Antropomotoryka nr 57 [2012]. - Akademia Wychowania Fizycznego ...

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NR 57 2012ANTROPOMOTORYKATHE MOVEMENT OF A HUMAN BEINGIN THE MEDICAL EXOSKELETON –THE ANTHROPOMOTORIC ASPECTSPORUSZANIE SIĘ CZŁOWIEKA W EGZOSZKIELECIEMEDYCZNYM – ASPEKTY ANTROPOMOTORYCZNEEmilia Mikołajewska*, Dariusz Mikołajewski*****PhD, Department of Rehabilitation, 10th Military Clinical Hospital with Polyclinic SPS ZOZ in Bydgoszcz, Poland***MSc, Department of Informatics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus Universityin Toruń, PolandKey words: rehabilitation, physical therapy, exoskeletons, biomechanicsSłowa kluczowe: rehabilitacja, fizjoterapia, egzoszkielety, biomechanikaSUMMARY • STRESZCZENIEExoskeletons are mechanical constructions attached to particular parts of a human body, supporting itsmovement with the in-built effectors. Exoskeletons are promising solutions as rehabilitation devices and astools, supporting patients, medical personnel, families and caregivers in everyday life activities. They may beparticularly helpful for the people with deficiencies and those who suffer from pathology of the central nervoussystem (CNS) in result of, for instance, a stroke. The aim is to improve the quality of life of such peopleby supporting and expanding their motoricity. As for today, the knowledge and understanding in the area ofadaptation of a human being to walking and performing everyday life activities in combination with such robotsas exoskeletons are limited. This article is aimed at estimating to what extent the possibilities in this field arebeing exploited.Egzoszkielety są konstrukcjami mechanicznymi mocowanymi do poszczególnych części ciała człowieka,wspomagającymi jego ruch za pomocą wbudowanych efektorów. Egzoszkielety stanowią obiecujące rozwiązaniazarówno jako urządzenia rehabilitacyjne, jak i wspierające pacjentów, personel medyczny, rodziny lub opiekunóww czynnościach codziennego życia. Mogą być szczególnie pomocne u osób z osłabieniami oraz cierpiących z powodupatologii ośrodkowego układu nerwowego, spowodowanych np. udarem. Celem ich funkcjonowania jestpoprawa jakości życia tych osób przez wsparcie i rozszerzenie ich zdolności motorycznych. Aktualny stan wiedzyoraz zrozumienie zagadnienia adaptacji człowieka do chodzenia i wykonywania czynności życia codziennegowe współdziałaniu z takimi robotami, jak egzoszkielet, są mocno ograniczone. Artykuł jest próbą oceny, w jakimstopniu wykorzystuje się dziś możliwości w tej dziedzinie biomechaniki.IntroductionThe medical exoskeleton, defined as a power suit attachedto particular points of the user’s body, allowinghim to expand his strength and motor capabilities (includingthe lost or limited ones) constitutes a promisingsolution in the field of medical robotics (includingrehabilitation robotics) for the people with deficits of thecentral nervous system or with the weakened musclepower. The exoskeleton is an excellent solution for thedisabled, seriously ill and elderly people not only in thearea of their mobility (replacing wheelchair and expand– 115 –
Emilia Mikołajewska, Dariusz Mikołajewskiing its capabilities) but also as a rehabilitation deviceinteracting with the user all day long in the course of thestandard exploitation of the device. Therefore, the importantelement is the analysis of the exoskeleton andthe interaction between a human being and a machineboth on the bio-cybernetic and biomechanical levels,which overlap here. It seems particularly significantalso from the viewpoint of introducing the steering ofexoskeletons with brain-computer interface (BCI). Oneof the research projects conducted nowadays in thisarea is MindWalker [2, 3]. In the market, there are alreadyfirst two commercial medical exoskeletons: HAL5and ReWalk (versions B1/B2); and the consecutive one– eLegs – is to be available in the middle of 2012 [4, 5].In the course of clinical trials and the development ofknowledge on the exoskeletons, the dynamic growth oftheir clinical applications is predicted.Two main basic groups of the applications of theexoskeletons are being under consideration here:• r e h a b i l i t a t i v e m o d e – the use of the exoskeletonin case of severely ill people, the disabled andthe aged as an ultra modern equivalent of a combinationof today’s wheelchair with a rehabilitationrobot, and the tele-medical system (for instance,tele-supervision); the aim of using the exoskeletonmay be here of a dualistic nature: providing the constantsupport of everyday life activities and mobilityby replacing, strengthening and supplementingthe particular functions’ parameter or else – whenthe exoskeleton is used temporarily – training theabove-mentioned functions (e.g. while gradually reducingthe support), so that – when the using of theexoskeleton has been completed – those functionsare performed by a patient in an improved way;• a s s i s t i v e m o d e – the use of the exoskeletonas a supporting device for medical personnel andcaregivers of the severely ill people, the disabledand the aged, particularly in case of the activitiesrequiring a great physical effort: the change of a position,moving over, assuming the upright position orreeducation of walking, bathing etc. [6, 7, 8, 9, 10].Scientific research on exoskeletons focuses primarilyon the understanding of biomechanics, nervous control,and energetic cost of the movement of a humanbeing in the exoskeleton and without it. It may suppleThe Alternative for a Wheelchair:The two-limb alternative (the exoskeletons only for lower limbs)The four-limb alternative (the exoskeletons for both lower andupper limbs)Supporting manyeveryday life activitiesNecessity to develop safetyand emergency systemsReducing energy costof a movement(e.g. in case of enfeeblement)Complex procedure of theuser’s adaptationand trainingPossibility of compensation(also temporary)of the OUN deficitsAdvantagesDisadvantagesIndividualchoiceAdjusting the steeringto the kind and levelof a deficitThe possibility of steeringwith the help of the brain-computerinterface (e.g. the MindWalker project)Exoskeleton is amobile rehabilitationdevice anda platform for telemedicalequipmentFigure 1. Advantages and disadvantages of using exoskeletons in rehabilitationNot fully examinedlong-term effectsof the exploitation– 116 –
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ORIGINAL PAPERSPRACE ORYGINALNE
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Kazimierz Mikołajec, Adam Maszczyk
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