Name: robotic mirror therapy system for functional recovery of hemiplegic arms
Uploaded: 2016-08-15T15:00:00.000+00:00
Duration: 10 min 32 s
Description: Watch this Scientific Journal Video about Robotic Mirror Therapy System for Functional Recovery of Hemiplegic Arms at JoVE.com

这项工作是由汉城脑聚变计划国立大学（800-20120444）和跨学科研究倡议计划从工程和医学院，首尔国立大学（800-20150090）学院的支持。

所有的程序进行审查，并由首尔大学医院的机构审查委员会批准。 1.镜治疗任务<ol><li>的2维镜疗法任务的示例（ 图3） <ol><li>而在照镜子的热身运动约5分钟自由移动健康手臂。 注意:一个可以利用一个节拍器，使病人可以行使健康臂的运动以有节奏的方式。 </li><li>在健侧，运球并放置一个小球变成类似台球约5分钟（"球在洞"任务）所选择的洞。运球并放置一个小球变成类似足球约5分钟（"足球游戏"任务）的目标。 </li><li>利用放置在桌面上的编号贴纸，移动对健康侧的手柄以数字顺序，并在反方向返回（"点跟踪"的任务）。重复约5分钟。 </li><li>在日常生活中，如AC使用任何对象起来，在用健侧把手，把它推到一个选定的地方（"移动杯"任务）。重复约5分钟。 </li></ol></li></ol> 2.镜机器人系统的组成<ol><li> AHRS传感器设置<ol><li>获得3市售AHRS的传感器。 注:AHRS传感器由磁传感器，加速度计，陀螺仪和传感器（共9个轴）。 </li><li>在AHRS传感器连接到带有USB接口的PC。 </li><li>使用超级终端或其它通讯软件来配置一般的传感器设置。 </li><li>对于每个AHRS传感器，设置为RS232通讯并选择COM端口。然后，波特率设置为每秒115,200位，数据位为8，奇偶校验为无，停止位为1，流量控制为无。 <ol><li>要检查COM端口，点击左下角的主页按钮。右键点击电脑上。然后单击属性。单击设备管理器。通过单击展开端口（COM和LPT）选项卡。 </li></ol></li><li>一旦COMMunication已经建立，设置信道100和分配ID为每个传感器。 注意:有些传感器可能需要加速度计，陀螺仪，磁力计和校正后使用。 </li><li>设置输出格式为四元数和组传感器显示的电池储备。 注:四元被用来加快计算以及消除万向节锁定奇点。 </li></ol></li><li>直流无刷电机的设置<ol><li>准备2高性能直流无刷电机及控制器。 </li><li>每个控制器，将电源线连接到电源。此外，电机电缆，霍尔传感器电缆和编码器电缆连接到电机。 </li><li> CAN-CAN电缆连接到另一个控制器。 注:CANopen总线，用于设备之间的通信。 </li><li>对于每个控制器设备之间的区分集节点ID。 </li><li>将USB电缆连接到PC的一般配置。 </li><li>接通电源到CONTRO电列尔斯和电机。 </li><li>使用电机制造商提供的系统配置软件配置和调节电机，霍尔传感器和编码器。 注:角度限制和位置必须配置为安全运行。 </li></ol></li><li>框架和马达组件 注:每个定制的部分是在引号命名。请参阅材料与设备的表和从图4至图13。 <ol><li>对于肘关节电机，将接头机构之一带键槽的电机轴用M5内六角螺钉（ 图4）固定。 </li><li>安全"弯头耦合中空圆筒罩"使用4倍的M5六角头螺丝（10mm）的肘部马达并将联接器的缓冲部分（中间滑块部分）上附着在步骤2.3.1接头主体的顶（ 图4）。 </li><li>塞球轴承为"肘屋顶架"与4倍M4六角头螺丝（8 MM）（ 图5）将其固定。 </li><li>插上"肘电机力量分散轴"为"下肘支撑"，并与4倍M3六角头螺丝（6毫米）固定。然后，将"上肘支撑"上的"下肘支撑"的顶部，并使用8X M3六角头螺丝（12mm）中（ 图6）固定。 </li><li>放置组件放在上面，组装在步骤2.3.3在中间，并且在接头主体的底部的最后一部分步骤2.3.4。一起加入，并与M5内六角螺丝（10毫米）（ 图7）固定联结体。 </li><li>安全组件在步骤2.3.5和装配在步骤2.3.2采用4 M5六角头螺丝（15毫米）（ 图7）。在步骤2.3.2旋转组件，以确保所有的4分。 </li><li>安全"下的手腕联结的空心筒盖"使用4X M4六角头螺丝（10mm）的手腕马达。然后，将一带键槽电机轴耦合机构和使用M4内六角螺丝固定;然后，放置在接头主体的顶部的联接器（ 图8）的缓冲部。 </li><li>附加"摩擦减少环"上的"手腕屋顶框架"用双面胶带或任何类型的粘合剂（ 图9）的顶部。 </li><li>插上"手腕马达力分散轴"为"处理"，用4倍M2.5六角螺栓（4mm）（ 图10）将其固定。 </li><li>放置组件放在上面，组装在步骤2.3.8在中间，并且在接头主体的底部的最后一部分步骤2.3.9。一起加入，并与M4内六角螺丝（10毫米）（ 图10）固定联结体。 </li><li>采用4 M3六角头螺丝（ 图11）在步骤2.3.10安全"手腕motor2roof2"与大会。 </li><li>安全装配步骤2.3.11和装配步骤2.3.7我们ING 4X M3六角头螺丝（15毫米）（ 图11）。 </li><li>安全2"联合限运动"，并采用4 M4六角头螺丝（15毫米）（ 图 12A）2轴衣领。 </li><li>使用固定环固定轴，并使用8X M3六角头螺丝（8 MM）（ 图12B）"腕屋顶框架"。 </li><li>滑动总成2.3.13轴环到轴装配2.3.14，并以"下肘支撑"采用4 M4六角头螺丝（15毫米），争取更多的轴环。然后，加入两部分，并与控制杆（ 图13A）固定。 </li><li>使用6X M4六角头螺丝（15毫米）（ 图 13B）安全"的支持墙"到组装步骤2.3.15。安全步骤2.3.16表立场和装配使用6X M6六角头螺丝（15毫米）（ 图13C）。 </li></ol></li></ol> 3.镜子罗布设计OT系统<ol><li>自动控制数学模型<ol><li>上肢运动的自动控制设置动态模型（ 图14）。 注:人体上肢运动的动力学模型可以用关节和链接的运动来表达。因此，使用等式为机器人操作，可以如以下所示得到的造型: <img alt="式（1）" src="/files/ftp_upload/54521/54521eq1.jpg" /> 注意: （ <img alt="公式（2）" src="/files/ftp_upload/54521/54521eq2.jpg" /> :关节位置矢量， <img alt="公式3" src="/files/ftp_upload/54521/54521eq3.jpg" /> :关节的速度矢量， <img alt="公式4" src="/files/ftp_upload/54521/54521eq4.jpg" /> :联合加速度矢量，H:惯性矩阵，F:科氏力和离心力矩阵，G:重力，E矢量:转矩矩阵由于与环境的相互作用， <img alt="式（1）" src="/files/ftp_upload/54521/54521eq5.jpg" /> :广义FORC矢量<html>适用于关节ES）的偏瘫和运动的健康臂展的不同方面。也就是说，偏瘫臂不能在一次移动由于瘫痪肌肉或不能提供所需要的运动足够的转矩。因此，该系统被设计为使得康复训练可以经由通过偏瘫臂正常运动来完成;换言之，恢复机器人附连到病人的偏瘫臂以从健康臂传递运动，并且可以简单地配制如下: （偏瘫手臂运动） - 康复机器人）=（健康手臂的运动）的运动。 </li><li>与康复机器人，患者的麻痹臂连接到操纵器，并观察附加力矩和延时由于瘫痪臂引起整个系统的错误。通过对偏瘫侧操纵检测这一点。 </li><li>测量误差（S（t）为跟踪误差）作为一个数学方程: ES / ftp_upload / 54521 / 54521eq6.jpg"/&gt; 注:（S:跟踪误差， <img alt="公式7" src="/files/ftp_upload/54521/54521eq7.jpg" /> :正定的设计参数矩阵， <img alt="式（8）" src="/files/ftp_upload/54521/54521eq8.jpg" /> :预期与实际位置之间的错误， <img alt="式（1）" src="/files/ftp_upload/54521/54521eq9.jpg" /> :期望和实际速度）上述跟踪误差可以与人类上肢运动的动态模型被组合和间的误差可表示为: <img alt="10式" src="/files/ftp_upload/54521/54521eq10.jpg" /> 注:（K D:用随时间变化反馈补偿微分增益值， <img alt="11式" src="/files/ftp_upload/54521/54521eq11.jpg" /> :惯性误差矩阵， <img alt="12式" src="/files/ftp_upload/54521/54521eq12.jpg" /> :科氏力和离心力误差矩阵） </li><li>为了控制康复机器人的每一个关节，使用LAGRangian动力学8。运动的每个关节的动态方程为: <img alt="13式" src="/files/ftp_upload/54521/54521eq13.jpg" /> 注:（D:系数矩阵， <img alt="14式" src="/files/ftp_upload/54521/54521eq14.jpg" /> :上述公式中执行机构惯性矩阵）系数D会影响关节的关节8之间的惯性耦合效应之间的扭矩。使用该数学模型的自动控制模型可以通过图14中的块方案进行说明。 </li></ol></li><li>软件协议（ 图15） <ol><li>当程序启动时，建立与电机和传感器通信，并且初始化值。一旦马达和传感器是在初始位置（参见4.1.3），移动到主循环。 注:主回路的采样频率，我们建议50 - 200样本/秒。对于最大延迟，我们建议2秒最多。另外，对于转矩限制，我们推荐以调节与软件的电动机电流值，以使肘马达可以施加25 - 40牛顿和手腕马达可以施加10 - 20牛顿米。 </li><li>由于它不是由一个停止按钮中断，连续读取的姿态和航向参考系统（AHRS）传感器的当前位置值，这些值传送到电机。 注:数据输出是在四元，并应适当转化为机器人的运动所需的角度。选择传感器的一个坐标的帧作为参考，并重置另一个传感器坐标帧。以计算出的帧作为参考，使用逆运动学，得到最终的输出偏转角。 </li><li>因为它不是由一个停止按钮中断，连续地检查电动机的立场和更新的值来完成的运动由AHRS传感器提供的所希望的位置。 注:马达位置由可在软件内与电机公司＆＃检查电机的编码器提供39; S提供的软件库命令。 </li><li>同时，记录从AHRS传感器各个角度和角速度。 </li><li>一旦任务完成，并在用户按下停止按钮时，退出该环路，并通过将其移动到初始位置完成机器人。 </li></ol></li><li>图形用户界面（GUI）（ 图16） <ol><li>添加"错误"，并在执行过程中，"错误输出"功能检测和调试错误。 </li><li>添加病人侧按钮选择机器人操作方（患者的麻痹侧）。 </li><li>构造一个病人信息框来识别患者。 </li><li>加入运动状态指示灯。 </li><li>添加角度限制控件的安全性。 </li><li>配置的最大速度，加速度和减速度对每个马达，以防止肌肉和肌腱损伤因僵硬上肢。 注:系统反映了偏瘫手臂的加速和减速。 </li><li>一个DD指标检索马达的位置和速度，以及输入电流信息。 </li><li>构建VISA资源名称的控制，建立AHRS传感器与系统之间的通信。 </li><li>添加校准功能，以消除累积的传感器漂移误差。 </li><li>安排传感器的指示器，以便检索传感器信息。 注:该传感器信息包括关节角度（连续两个传感器之间的夹角）和备用电池。 </li></ol></li><li>镜子机器人操作过程中克服手臂痉挛<ol><li>选择能够发挥足够的扭矩来克服痉挛每个关节电机。 注:手腕电机必须扭矩输出超过10牛米高，和肘部电机高出25牛米。 </li><li>为了将机器人运动牢牢传送到病人的手臂，使用由半弹性材料制成的固定在机器人外骨骼的前臂肩带。 注:半松紧带，如伸缩^ h布带或涤纶/尼龙弹性编织带，建议。如果条带太弹性，它不会保持在适当位置的臂。如果带子是不弹性可言，可以以高度弯头痉挛的情况下发生的肌肉或肌腱损伤。 </li><li>为了分离肘和手腕的运动，使用2与轴环组合固体帧由帧挤压它固定在手腕上。 注:轴环用于防止肌肉和肌腱损伤如果在手腕上的刚性过高。 </li><li>使用手柄围绕绑带的手固定到机器人。 </li></ol></li></ol> 4.镜机器人系统的临床应用<ol><li>开展机器人镜治疗<ol><li>调整高度和任务表的宽度根据病人的状况。 </li><li>设置镜像双臂之间的中线，并将它放在桌面或平台。 </li><li>放置在手柄，手腕AHRS传感器帧，并在与该机器人的方向平行健侧对准平台的边缘。 注:该传感器内部的偏航轴线应朝上。 </li><li>在计算机执行的疗法的软件。 </li><li>通过点击患者侧开关按钮选择偏瘫侧。 </li><li>设置根据患者关节状况的最大接头角度限制。对于安全操作，用肘关节屈曲极限小于50度，肘关节伸直上限超过-70，屈腕限制小于80º，和手腕扩展限制超过-60。 注:加号和减号也可自动纠正和限制也如出界在软件层面上纠正。 </li><li>设定最大速度，加速度和减速度。对于这些值，使用0和22.5 rpm转速区间内速度值在0和33 rpm转速区间内肘电机和使用速度值手腕电机。 注:对于传统的理疗镜，将所有的值为零来固定机器人。 </li><li>填写患者信息。 </li><li>运行程序之前打开所有AHRS传感器。 </li><li>通过点击在节目的左上角的箭头按钮运行程序。 </li><li>一旦"另存为"的提示弹出，写上字符串框，然后按OK结果数据正确的文件名。 </li><li>而机器人和健康臂处于初始位置（双手离身体并相互平行）时，按校准按钮初始化传感器值为零的初始位置。 注:参见1.1.1步骤 - 1.1.4本任务中使用的手中。 </li><li>当所有任务都完成后按STOP按钮。 注:对于机器人镜子疗法，生物医学工程师应作为主要的协调者和职业治疗师应该帮助病人。 </li></ol></li><li>对健康受试者的临床研究<ol><li>开展关于健康受试者临床研究证实安全性和可行性8。给这个指令（"不要在自己的移动你的手臂偏瘫"）的科目偏瘫手臂完全被动运动。 </li><li>放置在把手上的框架两前臂和手。然后，用固定带前臂。 </li></ol></li><li>疗效评价<ol><li>治疗前，进行功能评估，如采用Fugl -梅耶评估量表9，改良Ashworth规模10，改良Barthel指数11，捷成手功能测验，手功率测量，半侧忽视测试和运动诱发电位测试的病人。 </li><li>开展中风病人的临床试验有2维镜机器人30 - 每天60分钟。给这个指令（"不要在自己的移动你的手臂偏瘫"），以病人。 </li><li>病人完成最后一次会议后，进行后续的功能评价。 </li></ol></li></ol>

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B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interrater+reliability+of+a+modified+Ashworth+scale+of+muscle+spasticity.">Interrater reliability of a modified Ashworth scale of muscle spasticity.</a> Phys Ther. 67 (2), 206-207 (1987).</li><li>Shah, S., Vanclay, F., Cooper, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improving+the+sensitivity+of+the+Barthel+Index+for+stroke+rehabilitation.">Improving the sensitivity of the Barthel Index for stroke rehabilitation.</a> J Clin Epidemiol. 42 (8), 703-709 (1989).</li><li>Lo, A. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robot-assisted+therapy+for+long-term+upper-limb+impairment+after+stroke.">Robot-assisted therapy for long-term upper-limb impairment after stroke.</a> N Engl J Med. 362 (19), 1772-1783 (2010).</li><li>Ho, N. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+EMG-driven+exoskeleton+hand+robotic+training+device+on+chronic+stroke+subjects:+task+training+system+for+stroke+rehabilitation.">An EMG-driven exoskeleton hand robotic training device on chronic stroke subjects: task training system for stroke rehabilitation.</a> IEEE Int Conf Rehabil Robot. , 5975340 (2011).</li><li>Hesse, S., Schulte-Tigges, G., Konrad, M., Bardeleben, A., Werner, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robot-assisted+arm+trainer+for+the+passive+and+active+practice+of+bilateral+forearm+and+wrist+movements+in+hemiparetic+subjects.">Robot-assisted arm trainer for the passive and active practice of bilateral forearm and wrist movements in hemiparetic subjects.</a> Arch Phys Med Rehabil. 84 (6), 915-920 (2003).</li><li>Lum, P. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=MIME+robotic+device+for+upper-limb+neurorehabilitation+in+subacute+stroke+subjects:+A+follow-up+study.">MIME robotic device for upper-limb neurorehabilitation in subacute stroke subjects: A follow-up study.</a> J Rehabil Res Dev. 43 (5), 631-642 (2006).</li><li>Yang, C. L., Lin, K. C., Chen, H. C., Wu, C. Y., Chen, C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pilot+comparative+study+of+unilateral+and+bilateral+robot-assisted+training+on+upper-extremity+performance+in+patients+with+stroke.">Pilot comparative study of unilateral and bilateral robot-assisted training on upper-extremity performance in patients with stroke.</a> Am J Occup Ther. 66 (2), 198-206 (2012).</li><li>Nef, T., Mihelj, M., Riener, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=ARMin:+a+robot+for+patient-cooperative+arm+therapy.">ARMin: a robot for patient-cooperative arm therapy.</a> Med Biol Eng Comput. 45 (9), 887-900 (2007).</li><li>Ozkul, F., Barkana, D. E., Demirbas, S. B., Inal, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+proprioceptive+sense+of+the+elbow+joint+with+RehabRoby.">Evaluation of proprioceptive sense of the elbow joint with RehabRoby.</a> IEEE Int Conf Rehabil Robot. , 5975466 (2011).</li><li>Pehlivan, A. U., Celik, O., O'Malley, M. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mechanical+design+of+a+distal+arm+exoskeleton+for+stroke+and+spinal+cord+injury+rehabilitation.">Mechanical design of a distal arm exoskeleton for stroke and spinal cord injury rehabilitation.</a> IEEE Int Conf Rehabil Robot. , 5975428 (2011).</li><li>Zhang, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Feasibility+studies+of+robot-assisted+stroke+rehabilitation+at+clinic+and+home+settings+using+RUPERT.">Feasibility studies of robot-assisted stroke rehabilitation at clinic and home settings using RUPERT.</a> IEEE Int Conf Rehabil Robot. , 5975440 (2011).</li></ol>

作者什么都没有透露。

本研究的主要目的是开发一偏瘫臂的功能恢复使用自动控制算法实时镜机器人系统。机器人辅助治疗对中风后上肢功能障碍长期复苏的影响在以往的研究证明12有益的，各种臂机器人相继出台13-20。但是，实现双侧臂移动上肢机器人的以前的研究应用的机械连接，而无需使用反射镜，它是由镜疗法14-15的概念不同。因此，我们的研究可通过使用实际镜，以促进本体输入一个?...

对于患有中风，半身不遂手臂功能障碍的破坏性影响。执行双手活动的能力，对于日常生活中必不可少的，但偏瘫手臂功能缺损中风发作后常保持甚至几年。在医院的各种培训课程，练习，以增加运动或被动重复范围的简单任务有一个偏瘫手臂功能的恢复影响不大。出于这个原因，涉及到日常生活（ADL的）活动有意义的任务的训练已被应用到职业治疗医院。 镜治疗的效果是由以前的研究在神经康复1-4证明。镜疗法可如同偏瘫臂实时移动而移动所述健康臂通过使用反射镜的引出一个假象进行。它可以通过感觉皮层1的活化促进脑神经可塑性。因此，MOTOř功率和​​偏瘫臂的功能可以得到改善。然而，传统的镜疗法具有严格的限制在于，偏瘫臂实际上没有移动。 因此，我们开发了一个实时的2轴镜机器人系统作为一个简单的附加模块常规理疗镜，采用闭环反馈机制。这可能传达本体输入到感觉皮层，这被认为在神经可塑性和偏瘫臂的功能恢复（ 图1和2）5-7重要。

<table><tbody><tr><td>LabVIEW</td><td>National Instruments</td><td></td><td>System design software</td></tr><tr><td>24 V power supply</td><td>XP Power</td><td>MHP1000PS24 24V</td><td>Any 24 V power supply should do</td></tr><tr><td>AHRS sensor receiver</td><td>E2box</td><td>EBRF24GRCV</td><td></td></tr><tr><td>AHRS sensors</td><td>E2box</td><td>EBIMU-9DOFV2</td><td>You will need total 3 sensors. Any AHRS sensors will do</td></tr><tr><td>EC90 flat motor module</td><td>Maxon</td><td>323772 + 223094 + 453231</td><td>Any geared motor with higher than 30 Nm should do. (For our custom machined parts, you will need these particular flat motor and gear module, but the gear ratio and encoder may vary)&amp;nbsp;</td></tr><tr><td>EC45 flat motor module</td><td>Maxon</td><td>397172</td><td>Any geared motor with higher than 10 Nm should do (For our custom machined parts, you should use the same gear module but the gear ratio, motor, and encoder may vary)</td></tr><tr><td>EPOS2 70/10 controller</td><td>Maxon</td><td>375711</td><td>This can be replaced with EPOS 24/5 controller</td></tr><tr><td>EPOS2 24/5 controller</td><td>Maxon</td><td>367676</td><td></td></tr><tr><td>Connector and cable set</td><td>Maxon</td><td>381405 + 384915 + 275934 + 354045</td><td>You can also make these cables. Connectors and corresponding wire info can be found in &quot;300583-Hardware-Reference-En.pdf&quot; and &quot;300583-Cable-Starting-Set-En.pdf&quot;</td></tr><tr><td>Coupling- Oldham, Set Screw Type</td><td>Misumi</td><td>MCORK30-10-12</td><td>Type may vary</td></tr><tr><td>Coupling- High Rigidity, Oldham,&lt;br/&gt; Set Screw Type</td><td>Misumi</td><td>MCOGRK34-12-12</td><td>Type may vary</td></tr><tr><td>Shaft Collars</td><td>Misumi</td><td>SCWDM10-B &amp;nbsp;</td><td>You will need 4 sets</td></tr><tr><td>Shaft Collars</td><td>Misumi</td><td>SDBJ10-8</td><td>You will need 2 sets</td></tr><tr><td>Precision Linear Shaft</td><td>Misumi</td><td>&amp;nbsp;PSSFG10-200</td><td>Any straight 10 mm diameter shaft with at least 200 mm length should do&amp;nbsp;</td></tr><tr><td>Bearings with housings</td><td>Misumi</td><td>BGRAB6801ZZ</td><td></td></tr><tr><td>Elbow motor force dispersion shaft&amp;nbsp;</td><td>custom machined</td><td>3D CAD&amp;nbsp;</td><td></td></tr><tr><td>Lower elbow support</td><td>custom machined</td><td>Part Drawings</td><td></td></tr><tr><td>Elbow rooftop frame</td><td>custom machined</td><td>Part Drawings</td><td></td></tr><tr><td>Support wall</td><td>custom machined</td><td>Part Drawings</td><td>You will need 2 frames.</td></tr><tr><td>Elbow coupling hollow cylinder cover&amp;nbsp;</td><td>custom machined</td><td>Part Drawings</td><td></td></tr><tr><td>Wrist motor force dispersion shaft</td><td>custom machined</td><td>Part Drawings</td><td></td></tr><tr><td>Wrist rooftop frame</td><td>custom machined</td><td>Part Drawings</td><td></td></tr><tr><td>Upper wrist coupling hollow cylinder cover</td><td>custom machined</td><td>Part Drawings</td><td></td></tr><tr><td>Lower wrist coupling hollow cylinder cover</td><td>custom machined</td><td>Part Drawings</td><td></td></tr><tr><td>Joint movement limiter</td><td>custom machined</td><td>Part Drawings</td><td></td></tr><tr><td>Handle</td><td>3D printed</td><td>Part Drawings</td><td></td></tr><tr><td>Upper elbow support</td><td>3D printed</td><td>Part Drawings</td><td></td></tr><tr><td>Friction reduction ring</td><td>3D printed</td><td>Part Drawings</td><td></td></tr><tr><td>Acrylic mirror</td><td>custom laser cutting</td><td>Part Drawings</td><td></td></tr><tr><td>Task table</td><td>custom machined</td><td>Part Drawings</td><td></td></tr><tr><td>Silicone sponge</td><td></td><td></td><td></td></tr><tr><td>DOF limiter</td><td>3D printed</td><td>Part Drawings</td><td></td></tr><tr><td>DOF limiter lid</td><td>3D printed</td><td>Part Drawings</td><td></td></tr><tr><td>Healthyarm handle</td><td>3D printed</td><td>Part Drawings</td><td></td></tr><tr><td>Ball rollers - Press fit</td><td>Misumi</td><td>BCHA18</td><td></td></tr><tr><td>Goalpost</td><td>3D printed</td><td>Part Drawings</td><td></td></tr><tr><td>Circle trace</td><td>3D printed</td><td>Part Drawings</td><td></td></tr><tr><td>Angled assist</td><td>3D printed</td><td>Part Drawings</td><td>Optional</td></tr><tr><td>Curved assist</td><td>3D printed</td><td>Part Drawings</td><td>Optional</td></tr><tr><td>Plain assist</td><td>3D printed</td><td>Part Drawings</td><td>Optional</td></tr><tr><td>Task board</td><td>custom laser cutting</td><td>Part Drawings</td><td></td></tr></tbody></table>

robotic mirror therapy system for functional recovery of hemiplegic arms

镜疗法已在临床环境中用于中风后偏瘫臂的功能恢复被执行作为有效的职业疗法。它是由仿佛偏瘫臂实时移动而移动所述健康臂通过使用反射镜的引出一个假象进行。它可以通过感觉运动皮层的活化有利于大脑可塑性。然而，传统的镜疗法具有严格的限制在于，偏瘫臂实际上没有移动。因此，我们开发了一种实时2轴镜机器人系统作为使用闭合反馈机制，其使得偏瘫臂的实时运动常规镜疗法的简单的附加模块。我们用了3姿态和航向参考系统传感器，2无刷直流电机的肘，腕关节，和外骨骼框架。在6名健康受试者的可行性研究，机器人镜治疗是安全可行的。我们进一步选择有用的任务傣族活动LY住在离康复医生通过反馈训练。一个慢性中风患者镜机器人系统的2周申请后显示，在采用Fugl-Meyer评分尺度和肘部屈肌痉挛的改善。机器人镜疗法可提高本体输入到感觉皮层，这被认为是在神经可塑性和偏瘫臂的功能恢复重要。本文中所呈现的镜像机器人系统可以很容易地开发并有效地利用推进职业治疗。

六名健康受试者进行的"笔标记任务&#39;（与附着在健康手笔触摸的两个小板交替， 如图17），10倍历时每个受试者平均106秒。没有观察到的不良事件，并且机器人镜疗法被证明是可行的。 此外，在康复医生的临床研究进行。我们请专家意见，以确定有效的机器人镜治疗职业相应的任务。从6康复医生反馈，错觉的镜...

Watch this Scientific Journal Video about Robotic Mirror Therapy System for Functional Recovery of Hemiplegic Arms at JoVE.com

Robotic Mirror Therapy System for Functional Recovery of Hemiplegic Arms

我们开发了一个实时镜机器人系统使用自动控制技术偏瘫手臂功能恢复，进行了健康受试者通过反馈康复医生的临床研究，并立志任务。这个简单的镜子机器人可有效地应用于职业治疗脑卒中患者用偏瘫臂。

机器人镜治疗系统偏瘫武器功能恢复

Mirror therapy has been performed as effective occupational therapy in a clinical setting for functional recovery of a hemiplegic arm after stroke. It is ...

robotic-mirror-therapy-system-for-functional-recovery-hemiplegic

Research

JoVE Journal

Bioengineering

15.4K 次观看.  Seoul National University College of Medicine. 我们开发了一个实时镜机器人系统使用自动控制技术偏瘫手臂功能恢复，进行了健康受试者通过反馈康复医生的临床研究，并立志任务。这个简单的镜子机器人可有效地应用于职业治疗脑卒中患者用偏瘫臂。 

视频: Robotic Mirror Therapy System for Functional Recovery of Hemiplegic Arms

Haptic/Graphic Rehabilitation: Integrating a Robot into a Virtual Environment Library and Applying it to Stroke Therapy

Recent research that tests interactive devices for prolonged therapy practice has revealed new prospects for robotics combined with graphical and other forms of biofeedback. Previous human-robot interactive systems have required different software commands to be implemented for each robot leading to unnecessary developmental overhead time each time a new system becomes available. For example, when a haptic/graphic virtual reality environment has been coded for one specific robot to provide haptic feedback, that specific robot would not be able to be traded for another robot without recoding the program. However, recent efforts in the open source community have proposed a wrapper class approach that can elicit nearly identical responses regardless of the robot used. The result can lead researchers across the globe to perform similar experiments using shared code. Therefore modular "switching out"of one robot for another would not affect development time. In this paper, we outline the successful creation and implementation of a wrapper class for one robot into the open-source H3DAPI, which integrates the software commands most commonly used by all robots.

Recently, a vast amount of prospects have come available for human-robot interactive systems. In this paper we outline the integration of a new robotic device with open source software that can rapidly make possible a library of interactive functionality. We then outline a clinical application for a neurorehabilitation application.

触觉/图形康复：整合成一个虚拟的环境下图书馆的机器人，它应用于中风治疗

Recent research that tests interactive devices for prolonged therapy practice has revealed new prospects for robotics combined with graphical and other ...

科研

生物工程

Robotic Production of Cancer Cell Spheroids with an Aqueous Two-phase System for Drug Testing

Cancer cell spheroids present a relevant in vitro model of avascular tumors for anti-cancer drug testing applications. A detailed protocol for producing both mono-culture and co-culture spheroids in a high throughput 96-well plate format is described in this work. This approach utilizes an aqueous two-phase system to confine cells into a drop of the denser aqueous phase immersed within the second aqueous phase. The drop rests on the well surface and keeps cells in close proximity to form a single spheroid. This technology has been adapted to a robotic liquid handler to produce size-controlled spheroids and expedite the process of spheroid production for compound screening applications. Spheroids treated with a clinically-used drug show reduced cell viability with increase in the drug dose. The use of a standard micro-well plate for spheroid generation makes it straightforward to analyze viability of cancer cells of drug-treated spheroids with a micro-plate reader. This technology is straightforward to implement both robotically and with other liquid handling tools such as manual pipettes.

A protocol for robotic printing of cancer cell spheroids in a high throughput 96-well plate format using an aqueous two-phase system is presented.

癌症细胞球体机器人生产与药物测试的双水相系统

Cancer cell spheroids present a relevant in vitro model of avascular tumors for anti-cancer drug testing applications. A detailed protocol for producing ...

The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb

Neurologic disorders such as stroke and cerebral palsy are leading causes of long-term disability and can lead to severe incapacity and restriction of daily activities due to lower and upper limb impairments. Intensive physical and occupational therapy are still considered main treatments, but new adjunct therapies to standard rehabilitation that may optimize functional outcomes are being studied.
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that polarizes underlying brain regions through the application of weak direct currents through electrodes on the scalp, modulating cortical excitability. Increased interest in this technique can be attributed to its low cost, ease of use, and effects on human neural plasticity. Recent research has been performed to determine the clinical potential of tDCS in diverse conditions such as depression, Parkinson&#39;s disease, and motor rehabilitation after stroke. tDCS helps enhance brain plasticity and seems to be a promising technique in rehabilitation programs.
A number of robotic devices have been developed to assist in the rehabilitation of upper limb function after stroke. The rehabilitation of motor deficits is often a long process requiring multidisciplinary approaches for a patient to achieve maximum independence. These devices do not intend to replace manual rehabilitation therapy; instead, they were designed as an additional tool to rehabilitation programs, allowing immediate perception of results and tracking of improvements, thus helping patients to stay motivated.
Both tDSC and robot-assisted therapy are promising add-ons to stroke rehabilitation and target the modulation of brain plasticity, with several reports describing their use to be associated with conventional therapy and the improvement of therapeutic outcomes. However, more recently, some small clinical trials have been developed that describe the associated use of tDCS and robot-assisted therapy in stroke rehabilitation. In this article, we describe the combined methods used in our institute for improving motor performance after stroke.

The combined use of transcranial direct current stimulation and robotic therapy as an add-on for conventional rehabilitation therapy may result in improved therapeutic outcomes due to modulation of brain plasticity. In this article, we describe the combined methods used in our institute for improving motor performance after stroke.

经颅直流电刺激与上肢机器人治疗的联合应用

Neurologic disorders such as stroke and cerebral palsy are leading causes of long-term disability and can lead to severe incapacity and restriction of ...

神经科学

Real-time Video Projection in an MRI for Characterization of Neural Correlates Associated with Mirror Therapy for Phantom Limb Pain

Mirror therapy (MT) has been proposed as an effective rehabilitative strategy to alleviate pain symptoms in amputees with phantom limb pain (PLP). However, establishing the neural correlates associated with MT therapy have been challenging given that it is difficult to administer the therapy effectively within a magnetic resonance imaging (MRI) scanner environment. To characterize the functional organization of cortical regions associated with this rehabilitative strategy, we have developed a combined behavioral and functional neuroimaging protocol that can be applied in participants with a leg amputation. This novel approach allows participants to undergo MT within the MRI scanner environment by viewing real-time video images captured by a camera. The images are viewed by the participant through a system of mirrors and a monitor that the participant views while lying on the scanner bed. In this manner, functional changes in cortical areas of interest (e.g., sensorimotor cortex) can be characterized in response to the direct application of MT.

We present a novel combined behavioral and neuroimaging protocol employing real-time video projection for the purpose of characterizing the neural correlates associated with mirror therapy within the magnetic resonance imaging scanner environment in leg amputee subjects with phantom limb pain.

MRI 实时视频显示在与镜治疗的恐惧症肢体疼痛相关的神经相关性特征中的应用

Mirror therapy (MT) has been proposed as an effective rehabilitative strategy to alleviate pain symptoms in amputees with phantom limb pain (PLP). ...

Development of a Novel Task-oriented Rehabilitation Program using a Bimanual Exoskeleton Robotic Hand

A robot-assisted hand is used for the rehabilitation of patients with impaired upper limb function, particularly for stroke patients with a loss of motor control. However, it is unclear how conventional occupational training strategies can be applied to the use of rehabilitation robots. Novel robotic technologies and occupational therapy concepts are used to develop a protocol that allows patients with impaired upper limb function to grasp objects using their affected hand through a variety of pinching and grasping functions. To conduct this appropriately, we used five types of objects: a peg, a rectangular cube, a cube, a ball, and a cylindrical bar. We also equipped the patients with a robotic hand, the Mirror Hand, an exoskeleton&#160;hand that is fitted to the subject&#8217;s affected hand and follows the movement of the sensor glove fitted to their unaffected hand (bimanual movement training (BMT)). This study had two stages. Three healthy subjects were first recruited to test the feasibility and acceptability of the training program. Three patients with hand dysfunction caused by stroke were then recruited to confirm the feasibility and acceptability of the training program, which was conducted on 3 consecutive days. On each day, the patient was monitored during 5 min of movement in a passive range of motion, 5 min of robot-assisted bimanual movement, and task-oriented training using the five objects. The results showed that both healthy subjects and subjects who had suffered a stroke in conjunction with the robotic hand could successfully grasp the objects. Both healthy subjects and those who had suffered a stroke performed well with the robot-assisted task-oriented training program in terms of feasibility and acceptability.

This study reports the development of a novel robot-assisted task-oriented program for hand rehabilitation. The developmental process consists of experiments using both healthy subjects and subjects who have had a stroke and suffered from subsequent motor control dysfunction.

使用双骨外骨骼机器人手开发面向任务的新康复计划

A robot-assisted hand is used for the rehabilitation of patients with impaired upper limb function, particularly for stroke patients with a loss of motor ...

医学

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Targeted Muscle Reinnervation (TMR) improves the biological control interface for myoelectric prostheses after above-elbow amputation. Selective activation of muscle units is made possible by surgically re-routing nerves, yielding a high number of independent myoelectric control signals. However, this intervention requires careful patient selection and specific rehabilitation therapy. Here a rehabilitation protocol is presented for high-level upper limb amputees undergoing TMR, based on an expert Delphi study. Interventions before surgery include detailed patient assessment and general measures for pain control, muscle endurance and strength, balance, and range of motion of the remaining joints. After surgery, additional therapeutic interventions focus on edema control and scar treatment and the selective activation of cortical areas responsible for upper limb control. Following successful&#160;reinnervation of target muscles, surface electromyographic (sEMG) biofeedback is used to train the activation of the novel muscular units. Later on, a table-top prosthesis may provide the first experience of prosthetic control. After fitting the actual prosthesis, training includes repetitive drills without objects, object manipulation, and finally, activities of daily living. Ultimately, regular patient appointments and functional assessments allow tracking prosthetic function and enabling early interventions if malfunctioning.

This work presents a protocol to enhance prosthetic function after selective nerve transfer surgery. Rehabilitation interventions include patient information and selection, support of wound healing, cortical re-activation of sensory-motor areas of the upper limb, training of selective muscle activation, prosthetic handling in daily life, and regular follow-up assessments.

接受选择性神经转移的上肢截肢者的治疗干预

Targeted Muscle Reinnervation (TMR) improves the biological control interface for myoelectric prostheses after above-elbow amputation. Selective ...

通过基于虚拟现实的职业培训加强中风康复

Cognitive Function and Upper Limb Rehabilitation Training Post-Stroke Using a Digital Occupational Training System

Stroke rehabilitation often requires frequent and intensive therapy to improve functional recovery. Virtual reality (VR) technology has shown the potential to meet these demands by providing engaging and motivating therapy options. The digital occupational training system is a VR application that utilizes cutting-edge technologies, including multi-touch screens, virtual reality, and human-computer interaction, to offer diverse training techniques for advanced cognitive capacity and hand-eye coordination abilities. The objective of this study was to assess the effectiveness of this program in enhancing cognitive function and upper extremity rehabilitation in stroke patients. The training and assessment consist of five cognitive modules covering perception, attention, memory, logical reasoning, and calculation, along with hand-eye coordination training. This research indicates that after eight weeks of training, the digital occupational training system can significantly improve cognitive function, daily living skills, attention, and self-care abilities in stroke patients. This software can be employed as a time-saving and clinically effective rehabilitation aid to complement traditional one-on-one occupational therapy sessions. In summary, the digital occupational training system shows promise and offers potential financial benefits as a tool to support the functional recovery of stroke patients.

作者聚焦：使用数字职业培训系统实现中风患者的康复

The current protocol outlines how the VR-based digital occupational training system enhances the rehabilitation of patients with cognitive impairment and upper limb dysfunction following a stroke.

使用数字职业培训系统的中风后认知功能和上肢康复训练

Stroke rehabilitation often requires frequent and intensive therapy to improve functional recovery. Virtual reality (VR) technology has shown the ...

Brain-Computer Interface-controlled Upper Limb Robotic System for Enhancing Daily Activities in Stroke Patients

This study introduces a Brain-Computer Interface (BCI)-controlled upper limb assistive robot for post-stroke rehabilitation. The system utilizes electroencephalogram (EEG) and electrooculogram (EOG) signals to help users assist upper limb function in everyday tasks while interacting with a robotic hand. We evaluated the effectiveness of this BCI-robot system using the Berlin Bimanual Test for Stroke (BeBiTS), a set of 10 daily living tasks involving both hands. Eight stroke patients participated in this study, but only four participants could adapt to the BCI robot system training and perform the postBeBiTS. Notably, when the preBeBiTS score for each item was four or less, the BCI robot system showed greater assistive effectiveness in the postBeBiTS assessment. Furthermore, our current robotic hand does not assist with arm and wrist functions, limiting its use in tasks requiring complex hand movements. More participants are required to confirm the training effectiveness of the BCI-robot system, and future research should consider using robots that can assist with a broader range of upper limb functions. This study aimed to determine the BCI-robot system's ability to assist patients in performing daily living activities.

This study introduces a brain-computer interface (BCI) system for stroke patients, which combines electroencephalography and electrooculography signals to control an upper limb robotic hand, enhancing daily activities. The evaluation used the Berlin Bimanual Test for Stroke (BeBiTS).

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接受选择性神经转移的上肢截肢者的治疗干预

使用数字职业培训系统的中风后认知功能和上肢康复训练

使用数字职业培训系统的中风后认知功能和上肢康复训练

使用数字职业培训系统的中风后认知功能和上肢康复训练

Brain-Computer Interface-controlled Upper Limb Robotic System for Enhancing Daily Activities in Stroke Patients