Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

The Korean Society of Medical and Biological Engineering (대한의용생체공학회)
권호 표지
DOI QR코드

DOI QR Code

Development of an Active Training System for Rehabilitation Exercise of Hemiplegic Patients

편마비 환자의 재활운동치료를 위한 능동형 상지훈련시스템 개발

  • Lee, M.H. (Dept. of Biomed. Eng., Graduate School, Yonsei Univ., Institute of Med. Eng., Yonsei Univ.) ;
  • Son, J. (Dept. of Biomed. Eng., Graduate School, Yonsei Univ., Institute of Med. Eng., Yonsei Univ.) ;
  • Kim, J.Y. (Dept. of Biomed. Eng., Graduate School, Yonsei Univ., Institute of Med. Eng., Yonsei Univ.) ;
  • Kim, Y.H. (Dept. of Biomed. Eng., Graduate School, Yonsei Univ., Institute of Med. Eng., Yonsei Univ.)
  • 이민현 (연세대학교 대학원 의공학과, 연세의료공학연구원) ;
  • 손종상 (연세대학교 대학원 의공학과, 연세의료공학연구원) ;
  • 김정윤 (연세대학교 대학원 의공학과, 연세의료공학연구원) ;
  • 김영호 (연세대학교 대학원 의공학과, 연세의료공학연구원)
  • Received : 2010.08.23
  • Accepted : 2011.01.27
  • Published : 2011.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

An active training system has been developed to assist the upper extremity function in patients with spasticity. We also evaluated the performance of the developed assistive system in five normal subjects and one hemiplegic patient. The maximum voluntary contraction (MVC) tests for biceps brachii and triceps brachii were performed and the relationship between linear enveloped EMG signal and the elbow joint torque was found. In order to implement an active training, our system was designed to allow isokinetic movement only when the subject generates elbow joint motion larger than the pre-fixed threshold level. The proposed EMG-feedback control method could provide active exercises, resulting in better rehabilitation protocol for spastic patients.

Keywords

References

  1. A. D. Pandyan, H. Hermens, and G. R. Johnson, "Spasticity," Encyclopedia of Neuroscience, pp. 153-163, 2009.
  2. J. K. Lee and J. W. Lee, "Development of Rehabilitation Robot for Patients with Elbow Spasticity," The Korean Society of Mechanical Engineers, pp. 14-19, 2006.
  3. C. Butefisch, H. Hummelsheim, P. Denzler, and K. H. Mauritz., "Repetitive Training of Isolated Movements Improves the Outcome of Motor Rehabilitation of the Centrally Paretic Hand," Journal of Neurological Sciences, vol. 130, No. 1, pp. 59-68, 1995. https://doi.org/10.1016/0022-510X(95)00003-K
  4. C. L. Wu, M. H. Huang, C. L. Lee, C. W. Liu, L. J. Lin, and C. H. Chen, "Effect on Spasticity After Performance of Dynamic-Repeated-Passive Ankle Joint Motion Exercise in Chronic Stroke Patients," The Kaohsiung Journal of Medical Sciences, vol. 22, No. 12, pp. 610-617, 2006. https://doi.org/10.1016/S1607-551X(09)70361-4
  5. S. R. Pierce, R. T. Lauer, P. A. Shewokis, J. A. Rubertone, and M. N. Orlin, "Test-Retest Reliability of Isokinetic Dynamometry for the Assessment of Spasticity of the Knee Flexors and Knee Extensors in Children With Cerebral Palsy," Archives of Physical Medicine and Rehabilitation, vol. 87, No. 5, pp. 697-702, 2006. https://doi.org/10.1016/j.apmr.2006.01.020
  6. A. Nordez, P. Casari, and C. Cornu, "Accuracy of Biodex System 3 Pro Computerized Dynamometer in Passive Mode," Medical Engineering & Physics, vol. 30, No. 7, pp. 880-887, 2008. https://doi.org/10.1016/j.medengphy.2007.11.001
  7. T. J. Bovend'Eerdt, M. Newman, K. Barker, H. Dawes, C. Minelli, and D. T. Wade, "The Effects of Stretching in Spasticity: A Systematic Review," Archives of Physical Medicine and Rehabilitation, vol. 89, No. 7, pp. 1395-1406, 2008. https://doi.org/10.1016/j.apmr.2008.02.015
  8. J. R. Engsberg, K. S. Olree, S. A. Ross, and T. S. Park, "Quantitative Clinical Measure of Spasticity in Children with Ccerebral Palsy," Archives of Physical Medicine and Rehabilitation, vol. 77, No. 6, pp. 594-599, 1996. https://doi.org/10.1016/S0003-9993(96)90301-9
  9. D. J. Clark, E. G. Condliffe, and C. Patten, "Reliability of Concentric and Eccentric Torque during Isokinetic Knee Extension in Post-Stroke Hemiparesis," Clinical Biomechanics, vol. 21, No. 4, pp. 395-404, 2006. https://doi.org/10.1016/j.clinbiomech.2005.11.004
  10. B. J. Singer, J. W. Dunne, K. P. Singer, "The Short Term Effect of Cyclic Passive Stretching on Plantarflexor Resistive Torque after Acquired Brain Injury," Clinical Biomechanics, vol. 23, No. 9, pp. 1178-1182, 2008. https://doi.org/10.1016/j.clinbiomech.2008.07.006
  11. R. W. Selles, X. Li, F. Lin, S. G. Chung, E. J. Roth, and L. Q. Zhang, "Feedback-Controlled and Programmed Stretching of the Ankle Plantarflexors and Dorsiflexors in Stroke: Effects of a 4-Week Intervention Program," Archives of Physical Medicine and Rehabilitation, vol. 86, No. 12, pp. 2330-2336, 2005. https://doi.org/10.1016/j.apmr.2005.07.305
  12. B. T. vol.pe, M. Ferraro, D. Lynch, P. Christos, J. Krol, C. Trudell, H. I. Krebs, and N. Hogan, "Robotics and Other Devices in the Treatment of Patients Recovering from Stroke," Current Neurology and Neuroscience Reports, vol. 5, No. 6, pp. 465-470, 2005. https://doi.org/10.1007/s11910-005-0035-y
  13. M. E. Baar, J. Dekker, R. Oostendorp, D. Bijl, T. Voorn, and J. Bijlsma, "Effectiveness of Exercise in Patients with Osteoarthritis of Hip or Knee: Nine Months' Follow Up," Annals of the Rheumatic Diseases, vol. 60, No. 12, pp. 1123-1130, 2001. https://doi.org/10.1136/ard.60.12.1123
  14. J. Stein, H. I. Krebs, W. R. Frontera, S. E. Fasoli, R. Hughes, and N. Hogan, "Comparison of Two Techniques of Robot-Aided Upper Limb Exercise Training After Stroke," American Journal of Physical Medicine & Rehabilitation, vol. 83, No. 9, pp. 720-728, 2004. https://doi.org/10.1097/01.PHM.0000137313.14480.CE
  15. C. Burgar, P. Lum, P. Shor, and H. Van der Loos, "Development of Robots for Rehabilitation Therapy: The Palo Alto VA/Stanford Experience," Journal of Rehabilitation Research and Development, vol. 37, No. 6, pp. 663-673, 2000.
  16. B. T. vol.pe, H. I. Krebs, N. Hogan, L. Edelstein, C. Diels, and M. Aisen, "A Novel Approach to Stroke Rehabilitation: Robot-Aided Sensorimotor Stimulation," Neurology, vol. 54, No. 10, pp. 1938-1944, 2000. https://doi.org/10.1212/WNL.54.10.1938
  17. S. L. Wolf, M. Nacht, and J. L. Kelly, "EMG Feedback Training during Dynamic Movement for Low Back Pain Patients," Behavior Therapy, vol. 13, No. 4, pp. 395-406, 1982. https://doi.org/10.1016/S0005-7894(82)80003-8
  18. L. Weiss, J. Silver, and J. Weiss, "Easy EMG - A Guide to Performing Nerve Conduction Studies and Electromyography," Butterworth-Heinemann Medical, pp. 228-230, 2004.
  19. J. R. Potvin and S. H. Brown, "Less Is More: High Pass Filtering, to Remove up to 99% of the Surface EMG Signal Power, Improves EMG-Based Biceps Brachii Muscle Force Estimates," Journal of Electromyography and Kinesiology, vol. 14, No. 3, pp. 389-399, 2004. https://doi.org/10.1016/j.jelekin.2003.10.005
  20. A. Bruulsema, B. Maxwell, T. Black, B. Harding, and P. W. Stratford, "The Effect of Inter-Trial Rest Interval on the Assessment of Isokinetic Thigh Muscle Torque," Journal of Orthopaedic & Sports Physical Therapy, vol. 11, No. 8, pp. 362-366, 1990. https://doi.org/10.2519/jospt.1990.11.8.362
  21. K. H. Tsai, C. Y. Yeh, H. Y. Chang, and J. J. Chen, "Effects of a Single Session of Prolonged Muscle Stretch on Spastic Muscle of Stroke Patients," Proceedings of the National Science Council Republic of China, Part. B, vol. 25, No. 2, pp. 76-81, 2001.
  22. V. Baltzopoulos, J. G. Williams, and D. A. Brodie, "Sources of Error in Isokinetic dynamometry: Effects of Visual Feedback on Maximum Torque Measurements," Journal of Orthopaedic & Sports Physical Therapy, vol. 13, pp. 138-141, 1991. https://doi.org/10.2519/jospt.1991.13.3.138
  23. R. D. Hald and E. J. Bottjen, "Effect of Visual Feedback on Maximal and Submaximal Isokinetic Test Measurements of Normal Quadriceps and Hamstrings," Journal of Orthopaedic & Sports Physical Therapy, vol. 9, No. 3, pp. 86-93, 1987. https://doi.org/10.2519/jospt.1987.9.2.86
  24. D. M. Connelly, C. L. Rice, M. R. Roos, and A. A. Vandervoort, "Motor Unit Firing Rates and Contractile Properties in Tibialis Anterior of Young and Old Man," Journal of Applied Physiology, vol. 87, No. 2, pp. 843-852, 1999. https://doi.org/10.1152/jappl.1999.87.2.843

Cited by

  1. Electromyography Triggered Training System for Wrist Rehabilitation vol.34, pp.3, 2013, https://doi.org/10.9718/JBER.2013.34.3.148
  2. Wrist Rehabilitation Training Device Using Pneumatic Inflation and Deflation of Air Cells vol.36, pp.2, 2015, https://doi.org/10.9718/JBER.2015.36.2.37