脑卒中上肢康复机器人研究进展

doi:10.3969/j.issn.1672-6731.2023.01.004

中国现代神经疾病杂志 ›› 2023, Vol. 23 ›› Issue (1): 15-21. doi: 10.3969/j.issn.1672-6731.2023.01.004

• 大数据与人工智能赋能新医疗 • 上一篇下一篇

2 脑卒中上肢康复机器人研究进展

王壮¹, 王轶钊², 丘世因¹, 刘源¹, 石巍³, 巫嘉陵⁴, 明东¹

1. 300072 天津大学医学工程与转化医学研究院;
2. 300350 天津市环湖医院康复医学科;
3. 300191 天津市医疗器械审评查验中心;
4. 300350 天津市环湖医院神经内科天津市脑血管与神经变性重点实验室

收稿日期:2023-01-14 出版日期:2023-01-25 发布日期:2023-02-08
通讯作者: 刘源,Email:ryanliu@tju.edu.cn;石巍,Email:25558503@qq.com
基金资助:
国家重点研发计划项目（项目编号：2022YFF1202500）；国家重点研发计划项目（项目编号：2022YFF1202505）；国家自然科学基金资助项目（项目编号：62273251）；天津市科技计划项目（项目编号：21JCYBJC00420）

Research progress on upper limb rehabilitation robots for stroke

WANG Zhuang¹, WANG Yi-zhao², QIU Shi-yin¹, LIU Yuan¹, SHI Wei³, WU Jia-ling⁴, MING Dong¹

1. Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China;
2. Department of Rehabilitation Medicine, Tianjin Huanhu Hospital, Tianjin 300350, China;
3. Center for Medical Device Evaluation and Inspection of Tianjin, Tianjin 300191, China;
4. Department of Neurology, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin 300350, China

Received:2023-01-14 Online:2023-01-25 Published:2023-02-08
Supported by:
This study was supported by National Key Research and Development Program of China (No. 2022YFF1202500, 2022YFF1202505), the National Natural Science Foundation of China (No. 62273251), and Tianjin Science and Technology Plan Project (No. 21JCYBJC00420)

摘要/Abstract

摘要： 随着医工融合技术的发展与临床康复需求的提高，智能化上肢康复机器人因可为脑卒中患者提供高强度、高重复性主动康复训练，恢复上肢运动功能，实现脑神经重塑等作用，成为脑卒中康复领域的研究热门，但目前大多数上肢康复机器人系统仍处于实验室研发或临床验证阶段。本文总结国内外上肢康复机器人的最新研究成果，对比不同类型机器人的优势与不足，展望上肢康复机器人发展趋势，为促进其临床转化提供思路。

关键词: 卒中, 运动障碍, 上肢, 机器人, 康复, 综述

Abstract: With the development of the combination of medicine and engineering and the improvement of clinical rehabilitation demand, intelligent upper limb rehabilitation robots can provide stroke patients with high intensity and repetition of active rehabilitation training to restore the upper limb motor function and achieve the remodeling of damaged brain nerves. However, many upper limb rehabilitation robot systems are still in the stage of laboratory development or clinical verification. This paper summarizes the latest research results of upper limb rehabilitation robots at home and abroad, compares the advantages and disadvantages of different types of robots, looks forward to the development trend of upper limb rehabilitation robots, and provides ideas for further promoting clinical transformation.

Key words: Stroke, Motor disorders, Upper extremity, Robotics, Rehabilitation, Review

王壮, 王轶钊, 丘世因, 刘源, 石巍, 巫嘉陵, 明东. 脑卒中上肢康复机器人研究进展[J]. 中国现代神经疾病杂志, 2023, 23(1): 15-21.

WANG Zhuang, WANG Yi-zhao, QIU Shi-yin, LIU Yuan, SHI Wei, WU Jia-ling, MING Dong. Research progress on upper limb rehabilitation robots for stroke[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2023, 23(1): 15-21.

http://journal11.magtechjournal.com/cjcnn/CN/Y2023/V23/I1/15

参考文献

[1] Report on stroke prevention and treatment in China Writing Group. Brief report on stroke prevention and treatment in China, 2020[J]. Zhongguo Nao Xue Guan Bing Za Zhi, 2022, 19:136-144. 《中国脑卒中防治报告2020》编写组. 《中国脑卒中防治报告2020》概要[J]. 中国脑血管病杂志, 2022, 19:136-144.
[2] Wu S, Wu B, Liu M, Chen Z, Wang W, Anderson CS, Sandercock P, Wang Y, Huang Y, Cui L, Pu C, Jia J, Zhang T, Liu X, Zhang S, Xie P, Fan D, Ji X, Wong KL, Wang L; China Stroke Study Collaboration. Stroke in China:advances and challenges in epidemiology, prevention, and management[J]. Lancet Neurol, 2019, 18:394-405.
[3] Liu M, Ushiba J. Brain-machine Interface (BMI)-based neurorehabilitation for post-stroke upper limb paralysis[J]. Keio J Med, 2022, 71:82-92.
[4] Baniqued PDE, Stanyer EC, Awais M, Alazmani A, Jackson AE, Mon-Williams MA, Mushtaq F, Holt RJ. Brain-computer interface robotics for hand rehabilitation after stroke:a systematic review[J]. J Neuroeng Rehabil, 2021, 18:15.
[5] Everard G, Declerck L, Detrembleur C, Leonard S, Bower G, Dehem S, Lejeune T. New technologies promoting active upper limb rehabilitation after stroke:an overview and network meta-analysis[J]. Eur J Phys Rehabil Med, 2022, 58:530-548.
[6] Zhang L, Jia G, Ma J, Wang S, Cheng L. Short and long-term effects of robot-assisted therapy on upper limb motor function and activity of daily living in patients post-stroke:a meta-analysis of randomized controlled trials[J]. J Neuroeng Rehabil, 2022, 19:76.
[7] Yu L, Yu HL. Research and development of upper limb rehabilitation robot technology[J]. Sheng Wu Yi Xue Gong Cheng Xue Jin Zhan, 2020, 41:134-138. 余灵, 喻洪流. 上肢康复机器人研究进展[J]. 生物医学工程学进展, 2020, 41:134-138.
[8] Terranova TT, Simis M, Santos ACA, Alfieri FM, Imamura M, Fregni F, Battistella LR. Robot-assisted therapy and constraint-induced movement therapy for motor recovery in stroke:results from a randomized clinical trial[J]. Front Neurorobot, 2021, 15:684019.
[9] Doumas I, Everard G, Dehem S, Lejeune T. Serious games for upper limb rehabilitation after stroke:a meta-analysis[J]. J Neuroeng Rehabil, 2021, 18:100.
[10] Chien WT, Chong YY, Tse MK, Chien CW, Cheng HY. Robot-assisted therapy for upper-limb rehabilitation in subacute stroke patients:a systematic review and meta-analysis[J]. Brain Behav, 2020, 10:e01742.
[11] Gustavsen M, Jansen R, Kjendahl A, Lorentzen A. Motor Relearning Program approach improves short-term motor outcomes and reduces hospital stay after stroke[J]. Aust J Physiother, 2002, 48:59.
[12] Sun Y, Zehr EP. Training-induced neural plasticity and strength are amplified after stroke[J]. Exerc Sport Sci Rev, 2019, 47:223-229.
[13] Adkins DL, Boychuk J, Remple MS, Kleim JA. Motor training induces experience-specific patterns of plasticity across motor cortex and spinal cord[J]. J Appl Physiol (1985), 2006, 101:1776-1782.
[14] Shi XQ, Heung HL, Tang ZQ, Li Z, Tong KY. Effects of a soft robotic hand for hand rehabilitation in chronic stroke survivors[J]. J Stroke Cerebrovasc Dis, 2021, 30:105812.
[15] Nam C, Rong W, Li W, Cheung C, Ngai W, Cheung T, Pang M, Li L, Hu J, Wai H, Hu X. An exoneuromusculoskeleton for self-help upper limb rehabilitation after stroke[J]. Soft Robot, 2022, 9:14-35.
[16] Khan MA, Das R, Iversen HK, Puthusserypady S. Review on motor imagery based BCI systems for upper limb post-stroke neurorehabilitation:from designing to application[J]. Comput Biol Med, 2020, 123:103843.
[17] Gao X, Wang Y, Chen X, Gao S. Interface, interaction, and intelligence in generalized brain-computer interfaces[J]. Trends Cogn Sci, 2021, 25:671-684.
[18] Abiri R, Borhani S, Sellers EW, Jiang Y, Zhao X. A comprehensive review of EEG-based brain-computer interface paradigms[J]. J Neural Eng, 2019, 16:011001.
[19] Hochberg LR, Bacher D, Jarosiewicz B, Masse NY, Simeral JD, Vogel J, Haddadin S, Liu J, Cash SS, van der Smagt P, Donoghue JP. Reach and grasp by people with tetraplegia using a neurally controlled robotic arm[J]. Nature, 2012, 485:372-375.
[20] Carino-Escobar RI, Carrillo-Mora P, Valdés-Cristerna R, Rodriguez-Barragan MA, Hernandez-Arenas C, Quinzaños-Fresnedo J, Galicia-Alvarado MA, Cantillo-Negrete J. Longitudinal analysis of stroke patients' brain rhythms during an intervention with a brain-computer interface[J]. Neural Plast, 2019:ID7084618.
[21] Ramos-Murguialday A, Curado MR, Broetz D, Yilmaz Ö, Brasil FL, Liberati G, Garcia-Cossio E, Cho W, Caria A, Cohen LG, Birbaumer N. Brain-machine interface in chronic stroke:randomized trial long-term follow-up[J]. Neurorehabil Neural Repair, 2019, 33:188-198.
[22] Hardwick RM, Caspers S, Eickhoff SB, Swinnen SP. Neural correlates of action:comparing meta-analyses of imagery, observation, and execution[J]. Neurosci Biobehav Rev, 2018, 94:31-44.
[23] Chen L, Gu B, Wang Z, Zhang L, Xu M, Liu S, He F, Ming D. EEG-controlled functional electrical stimulation rehabilitation for chronic stroke:system design and clinical application[J]. Front Med, 2021, 15:740-749.
[24] Nojima I, Sugata H, Takeuchi H, Mima T. Brain-computer interface training based on brain activity can induce motor recovery in patients with stroke:a meta-analysis[J]. Neurorehabil Neural Repair, 2022, 36:83-96.
[25] Hogan N, Krebs HI, Charnnarong J, Srikrishna P, Sharon A. MIT-MANUS:a workstation for manual therapy and training. Ⅰ[C]. Proceedings IEEE International Workshop on Robot and Human Communication, Tokyo, Japan, 1992. New York:IEEE, 1992:161-165[2022-09-30]. https://ieeexplore.ieee.org/document/253895.
[26] Krebs HI, Hogan N, Aisen ML, Volpe BT. Robot-aided neurorehabilitation[J]. IEEE Trans Rehabil Eng, 1998, 6:75-87.
[27] Sheng B, Xie S, Tang L, Deng C, Zhang Y. An industrial robot-based rehabilitation system for bilateral exercises[J]. IEEE Access, 2019, 7:151282-151294.
[28] Richardson MC, Tears C, Morris A, Alexanders J. The effects of unilateral versus bilateral motor training on upper limb function in adults with chronic stroke:a systematic review[J]. J Stroke Cerebrovasc Dis, 2021, 30:105617.
[29] Toth A, Fazekas G, Arz G, Jurak M, Horvath M. Passive robotic movement therapy of the spastic hemiparetic arm with REHAROB:report of the first clinical test and the follow-up system improvement[C]. 9th International Conference on Rehabilitation Robotics, Chicago, United states, 2005. New York:IEEE, 2005:127-130[2022-09-30]. https://ieeexplore.ieee.org/document/1501067.
[30] Perry JC, Rosen J, Burns S. Upper-limb powered exoskeleton design[J]. IEEE/ASME Trans Mechatron, 2007, 12:408-417.
[31] Morone G, Palomba A, Martino Cinnera A, Agostini M, Aprile I, Arienti C, Paci M, Casanova E, Marino D, LA Rosa G, Bressi F, Sterzi S, Gandolfi M, Giansanti D, Perrero L, Battistini A, Miccinilli S, Filoni S, Sicari M, Petrozzino S, Solaro CM, Gargano S, Benanti P, Boldrini P, Bonaiuti D, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzoleni S, Mazzon S, Molteni F, Petrarca M, Picelli A, Posteraro F, Senatore M, Turchetti G, Straudi S; "CICERONE" Italian Consensus Conference on Robotic in Neurorehabilitation. Systematic review of guidelines to identify recommendations for upper limb robotic rehabilitation after stroke[J]. Eur J Phys Rehabil Med, 2021, 57:238-245.
[32] Prattichizzo D, Malvezzi M, Hussain I, Salvietti G. The sixth-finger:a modular extra-finger to enhance human hand capabilities[C]. The 23rd IEEE International Symposium on Robot and Human Interactive Communication, Edinburgh, UK, 2014. New York:IEEE, 2014:993-998[2022-09-30]. https://ieeexplore.ieee.org/document/6926382.
[33] Jing HW, Zhu YH, Zhao SK, Zhang QH, Zhao J. Research status and development trend of supernumerary robotic limbs[J]. Ji Xie Gong Cheng Xue Bao, 2020, 56:1-9. 荆泓玮, 朱延河, 赵思恺, 张清华, 赵杰. 外肢体机器人研究现状及发展趋势[J]. 机械工程学报, 2020, 56:1-9.
[34] Gan Q, Harris CJ. A hybrid learning scheme combining EM and MASMOD algorithms for fuzzy local linearization modeling[J]. IEEE Trans Neural Netw, 2001, 12:43-53.
[35] Carter-Davies D, Chen JS, Chen F, Li M, Yang CG. Mechatronic design and control of a 3D printed low cost robotic upper limb[C]. 2018 11th International Workshop on Human Friendly Robotics (HFR), Shenzhen, China, 2018. New York:IEEE, 2018:1-6[2022-09-30]. https://ieeexplore.ieee.org/abstract/document/8633519.
[36] Hussain I, Salvietti G, Spagnoletti G, Prattichizzo D. The soft-sixthfinger:a wearable EMG controlled robotic extra-finger for grasp compensation in chronic stroke patients[J]. IEEE Robot Auto Lett, 2016, 1:57-61.
[37] Hussain I, Spagnoletti G, Salvietti G, Prattichizzo D. An EMG interface for the control of motion and compliance of a supernumerary robotic finger[J]. Front Neurorobot, 2016, 10:18.
[38] Rossi S, Salvietti G, Neri F, Romanella SM, Cinti A, Sinigaglia C, Ulivelli M, Lisini Baldi T, Santarnecchi E, Prattichizzo D. Emerging of new bioartificial corticospinal motor synergies using a robotic additional thumb[J]. Sci Rep, 2021, 11:18487.
[39] Liu Y, Huang S, Wang Z, Ji F, Ming D. Functional reorganization after four-week brain-computer interface-controlled supernumerary robotic finger training:a pilot study of longitudinal resting-state fMRI[J]. Front Neurosci, 2022, 15:766648.
[40] Liu Y, Wang Z, Huang S, Wang W, Ming D. EEG characteristic investigation of the sixth-finger motor imagery and optimal channel selection for classification[J]. J Neural Eng, 2022, 19:30.
[41] Eraifej J, Clark W, France B, Desando S, Moore D. Effectiveness of upper limb functional electrical stimulation after stroke for the improvement of activities of daily living and motor function:a systematic review and meta-analysis[J]. Syst Rev, 2017, 6:40.
[42] Marquez-Chin C, Popovic MR. Functional electrical stimulation therapy for restoration of motor function after spinal cord injury and stroke:a review[J]. Biomed Eng Online, 2020, 19:34.
[43] Kapadia N, Moineau B, Popovic MR. Functional electrical stimulation therapy for retraining reaching and grasping after spinal cord injury and stroke[J]. Front Neurosci, 2020, 14:718.
[44] Lan Y, Yao J, Dewald JP. The impact of shoulder abduction loading on EMG-based intention detection of hand opening and closing after stroke[J]. Annu Int Conf IEEE Eng Med Biol Soc, 2011:4136-4139.
[45] Knutson JS, Gunzler DD, Wilson RD, Chae J. Contralaterally controlled functional electrical stimulation improves hand dexterity in chronic hemiparesis:a randomized trial[J]. Stroke, 2016, 47:2596-2602.
[46] Guggenberger R, Heringhaus M, Gharabaghi A. Brain-machine neurofeedback:robotics or electrical stimulation[J]? Front Bioeng Biotechnol, 2020, 8:639.
[47] Sousa ASP, Moreira J, Silva C, Mesquita I, Macedo R, Silva A, Santos R. Usability of functional electrical stimulation in upper limb rehabilitation in post-stroke patients:a narrative review[J]. Sensors (Basel), 2022, 22:1409.
[48] Karamians R, Proffitt R, Kline D, Gauthier LV. Effectiveness of virtual reality-and gaming-based interventions for upper extremity rehabilitation poststroke:a meta-analysis[J]. Arch Phys Med Rehabil, 2020, 101:885-896.
[49] Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, Deruyter F, Eng JJ, Fisher B, Harvey RL, Lang CE, MacKay-Lyons M, Ottenbacher KJ, Pugh S, Reeves MJ, Richards LG, Stiers W, Zorowitz RD; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for Adult Stroke Rehabilitation and Recovery:a Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association[J]. Stroke, 2016, 47:e98-169.
[50] Ahn S, Hwang S. Virtual rehabilitation of upper extremity function and independence for stoke:a meta-analysis[J]. J Exerc Rehabil, 2019, 15:358-369.
[51] Lee HS, Park YJ, Park SW. The effects of virtual reality training on function in chronic stroke patients:a systematic review and meta-analysis[J]. Biomed Res Int, 2019:ID7595639.
[52] Weber LM, Nilsen DM, Gillen G, Yoon J, Stein J. Immersive virtual reality mirror therapy for upper limb recovery after stroke:a pilot study[J]. Am J Phys Med Rehabil, 2019, 98:783-788.
[53] Choi YH, Paik NJ. Mobile game-based virtual reality program for upper extremity stroke rehabilitation[J]. J Vis Exp, 2018, (133):56241.

选择文件类型/文献管理软件名称

选择包含的内容

2 脑卒中上肢康复机器人研究进展

Research progress on upper limb rehabilitation robots for stroke

RichHTML

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	薛蓉, 张轩. 睡眠障碍对脑血管病的影响[J]. 中国现代神经疾病杂志, 2023, 23(8): 659-662.
[2]	张鹏, 陈涛, 许莉. 成人失眠认知行为疗法关键技术与流程改进建议[J]. 中国现代神经疾病杂志, 2023, 23(8): 663-667.
[3]	张轩, 薛蓉. 特发性快速眼动睡眠期行为障碍向神经系统变性疾病转化的生物学标志物研究进展[J]. 中国现代神经疾病杂志, 2023, 23(8): 668-673.
[4]	刘引, 汤永红, 翟锦霞, 邱媛. 慢性低度炎症与睡眠障碍研究进展[J]. 中国现代神经疾病杂志, 2023, 23(8): 674-677.
[5]	于洁洋, 张亚男, 李惠敏, 黄真灿, 李宛儒, 王赞. 发作性睡病与焦虑研究进展[J]. 中国现代神经疾病杂志, 2023, 23(8): 678-682.
[6]	库成心, 邓丽影, 谢亮. 缺血性卒中继发日间过度思睡研究进展[J]. 中国现代神经疾病杂志, 2023, 23(8): 683-686.
[7]	姜佳凤, 赵莲花, 赵伟. 褪黑素在阿尔茨海默病病理损害机制中的作用[J]. 中国现代神经疾病杂志, 2023, 23(8): 687-692.
[8]	黄沛, 王刚. 功能性帕金森综合征诊断与治疗[J]. 中国现代神经疾病杂志, 2023, 23(8): 738-741.
[9]	洪涛, 唐斌. 如何成为一名优秀的颅底外科医师[J]. 中国现代神经疾病杂志, 2023, 23(7): 571-574.
[10]	张庆硕, 宋丹丹, 周世越, 张金璐, 韩晓旭, 许顺良. 功能性步态障碍诊断与治疗[J]. 中国现代神经疾病杂志, 2023, 23(7): 604-609.
[11]	潘希娟, 邢英琦, 刘玉梅. 脑小血管病影像学评分方法[J]. 中国现代神经疾病杂志, 2023, 23(7): 633-637.
[12]	俞淑凤, 李宁, 徐健, 王鹏. 颈动脉漂浮血栓相关缺血性卒中诊断与治疗进展[J]. 中国现代神经疾病杂志, 2023, 23(7): 638-642.
[13]	王建, 李梦娇, 祝俊驰, 陈丽娟, 孔平. Wallenberg综合征合并高血压脑病发病的青年脑卒中一例[J]. 中国现代神经疾病杂志, 2023, 23(7): 648-651.
[14]	魏俊吉. 神经外科重症医学规范化诊断与治疗[J]. 中国现代神经疾病杂志, 2023, 23(6): 477-478.
[15]	杜倩, 邓素君, 邹姗, 金珺, 周青山. 宏基因组第二代测序技术在重症中枢神经系统感染中的应用[J]. 中国现代神经疾病杂志, 2023, 23(6): 479-484.

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

2 脑卒中上肢康复机器人研究进展

Research progress on upper limb rehabilitation robots for stroke

RichHTML

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价