Study On Precise Rehabilitation System For Bone And Joint Injury

Rehabilitation after bone and joint injury is a major clinical problem and has increasingly become one of the main causes of human disability and death.For the evaluation of limb muscle state after bone and joint injury,the external characterization methods are mainly used clinically,such as circumference measurement,joint range of motion measurement,local tension judgment of soft tissue,muscle contraction strength and endurance ability measurement.These methods have great subjectivity and uncertainty,and only qualitative grade evaluation can be carried out,and objective and accurate quantitative evaluation cannot be achieved.For the rehabilitation of bone and joint injury,the traditional rehabilitation treatment mainly includes local physiotherapy,active and passive joint movement and various physical measures.Patients vary greatly from person to person,and the underlying pathology may not be the same for the same performance.The current rehabilitation treatment lacks personalized and accurate treatment for diseases,resulting in the shortcomings of long rehabilitation cycle and inconspicuous effect,which can no longer meet the patients’ needs for higher quality of life and health status.The premise of accurate rehabilitation is accurate assessment.In this article,we design a set of closed-loop active rehabilitation system based on real-time biological signal feedback for the rehabilitation problem of bone and joint injury.And we study the key scientific issues of the mechanism of waste-use muscle atrophy and the rehabilitation utility of electrical stimulation based on this rehabilitation system.This closed-loop active rehabilitation system combined with many physiological parameters can not only realize the real-time dynamic monitoring of muscle physiological function in situ and accurate assessment of the state of disuse muscular atrophy,but also can take this as feedback,it is of great practical value to carry out precise electrical stimulation therapy to promote the rehabilitation of motor function of limbs more effectively and to rehabilitate the injured bones and joints.The main research content and innovation points of this article include:1)Hardware design and implementation of precise rehabilitation system after bone joint injury.To solve the key scientific issues after bone and joint injury,we designed and implemented a platform for accurate rehabilitation after bone and joint injury,integrating multi-channel s EMG acquisition system,multi-channel electrical stimulation system and flexible multi-modal biological parameters acquisition system.We also developed a closed-loop algorithm for the application of lower limb rehabilitation to adjust the intensity and pointed muscle of electrical stimulation based on the RMS value of s EMG and the angle of the lower limb moves.We also developed a flexible patch system with the measurement of skin impedance,blood oxygen,temperature,and p H as the extension system.The whole system can realize highprecision measurement of EMG and multi-physiological parameters,and apply appropriate electrical stimulation based on EMG and angle feedback.It integrates sensing,monitoring,and treatment,and realizes the closed-loop active rehabilitation based on real-time biological feedback.It solves the shortcomings of separation of sensing and rehabilitation and lack of personalized closed-loop rehabilitation with realtime dynamic feedback in the existing techniques.2)Non-invasive diagnosis of the causes of atrophy for bone and joint injury patients.A non-invasive surface Electromyography(s EMG)method is proposed,which uses the comprehensive analysis of time domain parameters and frequency domain parameters,combined with the application of machine learning algorithms,to successfully distinguish atrophy caused by nerve injury and muscle atrophy caused by limb braking.The specificity and sensitivity are 95.28% and 98.98%,respectively;it also achieves specificity(89.72%)and sensitivity(91.94%)during clinical diagnosis(91.94%).To a certain extent,it saves the complication of MRI and other examination methods,solves the shortcomings of the traditional bedside invasive diagnosis method,such as pain and single measuring point,and improves the accuracy of surface electromyography diagnosis.3)Non-invasive quantification of disuse atrophy for bone and joint injury patients.A multimodal assessment of the degree of muscle fiber atrophy after limb fracture using EMG,impedance,and blood oxygen is proposed.And a new s EMG signal analysis method is proposed to characterize the degree of atrophy of different types of muscle fibers.This new signal analysis method divides the frequency bands into different bounds to calculate the specific contribution range of the two types of muscle fibers to the s EMG spectrum.The frequency domain parameters had a high correlation coefficient of 0.945 and 0.974 with the mean cross-sectional area(CSA)parameters of fast and slow muscle fibers.This approach addresses the problems of the relatively single modality in conventional muscle atrophy characterization methods and the tissue staining requiring invasive biopsy testing of muscle tissue.4)The study of the effect of hybrid electrical stimulation on disuse atrophy for bone and joint injury patients.We proposed a targeted low frequency and high frequency hybrid functional electric stimulation(FES)parameter model.With the rat hind limb suspension model and electric stimulation application,we observed the change of fiber cross-sectional area and s EMG after electric stimulation intervention.After the proposed stimulation method was applied for 7 days,compared with the scheme of applying low-frequency FES or higher frequency FES alone,the proposed mixed FES scheme had a significant effect on slowing down the shrinkage of the two fibers,which changes the limitation that traditional electrical stimulation only affects single types of fiber,and improves the rehabilitation effect of the overall fiber.5)Non-invasive multi-modal monitoring of the wound healing process for bone and joint injury patients.The monitoring of wound regeneration in Bama pig fullthickness skin wound model was studied.Wound impedance,blood oxygen,p H,and temperature indicators are consistent with the biochemistry of the inflammatory cells actual in the wound,and observed the phenomenon of different recovery speeds on different samples,solving the wound surface caused by the wounds of traditional dressings in the wound position.The "black box" state and the relatively single problem of the mode of characterization have achieved a sense of quantitative awareness of the wound recovery process.