A 3-D Robot Design to Overcome Arm Dysfunction in Stroke

描述(申请人提供)：运动协调障碍是最不了解的，但在中风后的功能恢复方面往往是最令人衰弱的。这些协调缺陷以异常肌肉协同作用的形式表现出来，并导致有限和刻板的运动模式，使功能丧失。肌肉协同的这些限制的结果是肩部外展和肘部屈曲之间的异常耦合，这显著减少了中风幸存者在举起受损手臂的重量对抗重力时到达空间的能力。目前减轻这些异常协同作用的神经治疗方法充其量只能产生有限的功能恢复。为了弥补这一缺陷，目前的项目建议全面开发和检验一种新型的三维力控制机械臂的有效性，这种机械臂允许中风患者在功能运动过程中逐步克服肢体重量的负面影响。该开发项目的具体目标是将三维力控制机械臂HapticMASTER(HM)应用于Biodex System 3座椅系统，并将其与紧凑的实时3-D可视显示器集成，以生成实现虚拟机械环境的上肢康复设备。 目前康复科学中存在一个不足，需要一种能够准确评估和提供高度受控的针对患者的上肢康复的设备。用于测量和康复中风引起的运动不协调的手臂协调训练三维装置(ACT3D)的开发实现了这一需求。该设备将提供生理(力量和协调性)和功能表现(到达工作空间)的高分辨率测量，评估康复干预的有效性。因此，将获得量化的结果测量，并可用于评估患者的进展。该设备还将设计为提供新的干预措施，训练患有广泛上肢损害的个人，以逐步克服重力的负面影响。此外，ACT3D将被开发来模拟真实的真实场景，例如到达和取回空间中不同重量的物体。该设备将以安全舒适的方式与用户交互，并由医疗保健提供者快速设置。预计ACT3D将直接使目前遭受中风致残影响的大量个人受益。

DESCRIPTION (provided by applicant): Disturbances in movement coordination are the least well understood but often the most debilitating with respect to functional recovery following stroke. These deficits in coordination are expressed in the form of abnormal muscle synergies and result in limited and stereotypic movement patterns that are functionally disabling. The result of these constraints in muscle synergies is an abnormal coupling between shoulder abduction and elbow flexion, which significantly reduces a stroke survivor's reaching space when he/she lifts the weight of the impaired arm against gravity. Current neurotherapeutic approaches to mitigate these abnormal synergies have produced, at best, limited functional recovery. In an effort to remediate this shortcoming the current project proposes to fully develop and examine the effectiveness of a novel 3-D force controlled robot arm that allows persons with stroke to progressively overcome the negative effects of the weight of their limb during functional movements. The specific objective of this development project is to adapt a 3-D force controlled robot arm, the HapticMASTER (HM), to a Biodex System 3 seating system and integrate it with a compact real-time 3-D visual display to generate an upper extremity rehabilitation device that implements a virtual mechanical environment. There is a current deficiency in rehabilitation science calling for a device that has the capacity to both accurately evaluate and deliver highly controlled patient-specific upper extremity rehabilitation. Development of the Arm Coordination Training 3-D device (ACT3D) for the measurement and rehabilitation of stroke-induced movement discoordination realizes this need. The device will provide high-resolution measurements of physiological (strength and coordination) and functional performance (reaching workspace) evaluating the effectiveness of rehabilitation interventions. Therefore, quantitative outcome measures will be obtained and may be used to evaluate patient progress. The device will also be designed to deliver novel interventions that train individuals with a broad spectrum of upper extremity reaching impairment to progressively overcome the negative effects of gravity. Furthermore, the ACT3D will be developed to emulate real live scenarios such as reaching and retrieval of objects of different weight in space. The device will interface with the user in a safe and comfortable fashion quickly setup by a healthcare provider. It is anticipated that the ACT3D will directly benefit a large number of individuals who currently suffer from the disabling effects of stroke.