This paper proposes a novel standing assistance robot,which realizes voluntary movements of the patient within a safety motion range.In the previous studies,conventional assistive robots did not require patients to us...This paper proposes a novel standing assistance robot,which realizes voluntary movements of the patient within a safety motion range.In the previous studies,conventional assistive robots did not require patients to use their own physical strength to stand,which led to decreased strength in the elderly.Such general assistive robots helped patients by using a fixed motion reference pathway in spite of their original intention,and as a result,these robots failed to use the physical strength of the patients.Therefore,this study proposes a novel method for assisting the patient to stand up safely while using their physical abilities,by determining the range of movements that can be safely performed from the patient’s physical condition and allowing the patient to move freely within this range.The standing motion is a set of different movements:inclining the trunk forward,lifting the trunk,and extending the trunk.In this study,the range of movements in which the patient can safely stand in each movement is determined in terms of body stability and the muscle output that the patient can generate.Furthermore,this study proposes a robot control method that allows movements based on the patient’s free will if the patient’s posture is within the safety tolerance,and it corrects the movements when the patient’s posture is estimated to fall outside of it.The proposed idea is implemented in our new prototype,and its effectiveness is verified by experimental results with elderly subjects who live in the nursing care house.展开更多
<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Intraoperative surgical planning tools (ISPTs) used in curren...<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Intraoperative surgical planning tools (ISPTs) used in current-generation robotic arm-assisted total knee arthroplasty (RTKA) systems (such as Navio</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;"> and MAKO</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;">) involve employment of postoperative passive joint balancing. This results in improper ligament tension, which may negatively impact joint stability, which, in turn, may adversely affect patient function after TKA. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A simulation-enhanced ISPT (SEISPT) that provides insights relating to postoperative active joint mechanics was developed. This involved four steps: 1) validation of a multi-body musculoskeletal model;2) optimization of the validated model;3) use of the validated and optimized model to derive knee performance equations (KPEs), which are equations that relate implant component characteristics to implant component biomechanical responses;and 4) optimization of the KPEs with respect to these responses. In a proof-of-concept study, KPEs that involved two</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">com</span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">ponent biomechanical responses that have been shown to strongly correlate with poor proprioception (a common patient complaint post-TKA) were used to calculate optimal positions and orientations of the femoral and tibial components in the TKA design implanted in one subject (as reported in a publicly-available dataset). </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The differences between the calculated implant positions and orientations and the corresponding achieved values for the implant components in the subject were not similar to component position and orientation errors reported in biomechanical literature studies involving Navio</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;"> and MAKO</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;">. Also, we indicate how SEISPT could be incorporated into the surgical workflow of Navio</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;"> with minimal disruption and increase in cost. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> SEISPT is a plausible alternative to current-gen</span></span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">eration ISPTs.</span>展开更多
Subject-specific spinal musculoskeletal modeling can help understand the spinal loading mechanism during human locomotion.However,existing literature lacks methods to identify the maximum isometric strength of individ...Subject-specific spinal musculoskeletal modeling can help understand the spinal loading mechanism during human locomotion.However,existing literature lacks methods to identify the maximum isometric strength of individual spinal muscles.In this study,a muscle strength identification method combining isokinetic testing and musculoskeletal simulations was proposed,and the influence of muscle synergy and intra-abdominal pressure(IAP)on identified spinal muscle strength was further discussed.A multibody dynamic model of the spinal musculoskeletal system was established and controlled by a feedback controller.Muscle strength parameters were adjusted based on the measured isokinetic moments,and muscle synergy vectors and the IAP piston model were further introduced.The results of five healthy subjects showed that the proposed method successfully identified the subject-specific spinal flexor/extensor strength.Considering the synergistic activations of antagonist muscles improved the correlation between the simulated and measured spinal moments,and the introduction of IAP slightly increased the identified spinal extensor strength.The established method is beneficial for understanding spinal loading distributions for athletes and patients with sarcopenia.展开更多
基金This work is supported in part by a Grant-in-Aid for Scientific Research B(20H04566),B(22H03998)and C(16K01580)the Japan Society for the Promotion of Science,the Matching Planner Program(VP29117940231)Japan Science and Technology Agency,JST,and Individual Special Research Subsidy from Kwansei Gakuin University.
文摘This paper proposes a novel standing assistance robot,which realizes voluntary movements of the patient within a safety motion range.In the previous studies,conventional assistive robots did not require patients to use their own physical strength to stand,which led to decreased strength in the elderly.Such general assistive robots helped patients by using a fixed motion reference pathway in spite of their original intention,and as a result,these robots failed to use the physical strength of the patients.Therefore,this study proposes a novel method for assisting the patient to stand up safely while using their physical abilities,by determining the range of movements that can be safely performed from the patient’s physical condition and allowing the patient to move freely within this range.The standing motion is a set of different movements:inclining the trunk forward,lifting the trunk,and extending the trunk.In this study,the range of movements in which the patient can safely stand in each movement is determined in terms of body stability and the muscle output that the patient can generate.Furthermore,this study proposes a robot control method that allows movements based on the patient’s free will if the patient’s posture is within the safety tolerance,and it corrects the movements when the patient’s posture is estimated to fall outside of it.The proposed idea is implemented in our new prototype,and its effectiveness is verified by experimental results with elderly subjects who live in the nursing care house.
文摘<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Intraoperative surgical planning tools (ISPTs) used in current-generation robotic arm-assisted total knee arthroplasty (RTKA) systems (such as Navio</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;"> and MAKO</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;">) involve employment of postoperative passive joint balancing. This results in improper ligament tension, which may negatively impact joint stability, which, in turn, may adversely affect patient function after TKA. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A simulation-enhanced ISPT (SEISPT) that provides insights relating to postoperative active joint mechanics was developed. This involved four steps: 1) validation of a multi-body musculoskeletal model;2) optimization of the validated model;3) use of the validated and optimized model to derive knee performance equations (KPEs), which are equations that relate implant component characteristics to implant component biomechanical responses;and 4) optimization of the KPEs with respect to these responses. In a proof-of-concept study, KPEs that involved two</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">com</span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">ponent biomechanical responses that have been shown to strongly correlate with poor proprioception (a common patient complaint post-TKA) were used to calculate optimal positions and orientations of the femoral and tibial components in the TKA design implanted in one subject (as reported in a publicly-available dataset). </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The differences between the calculated implant positions and orientations and the corresponding achieved values for the implant components in the subject were not similar to component position and orientation errors reported in biomechanical literature studies involving Navio</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;"> and MAKO</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;">. Also, we indicate how SEISPT could be incorporated into the surgical workflow of Navio</span><sup><span style="font-size:12px;font-family:Verdana;"><span lang="ZH-CN" style="font-size:12pt;font-family:宋体;">®</span></span></sup><span style="font-family:Verdana;"> with minimal disruption and increase in cost. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> SEISPT is a plausible alternative to current-gen</span></span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">eration ISPTs.</span>
基金supported in part by the National Natural Science Foundation of China(grant numbers 12132009,12102035,and 12125201)Beijing Natural Science Foundation(grant number L212008).
文摘Subject-specific spinal musculoskeletal modeling can help understand the spinal loading mechanism during human locomotion.However,existing literature lacks methods to identify the maximum isometric strength of individual spinal muscles.In this study,a muscle strength identification method combining isokinetic testing and musculoskeletal simulations was proposed,and the influence of muscle synergy and intra-abdominal pressure(IAP)on identified spinal muscle strength was further discussed.A multibody dynamic model of the spinal musculoskeletal system was established and controlled by a feedback controller.Muscle strength parameters were adjusted based on the measured isokinetic moments,and muscle synergy vectors and the IAP piston model were further introduced.The results of five healthy subjects showed that the proposed method successfully identified the subject-specific spinal flexor/extensor strength.Considering the synergistic activations of antagonist muscles improved the correlation between the simulated and measured spinal moments,and the introduction of IAP slightly increased the identified spinal extensor strength.The established method is beneficial for understanding spinal loading distributions for athletes and patients with sarcopenia.
