基于功能性电刺激的上肢镜像康复运动控制研究

发布时间：2018-06-12 18:55

本文选题：迭代学习控制 + 模型预测控制　；参考：《东北大学》2014年硕士论文

【摘要】：脑卒中(脑中风)是严重危害人类健康和生命安全的常见的难治性疾病,存在着明显的三高(发病率高、致残率高、死亡率高)现象。脑中风幸存患者多数有不同程度丧失劳动力和生活不能自理的情况,致残率高达75%,给患者及其家庭带来了沉重的负担。脑卒中引发的肢体运动障碍患者经过正规的康复训练可以明显减少或减轻瘫痪的后遗症,因此有效的脑卒中患者的康复训练手段是亟需研究的课题。功能性电刺激技术(Functional Electrical Stimulation, FE S)是近年来迅速发展起来的一门崭新的医疗技术,其在脑卒中患者的肌肉锻炼以及神经通路的功能恢复方面效果显著,引起了众多医疗科研人员的关注。本文针对脑卒中患者上肢康复问题开展研究,将镜像康复方法与功能电刺激相结合,深入全面地分析了上肢镜像康复运动控制方法。本文的主要内容包括以下几个方面：首先,为最大程度降低FES引起的肌肉疲劳,本文对功能性电刺激不同参数调节对肌肉疲劳的影响进行了比较研究。功能性电刺激引起的肌肉疲劳已经成为阻碍功能性电刺激应用推广的主要限制因素,而降低功能性电刺激肌肉疲劳能够使得训练康复更加高效。为定量评估刺激脉宽、频率和幅值三种参数变化情况下引起的肌肉疲劳状况,本文创新性地提出基于表面肌电信号(sEMG)的肌肉疲劳强度判断准则,最后通过对实际人体FES刺激数据的分析总结得出了脉宽调节对肌肉疲劳影响较小的结论。其次,针对脑卒中患者肌肉力量不足,容易疲劳的特点,开展了基于脉宽调节功能性电刺激的离散动作镜像康复方法研究。通过KINECT捕捉患者健康侧的运动,将运动镜像到患侧肢体,结合FES使受控制的患侧肢体与健侧肢体以相同速度完成动作,实现离散镜像康复训练。为保证患侧肢体动作的准确性,提出了基于迭代学习控制(Iterative Learning Control, ILC)与PD反馈相结合的FES控制方法。通过对健康被试在不同速度(慢速、中速和快速)下的实验表明所提的方法对于患侧运动的跟踪取得了良好的效果。最后,针对具有一定肌肉力量和耐力的脑卒中患者,本文提出了基于功能电刺激的连续运动镜像康复训练方法,利用功能性电刺激控制患侧肢体实时跟踪健侧肢体的连续运动。本文针对人体肌肉骨骼特点,提出了基于模型预测控制(Model PredictiveControl, MPC)的患侧肢体跟踪控制方法。仿真和实验结果表明,模型预测控制能对患侧肢体运动实现良好的控制效果。综上,通过结合功能性电刺激以及镜像康复两种脑卒中康复手段,提出了基于功能性电刺激的离散动作镜像康复及连续动作镜像康复两种训练方法,仿真以及实验结果表明方法简单且有效,对于发展新型脑卒中康复技术,提升脑卒中康复效果起到了积极的促进作用。
[Abstract]:Cerebral apoplexy (stroke) is a common refractory disease that seriously endangers human health and life safety. Most of the survivors of stroke are unable to take care of themselves to some extent, and the disability rate is as high as 75, which brings a heavy burden to the patients and their families. Regular rehabilitation training can significantly reduce or alleviate the sequelae of paralysis in patients with motor disorders caused by stroke. Therefore, effective rehabilitation training for stroke patients is a subject that needs to be studied. Functional Electrical stimulation (FE S) is a new medical technique which has been developed rapidly in recent years. It has a remarkable effect on muscle exercise and functional recovery of nerve pathway in stroke patients. It has attracted the attention of many medical researchers. In this paper, the rehabilitation of upper limb in stroke patients was studied. The method of mirror rehabilitation and functional electrical stimulation was combined to analyze the motor control method of mirror rehabilitation of upper limb. The main contents of this paper include the following aspects: firstly, in order to minimize the FES induced muscle fatigue, the effects of different parameters of functional electrical stimulation on muscle fatigue were studied. Muscle fatigue caused by functional electrical stimulation has become the main limiting factor which hinders the application of functional electrical stimulation. Reducing functional electrical stimulation muscle fatigue can make training and rehabilitation more efficient. In order to quantitatively evaluate the muscle fatigue caused by the changes of pulse width, frequency and amplitude, a new criterion for judging muscle fatigue strength based on surface electromyography (SEMG) is proposed in this paper. Finally, the conclusion that pulse width regulation has little effect on muscle fatigue is concluded by analyzing the actual human FES stimulation data. Secondly, the discrete action mirror rehabilitation method based on pulse width regulation and functional electrical stimulation was carried out in view of the characteristics of insufficient muscle strength and easy fatigue in stroke patients. The movement of the healthy side of the patient was captured by KINECT, the movement was mirrored to the affected limb, and FES was combined with FES to complete the movement at the same speed as the healthy limb, and to realize the rehabilitation training of discrete mirror image. In order to ensure the accuracy of limb movement, an iterative learning control (ILC-based) and PD feedback based FES control method is proposed. Experiments on healthy subjects at different speeds (slow, medium and fast) show that the proposed method is effective in tracking the affected side motion. Finally, for stroke patients with certain muscle strength and endurance, a method of continuous motor mirror rehabilitation training based on functional electrical stimulation is proposed in this paper. Functional electrical stimulation is used to control the continuous movement of the affected limb in real-time tracking of the healthy limb. According to the characteristics of human musculoskeletal, a method of limb tracking control based on Model Predictive Control (MPC) is proposed. Simulation and experimental results show that the model predictive control can achieve a good control effect on the motion of the affected limb. On the basis of functional electrical stimulation and mirror rehabilitation, two training methods, discrete action mirror rehabilitation and continuous action mirror rehabilitation, were put forward. The simulation and experimental results show that the method is simple and effective, which plays a positive role in the development of new stroke rehabilitation technology and the improvement of stroke rehabilitation effect.
【学位授予单位】：东北大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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