対麻痺者の新しい歩行補助ロボットWPAL(Wearable Power‐Assist Locomotor)に関する予備的検討  [in Japanese] A Preliminary Report about a new Robot WPAL (Wearable Power-Assist Locomotor) for Paraplegic Gait Reconstruction  [in Japanese]

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Author(s)

    • 清水 康裕 SHIMIZU Yasuhiro
    • 藤田保健衛生大学坂文種報徳會病院リハビリテーション科 Department of Rehabilitation Medicine, Fujita Health University, Banbuntane-Hotokukai Hospital
    • 鈴木 亨 SUZUKI Toru
    • 藤田保健衛生大学医療科学部リハビリテーション学科 Faculty of Rehabilitation, School of Health Sciences, Fujita Health University
    • 才藤 栄一 [他] SAITOH Eiichi
    • 藤田保健衛生大学医学部リハビリテーション医学I講座 Department of Rehabilitation Medicine, School of Medicine, Fujita Health University
    • 田辺 茂雄 TANABE Shigeo
    • 藤田保健衛生大学医療科学部リハビリテーション学科 Faculty of Rehabilitation, School of Health Sciences, Fujita Health University
    • 加藤 正樹 KATOH Masaki
    • 藤田保健衛生大学病院リハビリテーション部 Department of Rehabilitation Medicine, Fujita Health University Hospital
    • 尾関 恩 OZEKI Megumi
    • 藤田保健衛生大学医療科学部リハビリテーション学科 Faculty of Rehabilitation, School of Health Sciences, Fujita Health University

Abstract

対麻痺者の歩行再建には骨盤帯長下肢装具が用いられている.装具は,関節の自由度を制限することで立位や歩行の安定を得る.しかし起立・着座の困難や歩行時の上肢への負担が大きく,実生活での使用に限界があった.股・膝・足関節に屈曲伸展自由度と力源を有する歩行補助ロボットWPAL(Wearable Power-Assist Locomotor)を開発中であり,予備的検討として,従来装具であるPrimewalkと比較した.1)対麻痺者3名において,歩行器を用いての起立・着座の自立度と歩行距離を比較した.装具では介助や見守りを要した例を含め,WPALでは3 名とも起立・着座と歩行が自立した.連続歩行距離はPrimewalkの数倍であった.2)練習期間が最長であった対麻痺者1名でトレッドミル上の6 分間歩行における心拍数,PCI,修正ボルグ指数,体幹の側方方向の動揺を比較した.心拍数,PCI,修正ボルグ指数が有意に低く,体幹の側方動揺が有意に少なかった.下肢に自由度と力源を付与したWPALは対麻痺歩行再建の実現化を大きく前進させるものと考えられた.

To restore gait function in paraplegic patients, hip-knee-ankle-foot orthoses are available. Orthoses maintain patient stability when standing and walking by restricting the degree of freedom the lower extremity joints. The disadvantages of orthoses include difficulties in standing and sitting movements, and the large burden placed on the upper extremities in walking. Usage of orthoses in daily living was therefore restricted. We are developing a gait assist robot, which we named WPAL (Wearable Power-Assist Locomotor). WPAL has a high degree of freedom and internal power for flexion-extension direction in each hip, knee, ankle joint. We compared WPAL with the conventional Primewalk orthosis as a preliminary investigation. (1) We compared independent standing ability and walking distance of a walker in WPAL and Primewalk orthosis. All three subjects achieved an independent level in standing and walking in WPAL, despite these users requiring assistance when using the Primewalk. Walking distances with the WPAL were several times greater when compared to walking distance with the Primewalk. (2) We performed a single case study using the patient who made the most entries into WPAL exercise. We compared heart rate, physiological cost index (PCI), modified Borg scale, lateral sway of trunk in 6 minutes walking on treadmill. His heart rate, PCI, and modified Borg scale were significantly lower and lateral sway was significantly smaller in WPAL gait. WPAL which has degree of freedom and internal power in the lower extremities is considered a step toward practical powered orthoses use in gait reconstruction for spinal cord injuries.

Journal

  • The Japanese Journal of Rehabilitation Medicine

    The Japanese Journal of Rehabilitation Medicine 46(8), 527-533, 2009

    The Japanese Association of Rehabilitation Medicine

Cited by:  8

Codes

  • NII Article ID (NAID)
    130000145911
  • NII NACSIS-CAT ID (NCID)
    AN00250275
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    1881-3526
  • NDL Article ID
    10412274
  • NDL Source Classification
    ZS35(科学技術--医学--外科学・整形外科学・麻酔学)
  • NDL Call No.
    Z19-283
  • Data Source
    CJPref  NDL  J-STAGE 
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