基于上肢运动评分的动作检测与动作识别的方法研究

目的:研究一种对Fugl-Meyer运动功能评分法上肢部分(FMA-UE)中同一运动中不同评分等级的动作进行自动检测与识别的方法。方法:系统采用了一套基于九轴传感器MPU9250的运动采集模块,可采集患者在运动过程中的加速度、角速度及磁力等信息。传感器佩带于受试者腕部,通过无线Wi-Fi的方式传输至电脑端。电脑端接收来自传感器的数据并进行动作检测,分析受试者是否开始运动。当检测到一个完整的动作结束后,对动作进行识别以区分FMA上肢部分中同一运动的三个不同等级。结果:对于同一上肢运动的三种不同难度等级,系统平均识别率达98.68%。结论:该方法在脑卒中患者的FMA上肢部分的功能评估中具有一定的应用价值。     

可穿戴传感装置对帕金森病患者上肢静止性震颤的量化评估价值

目的:评估采用可穿戴传感器量化评估帕金森病(Parkinson disease,PD)患者上肢静止性震颤的可行性。方法:15例PD患者和8例健康受试者双手穿戴检测装置,完成统一帕金森病评定量表(UPDRS)中的检测静止性震颤的标准动作。对采集到的上肢静止性震颤的加速度信号进行时域和频域分析,并与UPDRS中的静止性震颤评分进行相关性分析。结果:可穿戴设备可以良好地测定上肢静止性震颤的加速度均值、均方根值、峰值振幅和峰值功率的对数值;震颤的加速度均值、均方根值、峰值振幅和峰值功率的对数值与UPDRS中静止性震颤的评分高度相关(r分别为0.960、0.961、0.893、0.944)。结论:可穿戴传感装置可准确、客观、量化地评估PD患者上肢的静止性震颤,值得临床推广。     

机器人辅助训练对脑卒中患者上肢功能的效果

目的 观察自行研制的可穿戴智能上肢康复机器人对脑卒中患者上肢运动功能和日常生活活动能力的影响。     

基于体感技术上肢康复游戏系统的评价模块北大核心CSCD

目的基于体感交互技术开发上肢运动功能康复系统,观察其实时获得康复效果的模块功能。方法利用Kinect体感器的骨骼跟踪技术和Unity3D技术开发一款3D康复游戏系统。选取4个常用的上肢康复动作,利用动作引导轨迹引导5名健康受试者进行训练,按系统设计进行评分。结果 5位受试者在有引导轨迹的康复游戏系统下的得分高于无引导下的得分。结论基于Kinect的上肢康复游戏训练系统可以通过动作引导轨迹引导患者进行康复训练,并对康复效果进行量化评估。     

可穿戴传感系统在上肢康复中应用的研究与实践

本文对可穿戴传感系统在上肢康复领域中的研究进行综述调研,根据论题相关的关键词搜到61篇文章,基于对文章摘要的初选和全文的筛选最终纳入18篇。这些文章可以分为三类:进行运动和姿势监测;提供终端用户反馈;整合交互游戏。基于现有文献的技术成熟度,临床证据的有效性和系统可用性等方面对其进行探讨,设计出一套智能康复服装系统,可用于多种病症康复。该系统包括一件整合了可穿戴电子元器件和智能织物的服装和基于安卓设备的反馈平台,可以实时通过衣服上的震动模块或来自手机的屏幕反馈、语音提示给予用户反馈。     

基于体感技术上肢康复游戏系统的评价模块

目的基于体感交互技术开发上肢运动功能康复系统,观察其实时获得康复效果的模块功能。方法利用Kinect体感器的骨骼跟踪技术和Unity3D技术开发一款3D康复游戏系统。选取4个常用的上肢康复动作,利用动作引导轨迹引导5名健康受试者进行训练,按系统设计进行评分。结果 5位受试者在有引导轨迹的康复游戏系统下的得分高于无引导下的得分。结论基于Kinect的上肢康复游戏训练系统可以通过动作引导轨迹引导患者进行康复训练,并对康复效果进行量化评估。     

脑卒中肢体功能康复监测系统的设计

目的:通过软件与硬件相结合的监测方法,为脑卒中患者在治疗过程中建立运动功能检查评估档案,为医生提供客观、准确的实时数据。方法:实验于2005-09/2006-06在云南大学信息学院电子工程系完成。实验方自主开发YUB-400脑卒中康复治疗监测系统,该系统软件部分的主体在VisualBasic6.0下开发完成,部分图像处理功能使用VisualC 6.0开发完成,软件分为7个模块,分别为信息录入查询模块、图像采集模块、图像特征标记模块、比对计算模块、图像处理模块、打印报告模块和系统设置模块;硬件部分包括计算机、视频端口、视频摄像头和神经刺激器。系统控制神经刺激器对患者患处刺激,同时对患处的反应过程视频采样,之后应用标准神经系统评估法,依据运动过程的参数建立可靠的患者实时数据档案。结果:①系统经过对患者患处活动能力的数据分析,记录运动参数,包括运动距离、平均速度、最大速度、平均加速度、最大加速度等。并结合患者的基本信息,建立实时数据档案。通过实时数据档案可以与患者的历史数据相比较,从而客观反应脑卒中患者的康复状况。②产生误差的原因主要包括两个方面,测量过程的规范性和患者个体的心理因素。结论:利用YUB-400对脑卒中肢体功能康复监测,可代替以主观评价为主的传统康复评估方法。     

姿态与肌电融合的脑卒中患者上肢运动功能实时评估方法

摘要 目的：提出了一种基于运动姿态与肌电融合的脑卒中患者上肢运动功能实时评估方法。 方法：选取一定数量处于不同Brunnstrom分期的脑卒中患者。首先运用姿态与肌电检测传感器,分别采集康复动作评估过程中不同分期患者上肢运动姿态与表面肌电数据;其次分别提取患肢运动姿态与表面肌电数据特征,在融合姿态与肌电特征信息基础上获取患者上肢运动功能评估数据集;最后,选取具有较好实时分类性能的模糊支持向量机作为分类器,运用评估数据集测试上肢运动功能评估效果。 结果：基于模糊支持向量机构建的运动功能分类器经过离线训练后,姿态与肌电融合的分类器对脑卒中患者上肢运动功能实时评估准确率平均达到83%,且较单纯基于运动姿态(75%)或肌电(74%),具有更好的评估效果。 结论：姿态与肌电融合的上肢运动功能实时评估方法,能较准确地对脑卒中患者上肢运动功能进行实时Brunstrom分期。     

一种新型智能交互式上肢康复机器人研究

目的:针对现有的上肢康复机器人的不足,设计一款新型的智能交互式上肢康复机器人帮助脑卒中偏瘫患者完成上肢康复训练。方法:设计一种新型3个自由度的上肢康复机器人机械结构,利用套筒和弧齿锥齿轮组成的传动系统进行动力传输,所有电气系统元件统一安装于机器人底部机箱内减少噪音。设计电气控制系统,完成系统实验对样机进行验证,并用Unity3D引擎设计一款专用于本机器人的虚拟现实游戏使患者的训练更具有趣味性。结果:该机器人能按设计要求完成3自由度的运动,能很好地完成规划的预定动作并实现噪音小的设计目标。虚拟现实训练能够有效地提高康复训练的质量和效率。结论:该上肢康复机器人能基本实现预期功能和效果,帮助偏瘫患者进行训练达到康复的目的。     

运动姿态与肌电融合的脑卒中上肢运动功能评估系统的可行性研究

目的探讨基于运动姿态与表面肌电融合的上肢运动功能评估系统在脑卒中患者上肢运动功能评估中的可行性。方法 2018年1月至2019年3月,在南京同仁医院选取脑卒中患者10例,按照事先设计的康复评估动作,分别获取康复动作完成过程中患肢的运动姿态和表面肌电数据,运用运动姿态与肌电融合的上肢运动功能评估系统对患者上肢运动功能进行评估,并分别与单纯基于运动姿态或肌电的评估结果进行比较;同时分析系统评估效度。所有患者均接受Fugl-Meyer评定量表上肢部分(FMA-UE)的评估。结果运动姿态与肌电融合的上肢运动功能评估系统与FMA-UE评分之间呈正相关(r=0.891, P=0.001),优于单纯运动姿态(r=0.758, P=0.011)或肌电(r=0.697, P=0.025)评估结果。结论运动姿态与肌电融合的上肢运动功能评估系统能有效地对脑卒中患者上肢运动功能进行评估。     

上肢康复机器人结合常规康复训练对急性期脑卒中患者上肢功能的疗效研究

目的:观察上肢康复机器人结合常规康复训练对急性期脑卒中患者上肢运动功能的改善情况。方法:将50例脑卒中患者随机分为对照组和观察组,对照组每天进行2次常规康复训练,观察组每天进行1次常规康复训练及1次上肢康复机器人训练,每周治疗5d,共4周,治疗前后分别用Fugl-Meyer(上肢部分,FMA-UE)、改良日常生活能力(MBI)、肩关节主动关节活动度评价康复效果。结果:治疗后,2组患者的FMA-UE、肩关节主动关节活动度和MBI评估均有明显提高(P0.05),上肢康复机器人结合常规康复训练组的FMA-UE和肩关节前屈、水平内收、水平外展主动关节活动度与对照组相比提高更加明显(P0.05)。结论:上肢康复机器人结合常规康复训练对急性期脑卒中患者上肢功能有明显改善作用。     

运动反馈训练对偏瘫患者上肢运动功能和日常生活活动能力的疗效

目的 探讨了Armeo Spring上肢运动反馈训练对偏瘫患者上肢运动功能和日常生活活动能力的疗效。 方法 52例偏瘫患者随机数字表法分为观察组和对照组,各26例。对照组进行常规康复训练的基础上增加每日1次作业疗法训练,观察组在常规康复训练的基础上增加每日1次Armeo Spring上肢运动反馈的作业疗法训练,2组治疗时间均为5个月,治疗前和治疗后分别对2组患者上肢和手的主动关节活动度测量（AROM）、改良Barthel 指数(Modify Barthel Index,MBI)、Fugl-Meyer 评定量表(Fugl-Meyer motor assessment scale,FMA）和简易上肢机能检查（Simple Test for Evaluating hand Function,STEF）进行评价。 结果 治疗前2组患者MBI、FMA和WMFT比较差异无统计学意义（P＞0.05）;治疗后2组患者MBI、FMA和WMFT较治疗前比较差异有统计学意义（P＜0.05）,观察组MBI、FMA和WMFT较对照组差异均有显著统计学意义（P<0.05）,且观察组各项指标改善均优于对照组。 结论 通过上肢运动反馈训练联合常规康复可明显改善偏瘫患者上肢运动功能和日常生活活动能力。     

Effect of intramuscular botulinum toxin injection on upper limb spasticity in stroke patients

OBJECTIVE: To evaluate the therapeutic effect of intramuscular injection of botulinum toxin on spasticity of the upper limb, with emphasis on its influence over limb function. DESIGN: An open-label, noncontrolled trial with a duration of 12 wk was designed to determine the safety and efficacy of intramuscular botulinum toxin A injection in the treatment of 16 patients with stroke with spastic hemiparesis. Electromyographically guided intramuscular botulinum toxin A injections were applied to the spastic limbs. A detailed scale system was used for the evaluation of muscle tone and functional changes induced by botulinum toxin A treatment. RESULTS: No major side effect secondary to botulinum toxin A injection was reported. Statistically significant (P < 0.05) improvements of muscle tone, joint range of motion, hand muscle strength, and muscular pain were seen after the injection. The improvements lasted up to 8-12 wk after the treatment. However, there was no significant functional improvement except in two of the patients. CONCLUSIONS: Botulinum toxin A injection may help relieve upper limb spasticity and pain in patients with stroke. Its effect on function is probably determined by case selection.     

Function electrical stimulation mediated by iterative learning control and 3D robotics reduces motor impairment in chronic stroke

ABSTRACT: BACKGROUND: Novel stroke rehabilitation techniques that employ electrical stimulation (ES) and robotic technologies are effective in reducing upper limb impairments. ES is most effective when it is applied to support the patients' voluntary effort; however, current systems fail to fully exploit this connection. This study builds on previous work using advanced ES controllers, and aims to investigate the feasibility of Stimulation Assistance through Iterative Learning (SAIL), a novel upper limb stroke rehabilitation system which utilises robotic support, ES, and voluntary effort. METHODS: Five hemiparetic, chronic stroke participants with impaired upper limb function attended 18, 1 hour intervention sessions. Participants completed virtual reality tracking tasks whereby they moved their impaired arm to follow a slowly moving sphere along a specified trajectory. To do this, the participants' arm was supported by a robot. ES, mediated by advanced iterative learning control (ILC) algorithms, was applied to the triceps and anterior deltoid muscles. Each movement was repeated 6 times and ILC adjusted the amount of stimulation applied on each trial to improve accuracy and maximise voluntary effort. Participants completed clinical assessments (Fugl-Meyer, Action Research Arm Test) at baseline and post-intervention, as well as unassisted tracking tasks at the beginning and end of each intervention session. Data were analysed using t-tests and linear regression. RESULTS: From baseline to post-intervention, Fugl-Meyer scores improved, assisted and unassisted tracking performance improved, and the amount of ES required to assist tracking reduced. CONCLUSIONS: The concept of minimising support from ES using ILC algorithms was demonstrated. The positive results are promising with respect to reducing upper limb impairments following stroke, however, a larger study is required to confirm this.     

Correlated change in upper limb function and motor cortex activation after verum and sham acupuncture in patients with chronic stroke

BACKGROUND: Acupuncture may improve motor function in patients with chronic hemiparetic stroke, yet the neural mechanisms underlying such an effect are unknown. As part of a sham-controlled, randomized clinical trial testing the efficacy of a 10-week acupuncture protocol in patients with chronic hemiparetic stroke, we examined the relationship between changes in function of the affected upper limb and brain activation using functional magnetic resonance imaging (fMRI). METHODS: Seven (7) chronic hemiparetic stroke patients underwent fMRI and testing of function of the affected upper limb (spasticity and range-of-motion) before and after a 10-week period of verum (N=4) or sham (N=3) acupuncture. The correlation between changes in function of the affected upper limb and brain activation after treatment was tested across patients. RESULTS: We found a significant positive correlation between changes in function of the affected upper limb (spasticity and range of motion) and activation in a region of the ipsilesional motor cortex. Patients treated with verum acupuncture showed a trend toward a greater maximum activation change in this motor cortical area as compared to those treated with sham acupuncture. CONCLUSIONS: Acupuncture may improve function of the affected upper limb in chronic hemiparetic stroke patients by increasing activity in the ipsilesional motor cortex.     

Recovery of the upper limb post ischaemic stroke and the predictive value of the Orpington Prognostic Score

OBJECTIVE: To document upper limb recovery in stroke patients and investigate whether the Orpington Prognostic Score (OPS) performed within 48 hours of admission to hospital post ischaemic stroke was a predictor of upper limb function at six months and two years. DESIGN: Inception cohort design. SETTING: Teaching Hospital. SUBJECTS: One hundred and fourteen patients hospitalized with acute ischaemic stroke were stratified into three groups based on their OPS within 48 hours of admission post stroke and underwent further assessments at two weeks, six months and two years after stroke onset. MAIN MEASURES: Rivermead Arm Score (RAS), Nine Hole Peg Test (NHPT) and grip strength (GS). RESULTS: Patients with a good OPS and intermediate OPS showed significant recovery in all outcome measures for up to six months post stroke (p < 0.05), while those with a poor OPS at 48 hours showed no significant improvement (p > 0.05). The OPS score at 48 hours was the most highly correlated variable with upper limb outcome at six months (r= -0.728) and at two years (r= -0.712) compared with other variables such as age, class of stroke, sensation, grip strength and RAS. CONCLUSION: Stroke patients demonstrate differential upper limb recovery patterns which need to be taken in consideration when designing studies that investigate efficacy of rehabilitation, and the OPS is highly correlated with upper limb recovery at six months and two years.     

适应个体差异的下肢康复机器人步态规划与实现

目的 针对下肢康复机器人轨迹规划,进行适应个体差异康复运动模式的求解,实现精准康复。方法 在总结出下肢康复机器人6种运动模式后,根据人体多刚体理论,将下肢康复机器人外骨骼简化成二连杆机构,对运动模式进行逆运动学分析,并基于C#设计运动模式求解系统。结果 将基于C#运动模式求解系统计算的运动模式关节角度值传输到上位机,6种运动模式均成功应用于下肢康复机器人。通过运动模式逆运动学分析基于C#设计的运动模式求解系统,对于不同腿长的下肢运动功能障碍患者,进行适应个体差异的运动模式关节角度值求解。通过样机实验,下肢康复机器人能够按照规划的运动模式带动人体模型进行康复训练,且实际关节角度曲线与理论关节角度曲线基本重合,关节角度误差较小。结论 验证了适应个体差异运动模式求解的有效性和可行性。