北京生物医学工程

基于虚拟现实的下肢机器人多任务步态训练平台在早期偏瘫患者中的应用

Application of multi-task gait training platform of lower limb robot based on virtual reality in patients with early hemiplegia

作者：马良飞何蓬莉曾西西王蕊尹翎

单位：中国五冶集团有限公司医院康复医学科（四川成都 610000）<br />通信作者：尹翎。E-mail:2073745571@qq.com

关键词：虚拟现实；下肢机器人；多任务；可穿戴设备；眼动仪

分类号：R318.01 

出版年·卷·期（页码）：2022·41·5（495-499）

摘要：

目的观察基于虚拟现实的下肢机器人多任务步态训练平台在早期偏瘫患者中的应用效果。方法选取50例脑卒中患者，随机分为改良组、对照组各25例。对照组采用单纯的下肢机器人训练，改良组采用融入虚拟现实技术、眼动/平衡训练技术、非侵入神经调控技术、可穿戴设备（表面肌电图+近红外光脑成像）、远程诊疗的下肢机器人。两组干预9周，观察Fugl-meyer下肢运动功能评定表(Fugl-meyer assessment,FMA)、Berg平衡量表（Berg balance scale ，BBS）、改良Barthel指数（modified Barthel index ，MBI）、Holden步行功能分级。结果两组患者在治疗前后进行FMA评分、BBS评分、MBI指数评定，9周后两组在上述指标与治疗前相比，差异均有统计学意义（P <0.05）；而组间比较，而改良组在FMA评分、BBS评分、MBI指数评分均优于对照组，差异有统计学意义（P <0.05）。在Holden步行功能分级方面，治疗后9周后两组在Holden分级与治疗前有统计学意义（P <0.05）；而组间比较，而改良组在优于对照组，差异有统计学意义（P <0.05）。结论基于虚拟现实的下肢机器人多任务步态训练平台，能够实现视听多感官、多通道刺激和训练，通过眼球运动捕捉建立自适应算法；并在传统下肢机器人的步态参数采集基础上，融入sEMG和fNIRS的肌电参数、血红蛋白浓度变化，进行多指标的同步监测，最终实现具有自适应功能的、可调整、优化、更新训练方案的智能技术，提高干预疗效。

Objective To observe the application effect of a multi-task gait training platform for lower limb robots based on virtual reality in patients with early hemiplegia. Methods Fifty stroke patients were selected and randomly divided into modified group and control group with 25 cases each. The control group used simple lower-limb robot training, and the modified group used the improved the original lower-limb robot that was integrated virtual reality technology, eye movement/balance training technology, non-invasive neuromodulation technology, wearable equipment (surface electromyography + near-infrared light Brain imaging), remote diagnosis and treatment. The two groups were intervened for 9 weeks, and the Fugl-meyer lower limb motor function assessment scale (FMA), Berg balance scale (BBS), modified Barthel index (MBI), and Holden walking function classification were observed. Results The two groups of patients were assessed by FMA score, BBS score, and MBI index before and after treatment. After 9 weeks, the differences in the above indicators between the two groups were statistically significant (P <0.05); and the comparison between groups. The improved group was better than the control group in FMA score, BBS score, MBI index score, and the difference was statistically significant (P <0.05). In terms of Holden walking function classification, the Holden classification of the two groups after 9 weeks after treatment was statistically significant (P <0.05); while the comparison between the groups, the improved group was better than the control group, and the difference was statistically significant ( P <0.05). Conclusions Based on traditional lower-limb robots, this research has improved a virtual reality-based multi-task gait training platform for lower-limb robots, which can realize multi-sensory, multi-channel stimulus and training through audiovisual and eye movements. Based on the acquisition of gait parameters, the changes in electromyographic parameters and hemoglobin concentration of sEMG and fNIRS are incorporated, and multiple indicators are simultaneously monitored. Finally, an intelligent technology with adaptive function, adjustable, optimized, and updated training program is realized, and the intervention is improved.

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