assist of FES, the training on the station could improve not only the posture and the speed during walking, but also the motivation of patients.5) Using the walking speed on walking training station, and symmetricity of the walking as the indexes, the training effect could be evaluated. The evaluation before and after the training showed that, the training could improve the walking function of patients. Less