This is the 1,500th article of DaMedicineXiaoNursing
In the 21st century, more and more countries will experience an aging population, with the proportion of the elderly population in China reaching 17.8% in 2010, and according to the latest data from the Sixth National Census, the process of population aging is gradually accelerating in China. According to the latest data from the sixth national census, China's aging population is gradually accelerating, and by 2030, the proportion of people over 65 years old in China will surpass that of Japan, becoming the world's most aging country. The increase in the aging population has made China face the serious challenge of high incidence, disability and death rates of chronic diseases, and cerebrovascular disease is one of the major chronic diseases that jeopardize human health all over the world today. According to statistics, the annual incidence rate of stroke in China is 116-219 per 100,000 people, with a disability rate of 86.5%, and those who cannot take care of themselves account for 43.2%, with a quality of life significantly lower than that of the normal population, which has a serious impact on the lives of patients and their families. In order to improve the quality of life of stroke patients, systematic and standardized rehabilitation is necessary.
The traditional standardized systematic rehabilitation treatment needs to invest a lot of manpower and treatment time, but with the increase in the number of rehabilitation patients year by year, it makes the shortage of rehabilitation professionals in China come to the fore, in order to alleviate the contradiction between the imbalance between supply and demand, there is an urgent need to introduce new rehabilitation equipment as an auxiliary treatment technology into the field of rehabilitation therapy, in which the three-dimensional upper limb multi-joint training and evaluation system, intelligent lower limb gait system, and the intelligent lower limb gait system, are all used.
The Armeo Spring, a three-dimensional upper extremity multi-joint training and evaluation system for restoring upper extremity function, is designed for people with upper extremity and hand active movement disorders, and was researched and developed by the University of California, Irvine and the Rehabilitation Institute of Chicago***. It can effectively improve the user's upper limb coordination, muscle strength, shoulder, elbow, wrist and other joints range of motion and grip strength and other upper limb movement ability. It can offset the weight of the user's arm through a variety of training programs, reducing the difficulty of training and ensuring the safety of training through the arm weight reduction support technology. By moving the arm and wrist in a game-like environment, the patient can complete the movement required for daily life activities. The patient will control the simulated character in the screen to complete the correct movement of the arm in one, two and three dimensions, thus forming a progressive functional training, which is also fully in line with the basic guidelines for disease rehabilitation. This set of equipment in the clinical mainly applies to the neurological diseases and bone and joint system diseases caused by upper limb movement dysfunction, such as: cerebral infarction / cerebral hemorrhage, craniocerebral trauma, Parkinson's, as well as upper limb fracture and frozen shoulder, etc., the Armeo Spring in the process of treatment of individual differences is very large, with a strong uniqueness and relevance, according to the conditions of each patient, to formulate personalized treatment programs, most of the patients after treatment are all the way to the end of the treatment. Most of the patients gave high evaluation after the treatment.
3D Upper Extremity Multi-Joint Training and Evaluation System
In clinical practice, the functions of the upper and lower extremities complement each other, and although there is a difference in the timing and length of recovery, the ability to walk and the correct gait, which is indispensable to the patient's mobility, is a function that is highly valued in clinical rehabilitation medicine. Therefore, the lower limb rehabilitation robot for lower limb function improvement and gait correction is also of great significance. It contains the international standard 6 bells walking test, Cooper test and Barker test, which can assess the patient's exercise and cardiopulmonary function and provide scientific basis for training program development. walker-view can capture the angle change of the whole body joints during the running of the walking machine in real time through the anti-interference high-speed infrared camera system; record the change of the center of pressure of the body in real time, the length and width of the stride, the time of touchdown and weight-bearing symmetry and other basic gait conditions. Basic gait analysis data such as center of pressure change, step length and width, touchdown time and weight-bearing symmetry are recorded in real time. The movement and gait data are integrated and analyzed, and fed back to the patient in real time through the 47-inch screen at the front of the running platform, including left and right joints' movement angle, compensation (shoulder symmetry, spinal curvature, and pelvic symmetry), gait, etc. In the next step, the patient can be guided by the self-prescribed more than 20 kinds of walking and running training prescription programs and virtual scenarios, which will greatly improve the patient's gait and improve his/her performance. The next step is to guide the training and improvement with more than 20 walking and running prescription programs and virtual scenarios, which will greatly improve the patient's gait.
Intelligent Lower Limb Gait Evaluation and Training System
Another more advanced lower limb rehabilitation robot is Andago, a mobile rehabilitation training robot, mainly used to provide dynamic weight loss gait training for patients, so that the patient can be in an upright position, freeing the hands of the state of the actual ground walking training. Its specific anti-fall protection and real-time patient-following function can always escort the patient's training. The patient builds confidence and the therapist can focus on how to optimize the training for the patient without having to think about safety. Built-in training modes (patient-controlled, linear, therapist-controlled) are available to meet different training intensities and challenges. Weight-bearing is the foundation of all lower limb functions, especially walking, so lower limb rehabilitation robots need to be able to provide patients with posture control and weight loss similar to normal walking, the above two rehabilitation robots not only fulfill the tasks of general lower limb rehabilitation robots, but also to a large extent through the scientific design and precision calculations, so that patients are able to stand up earlier, walk more steadily and run faster!
Gait training with dynamic weight loss
More and more robots are entering the field of rehabilitation with better clinical treatment feedback and patient acceptance. A number of studies have also shown that robots in the field of rehabilitation can provide patients with movements similar to daily activities, can provide repeatable, task-oriented and interactive therapy for the paralyzed upper limb, can objectively and reliably monitor the status of patients' motor function improvement, and at the same time, can virtual reality scenarios, provide functional and purposeful therapy, increase the patient's interest in participating in the rehabilitation therapy and motivation, and then improve the patient's upper and lower limbs' The system can be used to improve the motor function of the upper and lower limbs of the patients.
Rehabilitation family "new weapons" in addition to the upper / lower limb rehabilitation robot, there are in recent years very popular, high-tech content is very high virtual reality therapy technology (referred to as VR) and transcranial magnetic stimulation therapy (referred to as TMS), of which VR is an emerging human-computer interaction technology, can be virtual reality technology, has been widely used in rehabilitation therapy. VR is an emerging human-computer interaction technology, and virtual reality technology has been widely used in various aspects of rehabilitation treatment: it has achieved good rehabilitation effects in the fields of cognitive rehabilitation of attention deficit, spatial perception disorder, memory disorder, etc.; the rehabilitation of emotional disorders, such as anxiety, depression, horror, and other mental disorders; and the rehabilitation of motor disorders such as motor dysfunction, poor balance and coordination, and chorea. TMS is a painless, non-invasive green treatment method, the magnetic signal generated by the device can be non-attenuated through the skull and stimulate the brain nerves, adjustable repetitive stimulation of the brain's central nervous system, which is mainly through different frequencies to achieve the role of excitation and inhibition, and then to achieve the treatment of clinical psychiatric disorders, neurological disorders, and rehabilitation dysfunction.
Transcranial Magnetic Stimulation (TMS)
Virtual Reality Technology
Comprehensively speaking, traditional manipulative therapy is undoubtedly the most effective treatment for patients and their families, but such methods also have the disadvantages of being time-consuming, labor-intensive, and difficult to repeat, and in many cases can only be performed one-on-one treatment; at the same time, due to the severe shortage of practitioners in our country, many patients do not receive timely and standardized rehabilitation. At the same time, due to the serious shortage of rehabilitation therapists in China, many patients do not receive timely and standardized rehabilitation treatment, thus missing the best time for treatment, while the "new weapon" of the rehabilitation family can largely assist or even partially replace the traditional manipulative therapy, which greatly improves the efficacy of the treatment and alleviates the shortage of manpower; on the other hand, with the increasing standard of living and the pursuit of quality of life, the disease has become more and more common in the late stage. On the other hand, as people's standard of living and pursuit of quality of life increase, the functional recovery of the late disease is as important as the traditional concept of health prevention and clinical medicine, which to a large extent also promotes the rapid development of rehabilitation medicine and related disciplines.
The rapid progress of science and technology has made a lot of the original impossible to become possible, but also for the clinical treatment of rehabilitation medicine to provide more choices and better programs, the future has come, rehabilitation medicine family of "new weapons" because of its good scientific and technological content, painless and non-traumatic physical characteristics, will be from now on, and rehabilitation Together with rehabilitation doctors and therapists, the "new weapons" of the rehabilitation medicine family, because of their technological, painless and non-invasive physical properties, will from now on provide better rehabilitation services for patients, from which people will be able to maximize functional recovery.
Author: Department of Rehabilitation Medicine, Huashan Hospital, Fudan University
Dongyan Xu, Physical Therapist in Charge
Supervisor: Department of Rehabilitation Medicine, Huashan Hospital, Fudan University
Prof. Yi Wu
Professor.