基于气动肌肉外骨骼和功能性电刺激的肢体康复技术研究

发布时间：2018-03-18 00:37

本文选题：外骨骼康复机器人　切入点：人工气动肌肉　出处：《华中科技大学》2016年博士论文　论文类型：学位论文

【摘要】：因神经损伤导致肢体运动功能障碍的患者日益增多。这将给家庭和社会带来沉重的负担,而康复训练能让瘫痪患者重新获得日常生活自理能力。以神经可塑性为理论依据的肢体康复,从最初的人工康复发展成为康复医学、计算机科学、机械工程、电子工程和控制理论为一体的智能康复。康复机器人和功能性电刺激是临床上两个主要的肢体智能康复技术。本文将康复机器人和功能性电刺激两种智能康复技术有机组合,探索肢体智能康复技术经济实用的新途径。可穿戴五自由度上肢外骨骼康复机器人RUPERT具有重量轻和造价低的特点。其各关节由一根具有内在柔顺性的人工气动肌肉驱动,是针对因上肢屈肌的肌张力过高而导致伸展运动障碍的一类患者研制的。为了扩大RUPERT的使用范围,并使其普及到软瘫期患者,作者对气动肌肉和神经肌肉电刺激进行建模,使用气动肌肉和电刺激的瘫痪肌肉形成双向对拉,并利用迭代学习控制的方法实现伸展辅助运动。手功能康复训练可以帮助患者恢复抓握功能,对患者的日常生活有着重大意义。患者主动参与训练相对被动训练更能促进手功能康复。作者借助研制的阵列电极,并通过扫描搜索方法寻找阵列电极的最佳刺激靶点,通过刺激较小的手指肌肉实现大力抓和释放的手功能活动。表面肌电信号能体现患者主动意图,而电刺激下表面肌电信号被刺激瑕疵和M波淹没。作者使用梳齿滤波器和空窗等技术提取主动表面肌电,实现上肢伸展和主动抓握训练。康复机器人可以替代康复治疗师对患者进行智能辅助,同时实时记录康复训练数据提供客观和定量的评价。然而康复机器人治疗的有效性仍存在争议。本文通过临床试验来验证五自由度RUPERT上肢外骨骼康复机器人的有效性。康复治疗师对患者训练前后的运动功能评估和作者对RUPERT试验数据分析,表明RUPERT上肢外骨骼康复机器人是安全的。在家庭环境训练中进一步证明了该康复机器人具有良好的应用效果。临床试验让大多数患者上肢运动功能得到改善,但有效性缺乏统计意义上的临床显著差异。对于肢体瘫痪的患者来说,下肢功能康复同等重要。本文研制了一款低造价应用于髋膝关节康复训练气动下肢外骨骼康复机器人。气动肌肉驱动的外骨骼机器人是一个高度非线性系统,这会造成步态跟踪控制的困难。作者先采用滑模代理控制算法(PSMC)对下肢外骨骼进行控制。PSMC不依赖模型,在位置误差过大时能产生慢速过阻尼作用,避免高的角速度和力过度饱和。早期被动步态训练有利于患者自然步态模式训练,对跟踪精度要求高。为了进一步提高步态训练跟踪精度,一种抖振减弱鲁棒滑模控制算法(CRVC)应用到下肢外骨骼步态训练控制上。CRVC跟踪精度优于PSMC,但CRVC需要建立复杂模型。神经损伤患者的踝关节会出现足下垂等运动功能失调。如果上述的髋膝外骨骼机器人再集成踝关节动力装置,下肢外骨骼结构会变得复杂并且重量会增加。作者研究了功能性电刺激应用于踝关节的康复技术,对踝关节跖屈／背屈运动进行神经肌肉电刺激动力学建模,并通过电刺激实验来探索相关肌肉(胫骨前肌、比目鱼肌和腓肠肌)最佳协调控制机制。借助下肢外骨骼和功能性电刺激组合,作者通过跑台步态实验实现了下肢髋膝踝关节一体训练的康复技术。
[Abstract]:As a result of motor dysfunction in patients with increasing nerve injury. This will bring heavy burden to the family and society, and rehabilitation training can let paralyzed patients regain self-care ability of daily life. The neural plasticity theory for limb rehabilitation, from the initial development of a manual rehabilitation rehabilitation medicine, computer science, mechanical engineering. Intelligent rehabilitation of electronic engineering and control theory. As one of the rehabilitation robot and functional electrical stimulation are the two main body of intelligent rehabilitation technique in clinic. The rehabilitation robot and functional electrical stimulation of two kinds of intelligent rehabilitation technology organic combination, and explore new ways of limb intelligent rehabilitation technology is economical and practical. It can wear the five degrees of freedom the upper limb exoskeleton rehabilitation robot RUPERT has the advantages of light weight and low cost. The characteristics of each joint of the artificial pneumatic muscles by a compliance with internal drive Still, is due to the high muscular tension of upper limb flexor and lead to development of a class with stretching disorder. In order to expand the scope of the use of RUPERT, and make it available to patients in flaccid paralysis, the stimulation model of pneumatic muscle and neuromuscular electrical, pneumatic muscle and muscle electrical stimulation of the formation of paralysis bidirectional pull, and by using iterative learning control to achieve extension assist movement. Hand rehabilitation training can help patients regain grip function, it is of great significance to the daily life of the patients. The patients to participate in the training of relative passive training can promote the rehabilitation of hand function. The author uses the developed electrode array, and find the best stimulation target the electrode array by scanning search method, to achieve strong grasp of and release hand function activities through the stimulation of smaller finger muscles. Surface EMG signals can reflect patients with active intent, and power Under the stimulation of surface EMG signal is stimulated and M wave defect extraction technology. The author uses the submerged comb filter and the window active surface EMG, achieve upper limb stretching and active grasping training. Rehabilitation robot can replace the intelligent assisted rehabilitation therapists for patients, at the same time evaluation record of rehabilitation training to provide objective and quantitative data. However, the effectiveness of the treatment of rehabilitation robots is still controversial. This paper verified the effectiveness of five degree of freedom RUPERT upper limb exoskeleton rehabilitation robot through clinical trials. Rehabilitation therapists on motor function assessment of patients before and after the training assessment and analysis of RUPERT test data show that the RUPERT of upper limb exoskeleton rehabilitation robot is safe. In the family environment in training further proof the rehabilitation robot has good application effect in clinical trials. Most patients make upper limb motor function improved But the lack of effective, clinically significant differences statistically. For patients with limb paralysis, lower limb function rehabilitation are equally important. This paper has developed a low cost used in hip and knee joint rehabilitation training pneumatic lower limb exoskeleton rehabilitation robot. The exoskeleton robot driven by pneumatic muscles is a highly nonlinear system, the will cause the gait tracking control problems. The author first adopts the sliding agent control algorithm (PSMC) of the lower extremity bone outside the control of.PSMC does not depend on the model, can produce slow damping effect in position error is too large, angular velocity and force to avoid high supersaturation. Early passive gait training is beneficial to patients with natural gait training. Requirements for high tracking accuracy. In order to further improve the tracking accuracy of gait training, a chattering weaken robust sliding mode control (CRVC) algorithm is applied to the lower extremity exoskeleton gait training control On the tracking accuracy of the.CRVC is better than PSMC, but CRVC needs to establish a complex model. Patients with nerve injury of ankle joint will appear foot drop movement dysfunction. If the hip and knee exoskeleton robot and ankle joint integrated power device, the lower extremity exoskeleton structure will become more complex and the weight will increase. The author studies the rehabilitation technology of functional electrical stimulation applied to the ankle joint, the ankle plantar flexion and dorsiflexion movement of neuromuscular electrical stimulation dynamics modeling, and through the electric stimulation experiment to explore the related muscles (tibialis anterior muscle, soleus and gastrocnemius) optimal coordination control mechanism. With the help of the lower extremity exoskeleton and functional electrical stimulation combined by treadmill the gait experiment achieved a rehabilitation technique of hip knee and ankle joint development training.

【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：TP242

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