机器人辅助步行训练改善帕金森病步态障碍研究进展

doi:10.3969/j.issn.1672-6731.2024.03.007

中国现代神经疾病杂志 ›› 2024, Vol. 24 ›› Issue (3): 151-157. doi: 10.3969/j.issn.1672-6731.2024.03.007

2 机器人辅助步行训练改善帕金森病步态障碍研究进展

赵卿¹, 卜时嬴¹, 靳令经¹^,²^,*()

1. 201619 上海, 同济大学附属养志康复医院(上海市阳光康复中心)神经康复中心
2. 201619 上海市残联智能康复辅助器具与技术重点实验室养志康复医院(上海市阳光康复中心)神经康复中心

收稿日期:2024-02-15 出版日期:2024-03-25 发布日期:2024-03-29
通讯作者: 靳令经
基金资助:
国家重点研发计划重点专项(2023YFC3603800-2023YFC3603803); 国家临床重点专科建设项目(Z155080000004); 上海市2023年度创新医疗器械应用示范项目(23SHS05500); 上海市级医院诊疗技术推广及优化管理项目(SHDC22023304)

Research progress on robot-assisted gait training to improve gait disorder in Parkinson's disease

Qing ZHAO¹, Shi-ying BU¹, Ling-jing JIN¹^,²^,*()

1. Center of Neurology and Neurorehabilitation, Shanghai Yangzhi Rehabilitation Hospital(Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China
2. Shanghai Disabled Person'Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices, Shanghai Yangzhi Rehabilitation Hospital(Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China

Received:2024-02-15 Online:2024-03-25 Published:2024-03-29
Contact: Ling-jing JIN
Supported by:
National Key Research and Development Program of China(2023YFC3603800-2023YFC3603803); National Clinical Key Specialty Construction Project(Z155080000004); Shanghai 2023 Innovative Medical Device Application Demonstration Project(23SHS05500); Shanghai Hospital Development Center Foundation—Shanghai Municipal Hospital Rehabilitation Medicine Specialty Alliance(SHDC22023304)

摘要/Abstract

摘要：

步态障碍是帕金森病的常见运动症状，严重影响患者生活质量和运动独立性。机器人辅助步行训练可显著缓解帕金森病步态障碍，特别是下肢运动功能，纠正步速、步长、步频等步态参数异常，减少冻结步态发生，提高运动耐力，增强平衡功能，最终改善生活质量，具有广阔的应用前景。本文重点阐述外骨骼机器人的分类和设计、临床疗效及作用机制，用于指导帕金森病的康复治疗实践。

关键词: 帕金森病, 步态, 康复, 机器人, 综述

Abstract:

Gait disorder is one of common motor symptoms in patients with Parkinson's disease (PD), significantly affecting their quality of life and mobility. Robot - assisted gait training (RAGT) can improve the motor symptoms of PD patients, particularly in terms of lower limb motor function. It corrects abnormal spatiotemporal parameters of gait, such as gait velocity, step length, and step frequency, reduces the occurrence of freezing of gait, improves endurance, enhances balance ability, and ultimately improves quality of life. This paper focuses on the classification and construction, clinical efficacy and mechanism of exoskeleton robot, which can be used to guide the rehabilitation treatment of PD.

Key words: Parkinson disease, Gait, Rehabilitation, Robotics, Review

赵卿, 卜时嬴, 靳令经. 机器人辅助步行训练改善帕金森病步态障碍研究进展[J]. 中国现代神经疾病杂志, 2024, 24(3): 151-157.

Qing ZHAO, Shi-ying BU, Ling-jing JIN. Research progress on robot-assisted gait training to improve gait disorder in Parkinson's disease[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(3): 151-157.

http://journal11.magtechjournal.com/cjcnn/CN/Y2024/V24/I3/151

图/表 3

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设备名称	生产商	机器人设计	机器人优缺点
Lokomat机器人	瑞士Hocoma公司	悬挂减重+ 跑台+ 外骨骼机器人	优点：通过悬挂减重技术逐步降低患者体重负担，提供髋膝关节外骨骼支撑以维持正确步态和姿势，可调节步态参数、支撑力量等，传感器精准实时反馈步态和姿势，结合跑台提高运动耐力缺点：成本较高，依赖专业人员操作和监控，训练趣味性较低
WalkBot_S机器人	韩国P&S Mechanics公司	外骨骼机器人	优点：基于外骨骼支撑之外，结合虚拟现实游戏实现患者与环境的直接交互，可将认知训练融入其中缺点：不提供体重支持和跑台，适用范围局限
SMA机器人	日本Honda R&D公司	可穿戴外骨骼机器人	优点：可穿戴，提高生活质量和自主性，可用于居家或社区康复，提高社交参与度缺点：成本较高，使用前需培训，刚性结构舒适度较差，适用范围局限
EksoGT机器人	美国Ekso Bionics公司	外骨骼机器人	优点：功能全面，包括步态矫正、助力支持、步态模式切换等，液压外骨骼轻量化设计减轻负担，配备触控屏以实时改变康复目标缺点：需辅助支撑，关节自由度较小，主动训练为主，病程适应范围较小，训练趣味性较低
GT1机器人	德国Reha-Stim公司	悬挂减重+ 踏板驱动外骨骼机器人	优点：末端执行器的设置减少痉挛状态，具有多种安全保护机制，体重支撑减少负担缺点：踏板驱动对改变步长、步幅等步态参数效果欠佳、速度参数较低
G-EO机器人	瑞士Reha Technology公司	悬挂减重+ 踏板驱动外骨骼机器人	同GT1机器人

设备名称	生产商	机器人设计	机器人优缺点
Lokomat机器人	瑞士Hocoma公司	悬挂减重+ 跑台+ 外骨骼机器人	优点：通过悬挂减重技术逐步降低患者体重负担，提供髋膝关节外骨骼支撑以维持正确步态和姿势，可调节步态参数、支撑力量等，传感器精准实时反馈步态和姿势，结合跑台提高运动耐力缺点：成本较高，依赖专业人员操作和监控，训练趣味性较低
WalkBot_S机器人	韩国P&S Mechanics公司	外骨骼机器人	优点：基于外骨骼支撑之外，结合虚拟现实游戏实现患者与环境的直接交互，可将认知训练融入其中缺点：不提供体重支持和跑台，适用范围局限
SMA机器人	日本Honda R&D公司	可穿戴外骨骼机器人	优点：可穿戴，提高生活质量和自主性，可用于居家或社区康复，提高社交参与度缺点：成本较高，使用前需培训，刚性结构舒适度较差，适用范围局限
EksoGT机器人	美国Ekso Bionics公司	外骨骼机器人	优点：功能全面，包括步态矫正、助力支持、步态模式切换等，液压外骨骼轻量化设计减轻负担，配备触控屏以实时改变康复目标缺点：需辅助支撑，关节自由度较小，主动训练为主，病程适应范围较小，训练趣味性较低
GT1机器人	德国Reha-Stim公司	悬挂减重+ 踏板驱动外骨骼机器人	优点：末端执行器的设置减少痉挛状态，具有多种安全保护机制，体重支撑减少负担缺点：踏板驱动对改变步长、步幅等步态参数效果欠佳、速度参数较低
G-EO机器人	瑞士Reha Technology公司	悬挂减重+ 踏板驱动外骨骼机器人	同GT1机器人

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2 机器人辅助步行训练改善帕金森病步态障碍研究进展

Research progress on robot-assisted gait training to improve gait disorder in Parkinson's disease

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2 机器人辅助步行训练改善帕金森病步态障碍研究进展

Research progress on robot-assisted gait training to improve gait disorder in Parkinson's disease

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