Ab$t~act-The restoration of walking capability is a key goal after stroke, traumatic brain injury and spinal cord injury. Conventional training methods, e.g. treadmill training, require great physical effort from the therapists to assist the patient. A robotic training machine would be desirable in order to improve the training and to relieve the therapists. In addition t o the general robot kinematics design issues, the designer of such a machine has to take into account several considerations specific to patient treatment in a rehabilitation clinic. Such a robotic walking simulator for neurological rehabilitation has been designed by our group and a prototype is currently being built. It will enable the therapist t o let the machine move the patients feet on programmable foot trajectories (e.g. walking on plane floor, stepping stairs up and down, walking on rough surfaces, disturbances during walking). Therefore the patients feet will be fixed on two separate footplates mounted on the robot endeffectors. The highly dynamic robotic system can be used as a universal walking simulator, not only for rehabilitation purposes, i.e. as a haptic foot device for a variety of virtual ground conditions.
Abstract-The restoration of gait is a key goal after stroke, traumatic brain injury and spinal cord injury. Conventional training methods, e.g. treadmill training, require great physical effort from the therapists to assist the patient. After the successful development and application of a mechanised gait trainer, a new research project of constructing a sensorised robot gait trainer is under way. The aim of this project is to build a robotic device which enables the therapist to let the machine move the patients feet, fixed on two footplates, on programmable foot trajectories (e.g. walking on the ground, stepping stairs up and down, disturbances during walking). Furthermore impedance control algorithms will be incorporated for online adaptation of the foot trajectories to the patients walking capabilities. Another important feature is the compliance control to simulate virtual ground conditions, i.e. the machine acts as a haptic foot device. Due to the partially high dynamic foot movements during normal walking, conventional industrial robots are not suitable for this task. This paper describes development aspects and problems that have to be dealt with during the design process of the robotised gait training machine.Keywords -gait rehabilitation, gait trainer, gait analysis, robot, compliance control I. INTRODUCTIONRestoration of gait following stroke, traumatic brain injury and spinal cord injury is an integral part of rehabilitation and it often influences whether a patient can return home or to work. Modern concepts of motor learning favor a task specific training, i.e. to relearn walking, the patient has to walk repetitively in a correct manner [1]. Treadmill training with partial body weight support proved effective at restoring gait in chronic nonambulant subjects after spinal cord injury and stroke [2].The major disadvantage of treadmill training is the great physical effort required by two therapists to ensure that the patient's gait is relatively normal throughout the training session of up to 25 minutes. Due to physical strain of the therapists the preciseness of the manually guided foot trajectory decreases the longer the training session lasts. Hence a robot gait training device supporting the therapists would enable longer training sessions in combination with much more precise foot trajectories, thus improving the learning success and relieve the therapists. A first step towards a solution for this problem was the design, construction and successful application of a mechanised gait trainer by our group [3] and an exosceleton robot gait trainer connected to a treadmill developed at the university hospital Balgrist, Switzerland [4].One major disadvantage of treadmill training in general and also both new approaches is the limited variability of different gait parameters and possible training trajectories. In general on the treadmill the patient can only train walking on the plane ground, but not e.g. stepping staircases up and down. It is desirable to let the patient train as many walking situation...
Wieder selbständig gehen zu können ist ein wesentliches Ziel der Rehabilitation nach Schädigungen des zentralen Nervensystems wie Schlaganfall und Querschnittslähmung. Moderne Konzepte des motorischen Lernens fordern ein aufgabenspezifisch repetitives Üben, d. h., wer wieder gehen lernen möchte, muß gehen. Die damit verbundene körperliche Belastung der Therapeuten setzt dieser Forderung Grenzen im klinischen Alltag. Der vorliegende Beitrag beschreibt die Entwicklung eines robotergestützten Laufsimulators zur Gangrehabilitation, der dem noch rollstuhlpflichtigen Patienten das wiederholte, autonome Üben eines individuellen Gangmusters bei gleichzeitiger Simulation der erfahrenen Theräpeutenhand ermöglichen soll. Technisch wurde das Prinzip der sog. programmable footplates mit Kraftkontrolle und Nachgiebigkeitsregelung gewählt. Die vorgestellte Lösung basiert für jeden Fuß auf einer planaren, parallel-seriellen Hybridkinematik mit drei Freiheitsgraden, die den Fuß in der Sagrttalebene bewegt. Basis für die Auslegung der Roboterkinematik waren ganganalytische Untersuchungen verschiedener Fußtrajektorien in der Ebene und auf der Treppe sowie Anforderungen der klinischen Handhabbarkeit und Sicherheitsaspekte. Die variable Nachgiebigkeitsregelung ertaubt eine Mensch-Maschine-Interaktion, die vom rein positipnsgeregeiten Abfahren vorgegebener Fußtrajektorien bis zur vollständigen Nachgiebigkeit während der Schwungbeinphase oberhalb eines virtuellen Bodenprofils nach Art eines haptic device reicht. Das vorgestellte Konzept verspricht im Vergleich zu bisher bekannten Techniken der Gangrehabilitation neue Möglichkeiten einer individuell abgestimmten Therapie.
This survey is on the new field of automated motor rehabilitation following stroke. Goals are to increase therapy intensity, relieve the strenuous effort of therapists, and the provision of an individually adjusted and documented therapy. Examples for upper limb rehabilitation are the "MIT-Manus" and the "MIME" to enable the unrestricted shoulder and elbow movement in the horizontal plane, and the "Bi-Manu-Track" for a bilateral passive and active practise of a forearm and wrist movement. In gait rehabilitation the "Lokomat®", a powered exoskeleton in combination with a motor-driven treadmill and the electromechanical gait trainer GT I with driven foot-plates are used. Clinical studies on the different devices are mentioned as well
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