机器人镜治疗系统偏瘫武器功能恢复
1Department of Biomedical Engineering,Seoul National University College of Medicine, 2Department of Rehabilitation Medicine,Chungnam National University Hospital, 3Interdisciplinary Program for Bioengineering,Seoul National University Graduate School, 4Department of Rehabilitation Medicine,Seoul National University Hospital, 5Seoul National University College of Medicine, 6Institute of Medical and Biological Engineering,Seoul National University
Summary
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。
Abstract
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。
Introduction
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。
Protocol
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.镜治疗任务的2维镜疗法任务的示例（ 图3） 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。 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?…
Representative Results
六名健康受试者进行的“笔标记任务'（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?…
Discussion
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?…
Divulgazioni
The authors have nothing to disclose.
Acknowledgements
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。
Materials
| LabVIEW | National Instruments | System design software | |
| 24V power supply | XP Power | MHP1000PS24 24V | Any 24V power supply should do |
| AHRS sensor receiver | E2box | EBRF24GRCV | |
| AHRS sensors | E2box | EBIMU-9DOFV2 | You will need total 3 sensors. Any AHRS sensors will do |
| EC90 flat motor module | Maxon | 323772 + 223094 + 453231 | Any geared motor with higher than 30Nm 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) |
| EC45 flat motor module | Maxon | 397172 | Any geared motor with higher than 10Nm should do (For our custom machined parts, you should use the same gear module but the gear ratio, motor, and encoder may vary) |
| EPOS2 70/10 controller | Maxon | 375711 | This can be replaced with EPOS 24/5 controller |
| EPOS2 24/5 controller | Maxon | 367676 | |
| Connector and cable set | Maxon | 381405 + 384915 + 275934 + 354045 | You can also make these cables. Connectors and corresponding wire info can be found in "300583-Hardware-Reference-En.pdf" and "300583-Cable-Starting-Set-En.pdf" |
| Coupling- Oldham, Set Screw Type | Misumi | MCORK30-10-12 | Type may vary |
| Coupling- High Rigidity, Oldham, Set Screw Type |
Misumi | MCOGRK34-12-12 | Type may vary |
| Shaft Collars | Misumi | SCWDM10-B | You will need 4 sets |
| Shaft Collars | Misumi | SDBJ10-8 | You will need 2 sets |
| Precision Linear Shaft | Misumi | PSSFG10-200 | Any straight 10mm diameter shaft with at least 200mm length should do |
| Bearings with housings | Misumi | BGRAB6801ZZ | |
| Elbow motor force dispersion shaft | custom machined | 3D CAD | |
| Lower elbow support | custom machined | Part Drawings | |
| Elbow rooftop frame | custom machined | Part Drawings | |
| Support wall | custom machined | Part Drawings | You will need 2 frames. |
| Elbow coupling hollow cylinder cover | custom machined | Part Drawings | |
| Wrist motor force dispersion shaft | custom machined | Part Drawings | |
| Wrist rooftop frame | custom machined | Part Drawings | |
| Upper wrist coupling hollow cylinder cover | custom machined | Part Drawings | |
| Lower wrist coupling hollow cylinder cover | custom machined | Part Drawings | |
| Joint movement limiter | custom machined | Part Drawings | |
| Handle | 3D printed | Part Drawings | |
| Upper elbow support | 3D printed | Part Drawings | |
| Friction reduction ring | 3D printed | Part Drawings | |
| Acrylic mirror | custom laser cutting | Part Drawings | |
| Task table | custom machined | Part Drawings | |
| Silicone sponge | |||
| DOF limiter | 3D printed | Part Drawings | |
| DOF limiter lid | 3D printed | Part Drawings | |
| Healthyarm handle | 3D printed | Part Drawings | |
| Ball rollers – Press fit | Misumi | BCHA18 | |
| Goalpost | 3D printed | Part Drawings | |
| Circle trace | 3D printed | Part Drawings | |
| Angled assist | 3D printed | Part Drawings | Optional |
| Curved assist | 3D printed | Part Drawings | Optional |
| Plain assist | 3D printed | Part Drawings | Optional |
| Task board | custom laser cutting | Part Drawings |
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Tags
Robotic Mirror TherapyHemiplegic ArmFunctional RecoveryOccupational TherapyProprioceptive InputSensory CortexNeuroplasticityStrokeAHRS SensorsCommunications SoftwareCOM PortBaud RateElbow-joint MotorCoupling BodiesMotor ShaftHex-socket ScrewCoupling Hollow Cylinder CoverSocket-head ScrewsBall BearingForce Dispersion Shaft
Citazione di questo articolo
Beom, J., Koh, S., Nam, H. S., Kim, W., Kim, Y., Seo, H. G., Oh, B., Chung, S. G., Kim, S. Robotic Mirror Therapy System for Functional Recovery of Hemiplegic Arms. J. Vis. Exp. (114), e54521, doi:10.3791/54521 (2016).