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Dual Mode Feedback-Controlled Cycling System for Upper Limb Rehabilitation of Children with Cerebral Palsy

  • Cho, Seung-Yeon (School of Mechanical and Control Engineering, Handong Global University) ;
  • Kim, Jihun (School of Mechanical and Control Engineering, Handong Global University) ;
  • Seo, Seong-Won (School of Mechanical and Control Engineering, Handong Global University) ;
  • Kim, Sung-Gyung (Pediatric Physiotherapy, K Institute of Motor Development) ;
  • Kim, Jaehyo (School of Mechanical and Control Engineering, Handong Global University)
  • 투고 : 2018.12.06
  • 심사 : 2019.03.10
  • 발행 : 2019.03.31

초록

Background/Objectives: This paper proposes a dual mode feedback-controlled cycling system for children with spastic cerebral palsy to rehabilitate upper extremities. Repetitive upper limb exercise in this therapy aims to both reduce and analyze the abnormal torque patterns of arm movements in three- dimensional space. Methods/Statistical analysis: We designed an exercycle robot which consists of a BLDC motor, a torque sensor, a bevel gear and bearings. Mechanical structures are customized for children of age between 7~13 years old and induces reaching and pulling task in a symmetric circulation. The shafts and external frames were designed and printed using 3D printer. While the child performs active/passive exercise, angular position, angular velocity, and relative torque of the pedal shaft are measured and displayed in real time. Findings: Experiment was designed to observe the features of a cerebral palsy child's exercise. Two children with bilateral spastic cerebral palsy participated in the experiment and conducted an active exercise at normal speed for 3 sets, 15 seconds for each. As the pedal reached 90 degrees and 270 degrees, the subject showed minimum torque, in which the child showed difficulty in the pulling task of the cycle. The passive exercise assisted the child to maintain a relatively constant torque while visually observing the movement patterns. Using two types of exercise enabled the child to overcome the abnormal torque measured in the active data by performing the passive exercise. Thus, this system has advantage not only in allowing the child to perform the difficult task, which may contribute in improving the muscle strength and endurance and reducing the spasticity but also provide customizable system according to the child's motion characteristic. Improvements/Applications: Further study is needed to observe how passive exercise influences the movement characteristics of an active motion and how customized experiment settings can optimize the effect of pediatric rehabilitation for spastic cerebral palsy.

키워드

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Figure 1. 3D Model of the Cycling System Device and Its Mechanical Components

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Figure 2. System Control Block Diagram

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Figure 3. Prototype

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Figure 4. Dual Mode Experimental Results

참고문헌

  1. Sung-Hoon Kang, Young-Hyeon Bae, "Comparison between the Effect of Aquatic Exercise Program and Land Exercise Program in Spastic Cerebral Palsy on Motor Function and Balance.", Med. J. Cairo Univ, Vol. 84, No. 1, March: 1-8, 2016
  2. Bobath, Karel, A neurophysiological basis for the treatment of cerebral palsy, Phil: JB Lippincott, 1980
  3. Virginia Knox, Andrew Lloyd Evans, "Evaluation of the Functional Effects of a Course of Bobath Therapy in Children with Cerebral Palsy.", Developmental Medicine and Child Neurology, 44: 447-460, 2002 https://doi.org/10.1111/j.1469-8749.2002.tb00306.x
  4. M. Ketelaar, "Effects of a Functional Therapy Program on Motor Abilities of Children with Cerebral Palsy.", Physical Therapy, Vol. 81, Issue 9, Pages 1534-1545, 2001 https://doi.org/10.1093/ptj/81.9.1534
  5. Geum-Ran Park, Jung-Soon Shin, "Rehabilitation of children with cerebral palsy riding effect on improving gross motor function.", The Korea Journal of Sports Scienc, 1, Vol. 20, No. 1, pp. 775-78, 2011
  6. Krick J, Murphy-Miller P, Zeger S, Wright E, "Pattern of growth in children with cerebral palsy." Journal of the American Dietetic Association, Vol. 96, Issue 7, Pages 680-685, 1996 https://doi.org/10.1016/S0002-8223(96)00188-5
  7. Park, Eun-Young, "Correlation between Manual Ability Classification System and Functional Evaluation in Children With Spastic Cerebral Palsy.", The Journal of the Korea Contents Association, Vol 9, Issue 7, p.248-256, 2009 https://doi.org/10.5392/JKCA.2009.9.7.248
  8. Lee, Hyun-Ju, Yi, Seung-Ju, "The Effect on Grip and Pinch Strength with Elbow and Wrist Angle.", The Journal of Korean Society of Physical Therapy, Vol. 15, No. 4, p.967-973, 2003
  9. Agnes Roby-Brami, Stephane Jacobs, Nezha Bennis, Mindy F. Levin, "Hand orientation for grasping and arm joint rotation patterns in healthy subjects and hemiparetic stroke patients.", Brain Research 969, p217-229, 2003 https://doi.org/10.1016/S0006-8993(03)02334-5
  10. Rosenbaum P, Daneth N, Leviton A, et al, "A Report: The Definition and Classification ofCerebral Palsy." Dev Med Child Neurol Suppl, 109:8-14, 2007
  11. Capute and Accardo's Neurodevelopmental Disabilities in Infancy and Childhood, Third Edition. Edited by Pasquale J. Accardo, MD. 2008, Paul H. Brookes Publishing Co, Baltimore, MD. p17.