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1.
目的应用三维步态分析评价下肢机器人训练对脑卒中偏瘫患者步行功能的影响。 方法采用随机数字表法将60例脑卒中偏瘫患者分为观察组及对照组,两组30例。2组患者均给予常规药物治疗及康复干预,对照组同时辅以传统下肢步行训练,观察组则辅以下肢机器人训练。2组患者下肢训练时长均为每次30min,每周训练5d。于治疗前、治疗8周后分别采用三维步态分析系统检测2组患者步态时间参数、时相参数、关节活动角度及地面反作用力大小等指标。 结果观察组患者经下肢机器人辅助训练后,其步速[(59.34±12.20)cm/s]、步频[(89.39±13.80)次/分钟]、跨步长[(74.17±15.54)cm]提高,步宽[(18.69±3.16)cm]缩小;患侧支撑期百分比[(69.72±10.06)%]、健侧与患侧支撑期比值(1.07±0.11)、双支撑期百分比[(16.85±8.23)%]、髋关节最大活动度[(35.39±9.31)°]、膝关节最大活动度[(50.21±15.34)°]、垂直地面反作用力峰值占体重百分比[(109.36±13.28)%]、患侧向前地面反作用力峰值占体重百分比[(6.95±1.98)%]均明显改善,与治疗前及对照组间差异均具有统计学意义(均P<0.05)。 结论与传统步行训练比较,下肢机器人训练能更有效改善脑卒中偏瘫患者步行功能,该疗法值得临床推广、应用。  相似文献   
2.
目的研制在骨折治疗中精确定位的机器人辅助远端锁钉瞄准系统。方法在以股骨髓内针远端锁钉植入手术中,采用模块化、小型化的并联机器人结构设计,应用机械臂空间定位技术,双目视觉、6自由度的机器人辅助髓内针远端锁钉瞄准系统。结合C型臂定位并实施导航控制进行远端锁钉植入。髓内针被分别置入塑料股骨(Swiss Sybone,5根,35孔)、人类干股骨标本(2根,12孔)、新鲜人尸体大腿(1具,6孔)。非扩髓型髓内针的尺寸范围从9/310到12/340。应用机器人辅助瞄准系统对上述髓内针进行远端锁钉植入,术中C型臂透视确认螺钉准确置入,记录锁钉植入过程的X线透视时间。结果所有远端锁孔被成功地锁定。在53个锁孔中,6例(11.1%)钻头触到锁定孔道,仍顺利穿过锁孔,没有对髓内针造成损伤。螺钉植入过程中需要的术中X线透视时间为1.8s±0.3s。结论医用机器人使仅应用两幅计算机校准的X线图像,不需要额外的术中X线透视来导航器械,手术过程中总的X线透射时间显著减少。人机交互功能操作易于掌握,可作为机器人辅助长骨治疗中精确定位和稳定操作的技术平台。  相似文献   
3.
Natural orifice surgery with an endoluminal mobile robot   总被引:2,自引:2,他引:0  
Natural orifice transgastric endoscopic surgery promises to eliminate skin incisions and reduce postoperative pain and discomfort. Such an approach provides a distinct benefit as compared with conventional laparoscopy, in which multiple entry incisions are required for tools and camera. Endoscopy currently is the only method for performing procedures through the gastrointestinal tract. However, this approach is limited by instrumentation and the need to pass the entire scope into the patient. In contrast, an untethered miniature robot inserted through the mouth would be able to enter the abdominal cavity through a gastrotomy for exploration of the entire peritoneal cavity. In this study, the authors developed an endoluminal robot capable of transgastric abdominal exploration under esophagogastroduodenoscopic (EGD) control. Under EGD control, a gastrotomy was created, and the miniature robot was deployed into the abdominal cavity under remote control. Ultimately, future procedures will include a family of robots working together inside the gastric and abdominal cavities after their insertion through the esophagus. Such technology will help to reduce patient trauma while providing surgical flexibility.  相似文献   
4.
BackgroundAs robotics continues to be applied to medical and nursing practice, nurse educators need to be aware of innovations and discuss practice and challenges with students.ObjectivesThis paper provides a literature review of the application of robotics in nursing and the implications for nurse education.Review methodsThe methodology adopted for this review was informed by the definition of service robots. The review focused on how clinical service robotics are being discussed in nursing and was undertaken using the Cochrane Library, ScienceDirect and ProQuest databases, using the truncated search terms: nurs* and robot*, education, students and future. Research articles were limited to those that were published in peer reviewed journals, between 2010 and 2019, since this covers the time when robotic science has been flourishing. The field of robotics is vast, thus the search yielded over 400 articles, but most are not specifically relevant to nursing. Twenty-six relevant papers were included.ResultsThematic review of the literature found four main developments affecting nursing and mixed perceptions and ideas among health care staff and the public across varied themes.ConclusionHealth care and nursing work are being transformed through robotics. New technologies, tasks and technician roles that currently do not exist will soon be part of the health workforce, and the nature of nursing work will inevitably change. In the light of such change, there is a need to redefine the nature and practice of nursing and to re-prioritise caring as fundamental to the nursing profession. These changes have implications for the education of future nursing professionals.  相似文献   
5.
目的 探讨末端驱动型下肢康复机器人训练对脑卒中患者下肢步行能力、下肢运动功能、步态及平衡功能的影响。 方法 将2018年8月至2019年8月在空军军医大学第一附属医院住院治疗的、符合纳入标准的39例脑卒中患者,按照随机数字表法将其分为训练组(21例)和对照组(18例)。2组患者均接受常规康复治疗,包括偏瘫肢体综合训练、中频脉冲电刺激等,对照组在此基础上接受减重平板步行训练,训练组接受末端驱动的下肢康复机器人训练,每日1次、每次20 min、每周6 d、持续4周。治疗前,治疗4周后(治疗后),采用功能性步行分级(FAC)、Fugl-Meyer运动功能评分下肢部分(FMA-LE)、威斯康星步态量表(WGS)及Berg平衡量表(BBS)进行评定。 结果 治疗前,2组患者FAC、FMA-LE、WGS及BBS评分比较,差异无统计学意义(P>0.05)。治疗后,2组患者各项指标均较组内治疗前显著改善(P<0.05),且训练组治疗后FAC分级[(2.61±0.70)级]、WGS[(23.29±3.85)分]及BBS评分[(35.40±8.41)分]较对照组显著提高(P<0.05)。 结论 末端驱动型下肢康复机器人训练较传统康复治疗,能更好地改善脑卒中患者的步行能力、步态及平衡功能。  相似文献   
6.
《Dental materials》2020,36(1):9-24
ObjectiveSummarizing the new state of the art of digital dentistry, opens exploration of the type and extent of innovations and technological advances that have impacted – and improved – dentistry. The objective is to describe advances and innovations, the breadth of their impact, disruptions and advantages they produce, and opportunities created for material scientists.MethodsOn-line data bases, web searches, and discussions with industry experts, clinicians, and dental researchers informed the content. Emphasis for inclusion was on most recent publications along with innovations presented at trade shows, in press releases, and discovered through discussions leading to web searches for new products.ResultsDigital dentistry has caused disruption on many fronts, bringing new techniques, systems, and interactions that have improved dentistry. Innovation has spurred opportunities for material scientists’ future research.SignificanceWith disruptions intrinsic in digital dentistry’s new state of the art, patient experience has improved. More restoration options are available delivering longer lifetimes, and better esthetics. Fresh approaches are bringing greater efficiency and accuracy, capitalizing on the interest, capabilities, and skills of those involved. New ways for effective and efficient inter-professional and clinician-patient interactions have evolved. Data can be more efficiently mined for forensic and epidemiological uses. Students have fresh ways of learning. New, often unexpected, partnerships have formed bringing further disruption — and novel advantages. Yes, digital dentistry has been disruptive, but the abundance of positive outcomes argues strongly that it has not been destructive.  相似文献   
7.
This investigation is one in a series of studies that address the possibility of stroke rehabilitation using robotic devices to facilitate “adaptive training.” Healthy subjects, after training in the presence of systematically applied forces, typically exhibit a predictable “after-effect.” A critical question is whether this adaptive characteristic is preserved following stroke so that it might be exploited for restoring function. Another important question is whether subjects benefit more from training forces that enhance their errors than from forces that reduce their errors. We exposed hemiparetic stroke survivors and healthy age-matched controls to a pattern of disturbing forces that have been found by previous studies to induce a dramatic adaptation in healthy individuals. Eighteen stroke survivors made 834 movements in the presence of a robot-generated force field that pushed their hands proportional to its speed and perpendicular to its direction of motion — either clockwise or counterclockwise. We found that subjects could adapt, as evidenced by significant after-effects. After-effects were not correlated with the clinical scores that we used for measuring motor impairment. Further examination revealed that significant improvements occurred only when the training forces magnified the original errors, and not when the training forces reduced the errors or were zero. Within this constrained experimental task we found that error-enhancing therapy (as opposed to guiding the limb closer to the correct path) to be more effective than therapy that assisted the subject.  相似文献   
8.

Aims

This analysis of the representations of the genesis and present actuality of robots is focused on the psychopathological characterisation of the fantasy of mutiny, so as to map its marked recurrence in the discourse of subjects and groups in clinical setting.

Method

First, the technological incarnation of the robot is explored to understand its in what way it appears as a double in the psychic reality of its designers and users. Secondarily, different iconic artistic productions are analyzed.

Results

Robots are tools secreted by humans, and their utilisation by humans in return alters their creators. In this interactive loop, robots are both the ideal ambassadors of the omnipotence of human science and a technical incarnation rivalling their own impotence.

Discussion

Among the designers of robots, the projection of a rebellion by their technological offspring imposes itself as a real signature. The nonhuman creature threatens to free itself from its human creator's hold and to enslave him by acquiring precisely the qualities that he lacks.

Conclusion

This study leads to the proposal for a psychopathological piloting system positioning the projective discourse of a subject or a collective towards robots between the poles of a dynamic, creative “transitional double” and the morbid circularity of a Münchhausen syndrome by proxy where a designer falsely induces and denounces a pathology in the being he has conceived.  相似文献   
9.
目的 观察平地行走式下肢外骨骼机器人训练对脑卒中患者步行功能的疗效。 方法 按随机数字表法将58例脑卒中患者分为机器人组(29例)和对照组(29例)。对照组给予常规康复治疗联合常规步行训练,机器人组则给予常规康复治疗联合外骨骼机器人步行训练。2组患者的步行训练均为每日2次,每次30 min,每周训练5 d,连续每次4周。于治疗前、治疗2周和4周后对2组患者的步行能力[包括6 min步行测试(6MWT) 和功能性步行分级(FAC)]和下肢运动功能[Fugl-Meyer下肢运动评定量表(FMA-LE)]进行评估,并于治疗前和治疗4周后检测2组患者的步态。 结果 治疗2周和4周后,2组患者的6MWT较组内治疗前均明显提高,差异均有统计学意义(P<0.01)。机器人组治疗2周后与组内治疗前的6MWT差值与对照组比较,差异有统计学意义(P=0.034)。治疗2周和4周后,2组患者的FMA-LE和FAC较组内治疗前均显著改善,差异均有统计学意义(P<0.01)。治疗4周后,2组患者的步频和步态周期与组内治疗前比较,差异均有统计学意义(P<0.01)。 结论 平地行走式下肢外骨骼机器人训练可改善脑卒中患者的步行能力和下肢运动功能,其疗效与常规步行训练相当。  相似文献   
10.
目的 探讨骨盆辅助式康复机器人训练对脑卒中偏瘫患者步态运动学的影响。 方法 采用随机数字表法将40例脑卒中偏瘫患者分为观察组及对照组,每组20例。2组患者均给予常规药物治疗及康复训练,观察组患者在上述干预基础上辅以骨盆辅助式康复机器人训练,每周训练6次,每次训练20 min,持续训练8周。于入选时及治疗8周后分别采用简化Fugl-Meyer下肢运动功能量表(FMA-LE)评定患者下肢运动功能,采用Berg平衡量表(BBS)评定患者平衡功能,通过Biodex Gait Trainer-2型步态分析系统检测患者步速、步长,采用骨盆辅助机器人系统检测患者骨盆旋转角、骨盆侧倾角、骨盆竖直移动及骨盆侧向移动等运动学参数。 结果 治疗后观察组患者FMA-LE评分、BBS评分、步速、健侧步长、患侧步长分别为(21.40±4.38)分、(39.45±4.47)分、(61.50±17.92)cm/s、(49.25±15.13)cm和(48.65±11.49)cm,均较治疗前及对照组治疗后明显改善(P<0.05)。治疗后观察组患者骨盆旋转角、侧倾角、竖直移动及侧向移动等运动学参数分别为(9.93±1.92)°、(15.57±1.68)°、(12.09±1.13)cm和(8.92±3.26)cm,均较治疗前及对照组治疗后明显改善(P<0.05)。 结论 在常规康复干预基础上辅以骨盆辅助式康复机器人训练,能进一步提高脑卒中偏瘫患者骨盆控制能力,改善步行功能及平衡能力,从而促进患者下肢运动功能恢复。  相似文献   
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