結合NTUH-II復健機器手臂及慣性感測系統針對神經與骨骼疾病開發之新穎雙側上肢訓練

Abstract

因神經或骨骼疾病而導致上肢功能障礙的患者於臨床上相當常見，即時進行復健可有效幫助這些患者恢復原有的機能並防止二次併發症的發生。為了最大化病人及治療師之訓練效益並節省復健治療之成本，啟蒙於物理治療領域近年發展的一套藉由患側及健側進行協同運動來促進受損機能復原之新穎治療手法－雙側上肢訓練，本研究結合了過去同團隊研發之八自由度外骨骼式第二代上肢復健機器人及一輕巧之穿戴式慣性感測系統，發展並實現一套嶄新之機械輔助式雙側上肢復健平台。受惠於第二代上肢復健機器人廣泛之可動範圍特性，本平台可提供病患涵蓋絕大多日常生活所需之單側及雙側上肢功能訓練。 本研究提出一被動及助力之機械輔助式雙側上肢復健，透過穿戴式慣性感測系統量測病患健側肢段自主運動，使位於機器復健手臂上之患側肢段進行對應點對點之運動軌跡追蹤。助力式輔助策略更進一步透過健側之運動資訊產生一虛擬引導力，藉此適時輔助患側與健側同時進行主動運動之協調性。此外，除了透過雙側上肢訓練進行自我復健控制外，本系統架構亦可採用教導式之主從控制，由物理治療師之動作簡潔地引導病患患側正確進行所需之運動訓練，滿足各式機械輔助式復健之需求。相較於傳統必需事前定義特定軌跡之方式，本系統架構能透過不同控制方法快速地創建更為複雜之運動軌跡。 本控制提出之控制方法已經由八位健康受試者之先期研究加以驗證，實驗結果顯示提出之控制方法可有效提升操作者於機械輔助式助力雙側上肢復健式之協調性並減少患側肢段不當之過度出力。

Patients with upper limb disabilities caused by neurologic or orthopedic disorder required duly rehabilitation to regain their motor function and prevent complications. To reduce the burdens on both physical therapists and patients, in this research, based on a novel physical therapy called bilateral arm training (BAT), which is one of self-rehabilitation capable of promoting recovery of the impaired side with the help from the intact side, we develop a bilateral control interface for our recently developed 8 degrees-of-freedom (DOFs) exoskeleton type upper extremity rehabilitation robot, named NTUH-II. To extract motion information of the intact arm, we employ our self-developed inertia motion unit (IMU) Measurement System. It turns out that the unique and compact feature of NTUH-II together with IMU, which is its especial large range of motion (ROM) for shoulder, can allow patients to and practice the activities of daily living (ADL) BAT extremely effectively. More specifically, the control strategies are to enable the patient’s impaired or injured limb to undertake passive or active-assistive rehabilitation therapy through Robot-assisted Bilateral Arm Training (RBAT) while letting IMU measure the voluntary motion of the healthy arm. As for the active-assisting strategy, it is to generate the guidance torque as a sufficient aid to the impaired side if needed with reference to the motion of the healthy side. In addition to the self-motion control, leader-follower control is also available on proposed control scheme, where the therapist is allowed to easily generate the desired motion profile for the motion on patient’s impaired side, and can satisfy various requirement in robot-assisted rehabilitation. Compared to the conventional approaches which are limited to specific types of pre-defined reference profile, the integration of the proposed framework enables us to generate and realize more sophisticated motion trajectories. Various experiments have been conducted on eight healthy subjects to verify the tracking performance and assisting effect of the proposed bilateral control, and the results show that proposed control scheme can boost the subject physical coordination with less effort. From these results, the utility of the developed bilateral control method has been confirmed.