用於肘部自助复康训练的移动式连续自驱外神经肌骨系统
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移动式外骨骼以及气动式柔性机器人为复康机器人设计的新方向，於自助式上肢训练极具应用潜力。但此类系统由於机械传动效率低、体积/重量大、以及功耗高，用於自助训练时存安全隐患，仍局限於专业操作下的临床研究中，基本无法实现患者自助式的独立操作。神经肌肉电刺激(NMES)与机械传动结构的混合系统为复康机器人设计的另一新方向。其优点在於NMES可以在机械外力辅助的基础上改善肌肉协调功能，复康功效较传统机械机器人更胜一筹；同时利用电刺激诱发的生物肌力输出可降低整体系统功耗。然而，与NMES相结合的移动式外骨骼或柔性机器人还未被研究，其挑战在於系统控制如何在移动设计平台上将不同系统集成优化，以及将瘫痪肢体的自主运动输出(VME)最大化，以实现有效复康。
本项目的主旨在於设计一创新的连续VME驱动的移动式外神经肌骨系统(exo-neuro-musculo-skeleton),用於中风後自助式肘关节训练。我们将整合并优化外骨骼与气动肌肉为肌骨联合体(musculo-skeleton),使之兼具快速机械传动、体积/重量小、和低功耗之优点。同时，我们将利用肌电信号(EMG)为生物信号输入，设计可整合NMES与肌骨联合体协同工作的新控制方法。之後，我们还将设计基於此系统的自助复康训练方案，并与现有移动式外骨骼系统相比较，利用随机对照临床试验来验证其可行性与有效性。由本项目产生的结果将会为复康机器人设计带来突破性的成果，其原理和方法可应用於其他关节。
Mobile rigid exoskeleton and soft robots with pneumatic muscles are new trends in robot for potential self-help rehabilitation of the upper limb.However,they are still confined in clinical studies requiring close professional assistance,because of low torque-to-weight ratios with heavy weights in the rigid exoskeleton triggering safety concerns for independent usage and slow power transmission in the pneumatic soft robots associated with uncertain rehabilitative effects.Neuromuscular electrical stimulation(NMES)and robot hybrid system is another new trend in rehabilitative mechatronics with the advantage of more effective in improving muscular coordination than robots without NMES.However,NMES has not been integrated with mobile exoskeletons,or soft robots,because of the challenges in control design 1)to coordinate the respective NMES and mechanical assistances for optimized muscular coactivating patterns,and 2)to maximize the involvement of voluntary motor effort(VME)from the paretic neuromuscular system required for effective rehabilitation,based on the mobile platform with limited mechatronic resources.
The goal of this project is to research a novel mobile mechatronic technology,i.e.,continuous VME-driven exo-neuro-musculo-skeleton for self-help elbow rehabilitation after stroke.We will optimize the mechanical integration between rigid exoskeleton and pneumatic muscle,i.e.,exo-musculo-skeleton,for achieving light weights with high torque-to-weight ratios and fast power transmissions at the same time through a balance between the pneumatic muscle and rigid exoskeletal structures.We will combine NMES with the exo-musculo-skeleton,i.e.,exo-neuro-musculo-skeleton,through a novel control design by using electromyography(EMG)as the bio-indicator of VME to continuously promote the voluntary effort from the paretic muscles with close-to-normal muscular coordination in elbow extension and flexion.We will also design a novel exo-neuro-musculo-skeleton assisted self-help elbow rehabilitation program for chronic stroke,whose effectiveness will be evaluated through a randomized clinical trial(RCT)by comparing with those achieved by the latest VME-driven rigid mobile exoskeleton for elbow on the market under close professional assistance.The outcomes of the project will bring technological breakthroughs in mobile mechatronics,with potential application to other body parts.The outcomes of the RCT will provide evidences for the feasibility and effectiveness of the exo-neuro-musculo-skeleton assisted self-help rehabilitation,which may benefit the large stroke populations.