therapist与患者通过外骨骼实现双向互动,提升中风后步态康复效果
Therapist-Exoskeleton-Patient Interaction for Gait Therapy
- therapist与患者穿戴外骨骼,通过弹簧阻尼器连接髋膝关节实现物理交互
- 8名慢性中风患者参与,干预后关节活动度、步态指标和肌肉激活均显著改善
- 适合需要精准康复又重视治疗师经验的临床场景
中风后患者常因下肢无力和关节自主控制丧失导致行走与平衡障碍。步态恢复是康复核心目标,传统依赖高强度治疗师指导训练,但人工辅助费力且难以同时调控多个关节。机器人外骨骼可提供多关节支持、减轻治疗师负担并实现客观反馈,但现有控制策略往往限制治疗师参与和灵活性。本文提出一种基于物理人-机-人交互(pHRHI)的新康复范式:治疗师与中风患者均穿戴下肢外骨骼,并在髋膝关节处通过弹簧阻尼元件虚拟连接,实现双向交互,使治疗师既能引导运动,又能接收触觉反馈。在8名慢性中风患者中的研究显示,pHRHI训练优于传统治疗师引导的跑步机步行,显著提升了关节活动范围、步态参数、肌肉激活水平及患者动机。结果表明pHRHI有望融合机器人精确性与治疗师直觉,提升康复效果。
原文摘要 · Abstract (English)
Following a stroke, individuals often experience mobility and balance impairments due to lower-limb weakness and loss of independent joint control. Gait recovery is a key goal of rehabilitation, traditionally achieved through high-intensity therapist-led training. However, manual assistance can be physically demanding and limits the therapist's ability to interact with multiple joints simultaneously. Robotic exoskeletons offer multi-joint support, reduce therapist strain, and provide objective feedback, but current control strategies often limit therapist involvement and adaptability. We present a novel gait rehabilitation paradigm based on physical Human-Robot-Human Interaction (pHRHI), where both the therapist and the post-stroke individual wear lower-limb exoskeletons virtually connected at the hips and knees via spring-damper elements. This enables bidirectional interaction, allowing the therapist to guide movement and receive haptic feedback. In a study with eight chronic stroke patients, pHRHI training outperformed conventional therapist-guided treadmill walking, leading to increased joint range of motion, step metrics, muscle activation, and motivation. These results highlight pHRHI's potential to combine robotic precision with therapist intuition for improved rehabilitation outcomes.
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