This paper presents a 1-DOF robot for hand rehabilitation exercises for hemiplegic patients. The robot provides the cylindrical grasp movement, which is one of the dominant Activities of Daily Living. Linkage Sliding Mechanism allows the proposed robot to be a simple and lightweight structure. Motion test for the healthy subjects are carried out to verify the performance of the robot. Consequently, it was confirmed that the proposed robot was suitable for performing hand rehabilitation treatment.

목적 : 본 연구는 상지운동장애를 가진 아동에게 상지재활로봇치료가 기능회복에 미치는 영향에 대하여 문 헌을 고찰하고 그 효과를 메타분석을 통해 알아보고자 한다. 연구방법 : 국외 검색엔진을 이용하여 자료를 수집하였다. 주요 검색용어는 ‘Upper extremity’, ‘Robotic’, ‘Rehabilitation’, ‘Child’ 등이 사용되었다. 2010년 1월부터 2020년 12월까지 게재된 연구 중 선정기준에 적합한 논문 22편을 선정하여 분석하였다. 결과 : 연구의 질적 분석 및 계량적 메타분석, 상지 재활로봇의 종류와 로봇 치료 전·후로 사용된 측정도 구를 분석하였다. 상지운동장애를 가진 아동에게 상지재활로봇치료의 효과는 큰 효과크기로 나타났으며, 통계적으로 유의하였다(p < .05). 결론 : 상지운동장애를 가진 아동에게 상지재활로봇의 치료는 로봇의 종류와 상관없이 기능회복에 효과적 임을 알 수 있었다. 이것은 임상에서 아동에게 상지 재활치료를 위한 치료방법으로 객관적인 근거가 될 수 있을 것이다.

목적 : 본 연구에서는 표전 근전도 신호를 기반으로 기존의 재활로봇 알고리즘의 성능의 개선하기 위한 새로운 특징 요소를 개발 및 검증하였다. 연구방법 : 기존의 선형 재귀 모델을 기반으로 한 실시간 로봇 제어 알고리즘을 수정하여, 2개 이상의 주파수 특징을 가지는 근 전도신호에 그 특징의 수에 맞추어 주파수 영역을 다르게 한 모델을 개발하였다. 결과 : 측정된 결과 개선된 알고리즘의 모델이 기존 모델대비 높은 정확도가 나옮을 확인할 수 있었으며, 향후 이를 적용 한다면, 근전도 기반 재활로봇의 정확도가 향상될 수 있음을 확인할 수 있었다. 결론 : 본 연구에서 제안된 복수의 필터뱅크 특징을 기반으로 한 개선될 선형 재귀알고리즘이 기존 알고리즘보다 높은 성능을 보임을 확인할 수 있었다. 이를 바탕으로 향후 뇌졸중 환자의 치료를 위한 재활 로봇을 제어하는데 활용된다면, 환자의 의지를 더욱 정확히 반영한 재활치료를 통하여 환자의 재활치료효과를 증진시킬 것이라 기대된다.

목적 : 로봇을 이용한 과제 기반의 로봇 상지재활 치료가 뇌졸중 환자의 상지 운동기능과 일상생활수행 (Activities of Daily Living; ADL)능력에 어떤 효과가 있는지 체계적 고찰과 메타분석을 실시하여 검 증하고자 하였다. 연구방법 : 1980년부터 2015년 12월까지 발표된 국외 무작위 대조군 실험(Randomized Controlled Trial; RCT)연 구들 중에서 과제와 함께 이루어지는 상지 로봇 재활치료를 대상으로 분석을 실시했다. EMBASE, Ovid-Medline, PubMed, CINAHL, Cochran CENTRAL을 통해 문헌검색과 선별을 실시했고, Scottish Intercollegiate Guidelines Network (SIGN)으로 문헌의 질평가를 The Grading of Recommendations, Assessment, Development and Evaluation (GRADE)로 근거의 수준을 마련했다. Cochrane collaboration’s tool for assessing risk of bias로 편향을 측정하고 RevMan 5.3 소프트웨어로 메타분석을 실시했다. 개별 연구들의 대상자 수, 중재 전-후 평균값, 표준편차 등을 자료합성에 사용하였다. 결과 : 12편의 연구가 최종 선정되었고 실험군의 대상자수는 총 341명(남성 235명, 여성 106명), 연령은 60.50 ± 5.51세의 분포를 보였다. 대조군의 경우 대상자수가 모두 301명(남성 207명, 여성 94명)이었고 58.55 ± 17.1세의 연령대를 보였다. 운동기능 전체의 효과크기는 2.63, Fugl-Meyer Motor Assessment (FMA)가 2.98, Box and Block Test가 2.25로 기능증진에 효과가 있었고, ADL 수행능력에서는 기능적 독립성 측정 (Functional Independence Measure; FIM)의 3.04을 제외하고 효과가 없었다. 결론 : 과제기반의 로봇상지재활치료는 뇌졸중 환자의 상지 운동기능과 ADL 수행능력에 전반적인 효과를 줄 수 있다. 장기적인 관점에서 로봇을 이용한 상지재활치료의 효과여부의 확인을 위해 임상 평가의 점 수나 등급으로 산출되는 결과변수에 대한 세밀한 추가 연구가 필요하다.

Robot-assisted rehabilitation therapy has been used to increase physical function in post-stroke patients. The aim of this meta-analysis was to identify whether robot-assisted gait training can improve patients’ functional abilities. A comprehensive search was performed of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Academic Search Premier (ASP), ScienceDirect, Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database up to April, 2014. Fifteen eligible studies researched the effects of robot-assisted gait training to a control group. All outcome measures were classified by International Classification of Functioning, Disability, and Health (ICF) domains (body function and structures, activity, and participation) and were pooled for calculating the effect size. The overall effect size of the robot-assisted gait training was .356 [95% confidence interval (CI): .186∼.526]. When the effect was compared by the type of electromechanical robot, Gait Trainer (GT) (.471, 95% CI: .320∼.621) showed more effective than Lokomat (.169, 95% CI: .063∼.275). In addition, acute stroke patients showed more improvement than others. Although robot-assisted gait training may improve function, but there is no scientific evidence about the appropriate treatment time for one session or the appropriate duration of treatment. Additional researchers are needed to include more well-designed trials in order to resolve these uncertainties.

NREX, an upper limb exoskeleton robot, was developed at the National Rehabilitation Center to assist in the upper limb movements of subjects with weak muscular strength and control ability of the upper limbs, such as those with hemiplegia. For the free movement of the shoulder of the existing NREX, three passive joints were added, which improved its wearability. For the flexion/extension movement and internal/external rotation movement of the shoulder of the robot, the ball lock pin is used to fix or rotate the passive joint. The force and torque between a human and a robot were measured and analyzed in a reaching movement for four targets using a six-axis force/torque sensor for 20 able-bodied subjects. The addition of two passive joints to allow the user to rotate the shoulder can confirm that the average force of the upper limb must be 31.6% less and the torque must be 48.9% less to perform the movement related to the axis of rotation.

This paper presents a force control based on the observer without taking any force or torque measurement from the robot which allows realizing more stable and robust human robot interaction for the developed multi-functional upper limb rehabilitation robot. The robot has four functional training modes which can be classified by the human robot interaction types: passive, active, assistive, and resistive mode. The proposed observer consists of internal disturbance observer and external force observer for distinctive performance evaluation. Since four training modes can be quantitatively identified as impedance variation, position-based impedance control with feedback and feedforward controller was applied to the assistive training mode. The results showed that the proposed sensorless observer estimated cleaner and more accurate force compared to the force sensor and the impedance controller embedded with the proposed observer completed the assistive training mode safely and properly.

This paper describes the development of a hand module of NREX (National Rehabilitation Center Robotic Exoskeleton) designed to assist individuals with sustained neurological impairments such as stroke and spinal cord injuries. To construct a simple and lightweight hand module, the robotic hand adopts a mechanism driven by a motor and moved by two four-bar linkages. The motor facilitates the flexion-extension movements of the thumb and the other four fingers simultaneously. Thus, an individual using the robotic hand module can effectively grip and release objects related to daily life activities. The robotic hand module has been designed to cover the range of motion with respect to its link distance. This hand module can be used in therapeutic rehabilitation as well as for daily life assistance. In addition, this hand module can either be mounted on an NREX or used as a standalone module.

The purpose of this study was to investigate effect of robot-assisted hand rehabilitation(AmadeoⓇ) on hand motor function in chronic stroke patients. This study used a single-subject experimental design with multiple baselines across individuals. Three chronic stroke survivors with mild to sever motor impairment took part in study. Each participants had 2 weeks interval of starting intervention. Participants received robot-assisted therapy(45min/session. 3session/wk for 6wks). Finger active range of motion(AROM) was assessed by Range of Assessment program in AmadeoⓇ, and test-retest reliability was verified using Pearson correlation analysis. To investigate effect of AmadeoⓇ, finger AROM was measured immediately after each sessions and Fugl-Meyer Assessment of Upper extremity, Motor Activity Log, Nine hole peg board test and Jebsen-Taylor hand motor function test were assessed at pre-post intervention. Results were analyzed by visual analysis and comparison of pre-post tests. The test-retest reliability of Range of Assessment was good(r=.99). After robot-assisted therapy, finger AROM of participant 1, 2, and 3 was respectively improved by 18%, 3.6%, and 6% each. Hand motor function of participant 1, 3 was improved on all four tests, but not effect in participant 2. Robot-assisted hand rehabilitation could improve finger AROM and effect on hand motor function in chronic stroke patients.

One of the important issues for structural and electrical specifications in developing a robot is to determine lengths of links and motor specifications, which need to be appropriate to the purpose of robot. These issues become more critical for a gait rehabilitation robot, since a patient wears the robot. Prior to developing an entire gait rehabilitation robot, designing of a 1DOF assistive knee joint of the robot is considered in this paper. Human gait motions were used to determine an allowable range of knee joint that was rotated with a linear type actuator (ball-screw type) and links. The lengths of each link were determined by using an optimization process, minimizing the stroke of actuator and the total energy (kinetic and potential energy). Kinetic analysis was performed in order to determine maximum rotational speed and maximum torque of the motor for tracking gait trajectory properly. The prototype of 1 DOF assistive knee joint was built and examined with a impedance controller.