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双语推荐：下肢康复机器人

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通过分析人的下肢各关节的特征及自由度，设计可穿戴式下肢康复外骨骼机器人结构，利用CAD软件solidworks进行三维建模。为了实现可穿戴式下肢康复外骨骼机器人稳定行走功能，本文运用零力矩点( ZMP)判断依据进行步态规划。在机器人进行步态规划时采用三次样条插值法得到可穿戴式下肢康复外骨骼机器人各关节的平滑运动轨迹，同时，摆动腿在运动过程中脚底与地面始终平行。最后在ADAMS软件中建立可穿戴式下肢康复外骨骼机器人的虚拟样机进行运动学仿真。
Through analyzing the characteristics and freedom of human lower extremity joints, this paper designs a structure of the wearable lower limbs rehabilitation exoskeleton robot and builds a three-dimensional modeling by solidworks software of CAD. In order to realize the function of the stable walking for the wearable lower limbs rehabilitation exoskeleton robot,it uses the principle of ZMP to plan gait. In the process of planning gait,it gets the smooth trajectory of every joint by cubic spline interpolation, keeping the foot of swinging legs parallel to the ground. Finally, it establishes a virtual prototype of the wearable lower limb rehabilitation exoskeleton robot and makes a simulation in ADAMS software.

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目的：探讨虚拟现实技术结合康复机器人训练对早期脑卒中偏瘫患者步行功能的治疗效果。方法：42例早期脑卒中偏瘫患者随机分为虚拟现实康复机器人组（实验组）和康复机器人组（对照组），每组各21例。2组均进行常规康复治疗基础上，实验组进行虚拟现实技术结合康复机器人训练，而对照组只进行传统的康复机器人训练，均为30min／次，5次／周，共进行8周。治疗前后采用Fugl-Meyer下肢评定表（FMA-LE）、10m步行能力测试（10MW），起立-步行测试（TUG）和6分钟步行能力测试（6MWT）进行评定。结果：治疗8周后，2组患者的FMA下肢评分、10MW、TUG和6MWT均较治疗前明显提高（P＜0．05），实验组除FMA下肢评分外，其它各项评定与对照组比较均具有显著差异（ P＜0．01）。结论：应用虚拟现实技术结合康复机器人步态训练对早期脑卒中偏瘫患者进行功能训练能提高患者的步行功能。
Objective:To investigate whether the training of gait to locomotion was greater using a virtual environment coupled with a robot or with the robot alone .Methods:42 subjects with sub -acute stroke participated in this study .They had conducted the rehabilita-tion therapy, and randomly assigned to experiment group (21 subjected) trained with the robot virtual reality system and the control group (21 subjects) trained with the robot alone, the 8 week training protocol:30 min per session, and 5 sessions per week.Outcome measures were included Fugl-Meyer of lower extremity (FMA-LE), 10-meter walk test (10MW), time up and go test (TUG), and 6-minute walk test (6MWT).Results:After 8-week training, the FMA-LE, 10MW, TUG and 6MWT were all significant difference (P<0.05) compared with pre-treatment in two groups.Significant changes (P<0.01) in velocity and distance walked were demonstrated for the group trained with the robotic device coupled with the VR than training with the robot alone , exp

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根据下肢康复的需要,结合已有的外骨骼下肢康复机器人技术,使用GSM构建了一个远程的下肢康复系统。系统使用短信服务实现康复信息的远程监控,并具有信息管理功能。同时,系统可以实现责任医务人员与系统维护人员的定制短消息提醒服务。此系统可以作为基于物联网的智慧医疗系统的子系统进行应用,以实现社区康复或家庭康复的需求。
A rehabilitation system is designed with existing exoskeleton rehabilitation robots for lower limbs based on GSM.SMS is used to realize the remote monitoring of rehabilitation information from the terminal robots,and an information man-agement system is included.Meanwhile,the sys-tem contains short message reminding services for medical physicians and maintenance staff to inform them of notable information.This system can be used as a subsystem of a smart healthcare system which is based on IoT to realize community based rehabilitation or home based rehabilitation.

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近年来，康复机器人辅助中风病人的康复治疗吸引了越来越多的关注。相对于传统的由康复师进行的中风治疗，康复机器人进行的治疗更为精确，且不受康复师主观因素的影响，能够显著提高康复治疗的效果。本文介绍了一个拥有5自由度上肢与4自由度下肢的可穿戴便携式康复外骨骼机器人。机器人的所有自由度都由患者的肌电信号驱动，帮助患者进行失能肢体的康复训练。该机器人可穿戴和便携的特性为患者行走功能的康复提供了新的手段。康复过程中，患者的所有康复运动数据(包括患者的表面肌电信号数据和每个关节的运动数据)都可以被采集，便于在线分析和离线记录。
Robot-assisted rehabilitation which promises to redefine clinical strategies has drawn more and more attention for stroke therapy recently. Compared with classic rehabilitation limited to subjective observation of therapists on patients, the treatment by robotic devices can be more precise to improve the rehabilitation effects. In this paper, a wearable and portable rehabilitation robot with upper limbs of 5 degrees of freedom (DOFs) and upper limbs of 4 DOFs was introduced. The surface electromyographic (sEMG) signals were used to drive all the DOFs of both limbs to aid the training of prosthetic limbs. All data during the rehabilitation, including the sEMG signals and joint motions, can be collected for the purposes of both online analysis and offline storage.

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目的探讨多体位智能化下肢康复机器人对下肢运动功能、下肢肌张力以及步行能力的改善情况。方法40例脑卒中偏瘫患者随机分成对照组和治疗组，各20例。对照组进行常规康复训练；治疗组在此基础上增加多体位智能化下肢康复机器人训练，每天20 min，共10周。采用Berg平衡量表(BBS)、简式Fugl-Meyer评分法(FMA)、改良Barthel指数(MBI)、功能性步行分级(FAC)、10 m最大步行速度、改良Ashworth评分量表(MAS)进行评价。结果两组患者BBS、FMA和MBI评分均较治疗前明显升高(P<0.01)，治疗后治疗组评分明显高于对照组(P<0.01)。治疗组治疗后FAC步行功能分级3级及以上者、10 m最大步行速度均优于对照组，MAS评分明显低于对照组(P<0.01)。结论多体位智能化下肢康复机器人对患者下肢运动功能和平衡功能的提高有一定的作用。
Objective To explore the effects of multi-position lower limb rehabilitation robot on motor function in hemiplegia patients after stroke. Methods 40 stroke patients with hemiplegia were randomly divided into control group and observation group, with 20 cases in each group. Both groups received conventional rehabilitation training, and the observation group received multi-position lower limb rehabili-tation robot training, 20 min a day. Berg balance scale (BBS), Fugl-Meyer assessment (FMA), modified Barthel index (MBI), Functional Ambulation Category (FAC), 10 minutes maximum walking speed and modified Ashworth scale (MAS) were used to evaluat the outcome. Results The scores of BBS, FMA and MBI increased after treatment in both groups (P<0.05), and the score was more in the observation group than in the control group (P<0.01). The FAC and 10 minutes maximum waking speed were better, and the score of MAS was lower in the observation group than in the control group after treatment (P<0.01

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目的 探讨Lokomat下肢康复训练机器人对脑梗死偏瘫患者关节活动度和下肢运动功能的相关性.方法 将下肢功能偏瘫的患者40例随机分为对照组(20例)和机器人组(20例).对照组给予康复指导,自行训练；机器人组给予下肢康复机器人运动训练,每次30 min,每周3次,连续训练10周(2个疗程).于治疗前、治疗2个疗程后(治疗后)分别评测2组患者的下肢运动功能、肌力肌张力和髋膝关节活动度.结果 治疗前,2组间Fugl-Meyer下肢运动功能评分和髋、膝关节活动度比较,差异无统计学意义(P＞0.05)；治疗后,机器人组的Fugl-Meyer下肢运动功能评分和髋、膝关节活动度分别为(27.09 ±4.95)分、(17.43±1.97)°和(29.17 ±2.20)°,与组内治疗前的(11.82 ±3.12)分、(9.42±1.42)°、(13.84 ±2.95)°以及对照组治疗后的(24.55±10.09)分、(9.94±2.42)°和(26.36 ±1.30)°比较,差异均有统计学意义(P＜0.05).治疗前,2组患者下肢肌力肌张力比较,差异无统计学意义(P＞0.05)；治疗后,机器人组和台疗组的各项肌力肌张力与组内治疗前比较,差异均有统计学意义(P＜0.05),且机器人组治疗后各项肌力肌张力均优于对照组治疗后(P＜0.05).采用Peairson相关分析法计算髋、膝关节活动度与下肢关节活动度的相关性,下肢运动功能与髋、膝关节活动度均呈正相关.结论 Lokomat机器人康复训练可显著改善缺血性脑卒中偏瘫患者的关节活动范围,增强肌力并降低肌张力,进一步提高下肢运动功能.
Objective To investigate the effect of Lokomat gait training rehabilitation robot on joint motion and lower limb function in hemiplegic patients after stroke.Methods Forty hemiplegic patients after stroke were randomized equally into a robotic group and a control group (20 cases in each group).The robotic group received robotic rehabilitation therapy in addition to routine rehabilitation training,while the control group was only given instructions for routine rehabilitation training.All the patients were assessed at the beginning of the training and at the end of 4,8 and 10 weeks of treatment.The Fugl-Meyer Assessment of lower extremities (FMA),range of motion (ROM) in hip and knee,force and tone of bilateral hip/knee flexors and extensors were used to evaluate stepping function before training,and after 4,8 and 10 weeks of treatment.Results There was no significant difference between the 2 groups with regard to FMA scores,the ROM in hip and knee,as well as force and tone of bilateral

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瘫痪病人的数量与日俱增,其康复训练通常是一个长期的过程.相对于传统的理疗,使用机器人辅助康复训练能够提高效率,降低成本,减少理疗师的人员和体力消耗,因此节省了康复医疗资源,并且可以完成更加多样的主被动训练策略,从而提高了康复效果.根据患者进行康复运动时的身体姿态,下肢康复机器人可分以下4类:坐卧式机器人、直立式机器人、辅助起立式机器人和多体位式机器人,坐卧式又细分为末端式和外骨骼式,直立式进一步划分为悬吊减重(Suspending body weight support,s BWS)式步态训练机器人和独立可穿戴式机器人.由于下肢康复机器人是与运动功能受损的患肢相互作用,为了给患者创造一个安全、舒适、自然的训练环境,机器人和患者之间的交互控制不可或缺.根据获取运动意图时所使用的传感器信号,交互控制可以基本分为两类:1)基于力信号的交互控制;2)基于生物医学信号的交互控制.在基于力信号的交互控制中,力位混合控制和阻抗控制是最为常用的两种方法;而在基于生物医学信号的交互控制中,表面肌电(Surface electromyogram,s EMG)和脑电(Electroencephalogram,EEG)最常被用于运动意图的推断.
The number of paralytic sufferers is currently growing huge and the rehabilitation for them is usually a long-time process. Compared to the traditional physiotherapy, rehabilitation with the assistance of robots can reduce the cost and time, and less labor intensity is required. Moreover, various training strategies are provided by robots, so that rehabilitation effect can be improved. Lower limb rehabilitation robots are categorized into horizontal exercisers, vertical locomotors, sit-to-stand aids and multi-orientation hybrids, according to the posture of patient during therapy. Horizontal exercisers are subcategorized into end effectors and exoskeletons, and vertical locomotors are further grouped as suspending body weight support (sBWS) based gait trainers and stand-alone wearables. Interactive control between mechanism and patient is required to create a secure, comfortable and natural training environment for paralytic patients. According to the signals employed to dedu

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目的：探讨Lokomat下肢康复机器人训练在脑卒中患者步行障碍中的应用效果。方法：将60例脑卒中偏瘫患者随机分为观察组（30例）和对照组（30例），均神经发育疗法、主/被动牵伸、ADL训练、必要的矫形器应用、传统中医治疗等基础康复治疗，观察组在基础治疗基础上进行30min的Lokomat下肢康复机器人辅助步行训练，治疗强度和时间为40减重支持、75%的引导力量、1.5km/h步行速度，步行30min；对照组则在基础治疗基础上进行30min以提高步行能力为目标的治疗师辅助步行训练，所有治疗均5次/周，1次/天，共45min/次，在治疗前、治疗8周后分别进行康复效果评价。结果：治疗8周后，两组患者的Fugl-Meyer评分、Berg平衡量表评分、6min步行距离、FAC评分、MAC评分均较治疗前显著改善（P<0.05），且观察组各项评定均显著优于对照组（P<0.01）。结论：应用Lokomat下肢康复机器人训练能有效提高脑卒中患者的步行能力。
Objective:To observe the application effect of lower limb rehabilitation robot in walking disability of stroke patients. Methods:60 cases of stroke patients were randomly divided into treatment group (30 cases) and control group (30 cases). The two groups were treated with basic reha-bilitative therapy, which including neurodevelopmental therapy, active/passive stretching、ADL training、brace、traditional Chinese medicine etc. In addition, the treatment group was treated with lower limb rehabilitation robot training, the control group was treated with traditional therapist-assist gait training. Results:There was significant difference in all outcome measurements in both two groups (P<0.05) after 8 weeks intervention, and there was significant difference in all outcome measurements except the FMA between the treatment group and the control group (P<0.01). Conclu-sions:The application of Lokomat lower limb rehabilitation robot can effectively improve the walking ability in pati

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目的 探讨下肢康复机器人训练对急性脑卒中患者下肢运动功能的影响.方法 将42例急性脑卒中患者按随机数字表法分为治疗组和对照组,每组21例,对照组给予常规康复治疗,治疗组在此基础上辅以下肢康复机器人训练,每次10 ～ 20 min,每周6次,共8周.分别于治疗前和治疗8周后(治疗后)采用简化Fugl-Meyer运动功能量表(FMA)评定下肢运动功能,采用Berg平衡量表(BBS)评定平衡功能,采用Rivermead运动指数(RMI)评定日常生活活动(ADL)能力,以及采用功能性步行分级(FAC)评定患者步行能力,并进行统计学比较分析.结果 治疗前2组患者FMA、BBS和RMI评分的组间比较,差异均无统计学意义(P＞0.05)；治疗后2组患者FMA、BBS和RMI评分均优于组内治疗前水平(P＜0.05),且治疗组均明显优于对照组(P＜0.05).治疗前,对照组和治疗组患者能独立步行(FAC分级≥3级)的患者分别为5例(23.8％)和8例(38.1％),组间差异无统计学意义(P＞0.05)；治疗后,对照组和治疗组独立步行患者分别增加到12例(57.1％)和18例(85.7％),经统计学分析比较,治疗后2组患者步行功能均较组内治疗前有明显提高(P＜0.05),且治疗后治疗组患者步行功能明显优于同期对照组(P＜0.05).结论 下肢康复机器人训练可进一步改善急性脑卒中偏瘫患者的下肢运动功能.
Objective To investigate the effects of robot-assisted lower limb rehabilitation on the lower limb motor function of hemiplegic patients in the acute stage.Methods Forty-two hemiplegic patients in the acute stage were randomly divided into a treatment group and a control group with 21 in each.Both groups were treated with routine rehabilitation interventions,but the treatment group also undertook robot-assisted lower limb rehabilitation training.The training lasted for 10 to 20 min/d,6 d/week for 8 weeks.Lower limb motor function,balance,ability in the activities of daily living and walking ability were assessed with a simplified Fugl-Meyer assessment,the Berg balance scale,the Rivermead motility index (RMI) and functional ambulation categories (FACs).Results Before the intervention there was no significant difference between the two groups in any of the assessments.After training,both groups showed significant improvements in terms of their FMA,BBS,RMI and FAC results.The treatment gr

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为了实现下肢外骨骼康复机器人的实时跟随,并且恒力减重功能。在下肢外骨骼康复机器人顶部设立可移动的减重平台。采用LPC2132控制器对步进电机进行闭环控制。电路控制系统中,采用A/D转换模块获取传感器信号,PWM发射模块驱动步进电机运动,串口通信模块与上位机进行交互。利用Proteus对脉冲信号进行仿真,通过试验证明了系统具有稳定的运行状态。
In order to achieve real-time follow and Constant weight loss function of the lower extremity exoskeleton rehabili-tation robot,a removable weight loss platform was set up at the top of the lower extremity exoskeleton rehabilitation robot. The controller LPC2132 is used for the closed-loop control of stepping motor. In the circuit control system,the sensor signal is got by A / D convertion module,the PWM transmitter module drives stepping motor,and the serial communication module is used to interact with the host computer. The pulse signal was simulated by Proteus. The simulation result proves that the system has stable operating state.

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