卧姿下肢康复训练运动生物力学特性  

Lower-extremity movement biomechanical characteristics during in-bed rehabilitation

作　　者：潘飞羽 贾炎冰 杨孟辉 吕逸飞 赵军[2] 郝智秀 王人成[1] PAN Feiyu;JIA Yanbing;YANG Menghui;LU Yifei;ZHAO Jun;HAO Zhixiu;WANG Rencheng(Department of Mechanical Engineering,Tsinghua University,Beijing 100084,China;Department of Neurology,China Rehabilitation Research Center,Beijing 100068,China)

机构地区：[1]清华大学机械工程系,北京100084 [2]中国康复研究中心神经内科,北京100068

出　　处：《清华大学学报（自然科学版）》2023年第12期1984-1993,共10页Journal of Tsinghua University(Science and Technology)

基　　金：国家重点研发计划(2020YFC2007602)。

摘　　要：现有的卧姿康复机器人功能单一、使用率低。该文设计了仰卧踏车、仰卧抬腿、侧卧抬腿等典型卧姿训练动作测量实验,并基于OpenSim建立了卧姿肌肉骨骼模型,计算分析关节角度、肌肉激活度及其耦合关系,研究了卧姿康复训练时髋、膝、踝关节及其主要驱动肌群的变化规律,探讨卧床患者运动训练的康复机制,为相关康复机器人的运动功能设计提供了理论依据。结果表明:仰卧踏车具有更高的膝关节与踝关节活动度,但整体肌肉激活度表现较另2种动作偏低;其关节运动幅度越大,肌肉激活度越高。仰卧抬腿与侧卧抬腿分别对髋关节屈曲与外展活动度以及相关肌群有明显激活;抬腿速度越快,肌肉激活度越高,但相对于地面的水平位移量越大;抬腿角度变大时,肌肉激活度均值整体降低,相对于地面的水平位移量变大。该研究发现仰卧抬腿、侧卧抬腿、仰卧踏车运动对人体关节与肌肉的作用各有侧重,在临床上采用侧卧、仰卧等多种动作组合训练可以提高康复效果,康复机器人最好能提供更多的矢状面和冠状面康复训练功能。[Objective] With the increasing of the disabled elderly population, the demand for in-bed rehabilitation robots increases. However, the clinical utilization rate of in-bed rehabilitation robots remains low because biomechanical studies on lying posture rehabilitation training are few. The function of an in-bed rehabilitation robot is relatively simple. However, its rehabilitation efficiency should be improved. Therefore, this study aimed to evaluate the joint motion and muscle activation with different movements of lying posture and provide a theoretical basis for designing the motor function of lower-extremity rehabilitation robots. [Methods] We designed a measurement experiment of three typical in-bed rehabilitation training movements, including cycling and straight leg raising in supine and lateral decubitus positions. Furthermore, different variables of velocity and amplitude/distance were set for each movement. Ten healthy subjects performed three movements during the experiment. Kinematics data were collected using a Vicon motion capture system and electromyography data were collected using a Noraxon electromyography acquisition device. A musculoskeletal model for the simulation of supine motion was developed using the software OpenSim. This model included 23 degrees of freedom and 92 muscles of the trunk and lower limbs, which could simulate a larger range of hip and knee flexion than the usual models. Further, a weld constraint was added between the trunk and the ground in the musculoskeletal model to compensate for human-ground contact force. Kinematics data were then imported into the OpenSim model for model scaling, inverse kinematics, and static optimization calculation steps. Then, joint angle and muscle activation were obtained. Electromyography data were compared to the simulation data to verify the musculoskeletal model's reliability. [Results] The OpenSim model was confirmed to be reliable and accurate for simulation. Cycling in supine position showed a higher range of motion(ROM) in the knee and

关 键 词：卧姿康复训练 运动生物力学 肌肉骨骼模型 下肢康复机器人 

分 类 号：R496[医药卫生—康复医学]