System and method for restoring human motor activity

Abstract

The claimed system and method relate to restoring motor activity in case of neurological disorders and musculoskeletal system diseases. The system is a robotic kinesiotherapy two-tiered exoskeleton includinga stationary three-dimensional frame skeleton (SS), anda controllable movable skeleton (CMS) of kinematically connected orthopaedic modules (OM) fastened to corresponding body parts. The system also includes a subsystem displaying a virtual reality associated with the exoskeleton, position control hardware/software (PCHS) for each OM, and feedback means, employing physiological indicator sensors (PIS), wherein each OM and PIS is connected to PCHS via SS. For restoring a patient's movement and training purposes, matrices of movement stereotypes are generated as an individual virtual motor pattern, and transmitted to the patient via a visual channel with a signal to CMS to prompt the movement of a corresponding body part. The system facilitates maintaining the patient's individual position and chosen movement direction.

Claims

1. A system for human motor function recovery made as a robotic kinetic trainer with a whole-body exoskeleton, formed by a controlled movable frame, consisting of kinematically interconnected orthopaedic modules with a suspension system that correspond to body parts, designed with a fixation possibility on relevant body parts and actuated by the drives subsystem, the control hardware and software for spatial position change of each orthopaedic module executed on the basis of a computer with a controller with the possibility of controlled connection to each orthopaedic module via the corresponding drive, and the feedback means based on at least one sensor of at least one human body physiological indicator, wherein the controlled movable frame is kinematically connected to the outer rigid fixed frame made as a three-dimensional frame structure defining a space for changing the position of orthopaedic modules and forming a two-layer exoskeleton together with the controlled movable frame, there is also electromechanical drives subsystem on the outer fixed frame, where each of the drives is connected to the corresponding orthopaedic module via the flexible connection, each orthopaedic module and each sensor of the human body physiological indicator are connected to the control hardware and software for spatial position change of each orthopaedic module via the outer fixed frame, the control hardware and software for spatial position change of each orthopaedic module of the claimed system are also equipped with a virtual reality imaging subsystem configured to co-operate with the electromechanical drives subsystem, the two-layer exoskeleton is equipped with the initial suspension position fixation device with support in the hip area and/or in the upper body area.

2. The system according to claim 1 wherein the virtual reality imaging subsystem has at least one visualizer, wherein the control hardware and software for spatial position change of each orthopaedic module are also equipped with a unit for creating at least one specific virtual reality environment connected to the visualizer to generate motor motion images.

3. The system according to claim 1 wherein each orthopaedic module is designed with an option for mechanotherapy of individual joints and/or to transmit vibrational and/or massaging influences to respective body parts.

4. The system according to claim 1 wherein the controlled movable frame is equipped with at least one additional element selected from the group consisting of at least the fixtures and cushioning elements as well as customization elements.

5. The system according to claim 1 wherein the kinematic connection between the orthopaedic modules is ensured by electromechanical parts.

6. The system according to claim 1 wherein the initial suspension position fixation device is designed with a possible lower body support in the perinea region.

7. The system according to claim 1 wherein the initial suspension position fixation device is designed with a possible upper body support.

8. The system according to claim 1 wherein the initial suspension position fixation device is designed separately with a possible upper body support and lower body support in the perinea region with the possibility to adjust the distribution of the fixation percentage between the upper and lower parts.

9. The system according to claim 1 wherein body fixation devices can also be equipped with cushioning components facilitating passive adduction of the body part towards at least one point of the rigid fixed frame.

10. The system according to claim 1 wherein the control hardware and software for spatial position change of each orthopaedic module are designed to remotely record and/or correct the program for the coordinated functioning of the virtual reality imaging subsystem and the electromechanical drives subsystem.

11. The system according to claim 1 wherein the control hardware and software for spatial position change of each orthopaedic module also have a control module in the form of a mechanic arm, designed with a possibility of manual control by the trainee by a spatial position change of each orthopaedic module.

12. A method for human motor function recovery, including preparation of an individual training motor recovery program and creation of motion pattern in the central nervous system according to the prepared program by forced relevant change of the spatial position of body parts using the human motor function recovery system including the exoskeleton connected to computer-based controls wherein the system of claim 1 is used for human motor function recovery, while recovery is carried out in two stages, when at the first stage, stable motion pattern matrices are created or restored in the central nervous system; at the same time, a motor image of at least one virtual motion is generated in accordance with the individual training motor program, which is visualized and transmitted through the visual channel to the trainee's central nervous system, while a control action corresponding to this motion is transmitted to the controlled movable frame of the exoskeleton that forces at least one corresponding body part to move over and over again, and at the second stage, the connections between the surrounding events and the recovered motion pattern matrices are restored as responses to these events; at the same time, a motor image of at least one virtual event requiring a motor response is generated, which is visualized and transmitted through the visual channel to the trainee's central nervous system, followed by a control action corresponding to this motor response transmitted to the controlled movable frame of the exoskeleton that forces at least one corresponding body part to move over and over again, and by doing so, the trainee's condition, in particular the condition of the locomotor system, is monitored using feedback.

13. The method according to claim 12 wherein the training motor program is prepared taking into account the load dosage and complicating the training motions starting with simple ones, performed in lying or standing position.

14. The method according to claim 12 wherein the training motor program is prepared in a way that motor images are created by complicating them from static and statnamic to dynamic ones.

15. The method according to claim 12 wherein the training load is dosed based on previous and current practice results, as well as on dynamic (determined during the practice) assessment of the trainee's locomotor system active structures viscoelasticity in automatic or manual mode.

16. The method according to claim 12 wherein the training motor program is prepared taking into account motion space limitations due to the virtual component, which directs the virtual motion towards the motion space limitation, thus forming an idea in the patient's central nervous system of the potential readiness of the locomotor system to use this part of the motion space.

17. The method according to claim 12 wherein the training motor program is prepared taking into account motion space limitations due to the controlled movable frame of the exoskeleton, using which the practiced motion is oriented towards the motion space limitation, thus forming an idea in the patient's central nervous system of the potential ability of the locomotor system to use this part of the motion space.

18. The method according to claim 12 wherein the training motor program is prepared taking into account motion space limitations due to the virtual component and the controlled movable frame of the exoskeleton, which together strengthen the motion matrix oriented towards motion space limitation.

19. The method according to claim 12 wherein the active practice is provided with overcoming the resistance of the cushioning components facilitating passive adduction of a body part due to an arbitrary movement of the body part in at least one direction of the motion pattern matrix.

Description

[0070] In particular, the drawings outline:

[0071] FIG. 1general view of one of the embodiments of the claimed system (with a patient);

[0072] FIG. 2rear view of the exoskeleton (controlled movable frame) in one of the embodiments of the claimed system (with the patient);

[0073] FIG. 3side view of the exoskeleton (with the patient);

[0074] FIG. 4general view of the rigid fixed frame in one of the embodiments (with the patient);

[0075] FIG. 5side view of FIG. 4 frame;

[0076] FIG. 6bottom view of FIG. 4 frame;

[0077] FIG. 7scheme of the claimed method's motor programming principle;

[0078] FIG. 8scheme of the claimed method's motor control principle;

[0079] FIG. 9simplified hardware and software flowchart;

[0080] FIG. 10the algorithm for determining the viscoelasticity of the locomotor system articulations.

[0081] FIG. 11the algorithm for automatic selection of exercises performed on two legs (two-point exercises) and one leg (one-point exercises).

PREFERRED EMBODIMENTS OF THE INVENTION

[0082] FIG. 1 shows a general view of one of the embodiments of the claimed system for human motor function recovery with a patient. The system is designed as a robotic kinetic trainer containing a whole-body exoskeleton 1. The exoskeleton is formed by a controlled movable frame 2, consisting of kinematically interconnected orthopaedic modules 3 that correspond to body parts. Orthopaedic modules 3 are equipped with fixatives 4 for fixation on respective body parts and are actuated by the drives subsystem (not specified in FIG. 1). The system also has the control hardware and software 5 for spatial position change of each orthopaedic module 3 executed on the basis of a computer with a controller (not specified in the drawings) with the possibility of controlled connection to each orthopaedic module 3 via the corresponding drive. The system also has feedback means based on the sensors (not specified in FIG. 1) of human body physiological indicators 1. The controlled movable frame 2 is kinematically connected to the outer rigid fixed frame 6 made as a three-dimensional frame structure defining a space for changing the position of orthopaedic modules 3 and forming a two-layer exoskeleton together with the controlled movable frame 2. Electromechanical drives subsystem 7 is located on the outer rigid fixed frame 6. Each of the drives is connected to the corresponding orthopaedic module 3 by a flexible connection 8. Each orthopaedic module 3 and each sensor of the human body physiological indicator 1 are connected to the control hardware and software 5 for spatial position change of each orthopaedic module 3 via the outer fixed frame 6. The control hardware and software 5 for spatial position change of each orthopaedic module 3 are also equipped with a virtual reality imaging subsystem configured to co-operate with the electromechanical drives subsystem. The two-layer exoskeleton is equipped with the initial suspension position fixation device 9 with support in the hip area and/or in the upper body area. Each orthopaedic module 3 is designed with an option for mechanotherapy of individual joints.

[0083] FIG. 2 shows the rear view of the exoskeleton, controlled movable frame in one of the embodiments, and FIG. 3 shows the side view. The orthopaedic modules 3 (femoral, knee, etc.) are kinematically interconnected by electromechanical parts 10 effected based on electric motors 11 connected with respective levers 12. Orthopaedic modules 3 (femoral, knee, etc.) can be designed to transmit vibrational and/or massaging influences to respective body parts. The corresponding means are not presented in the drawings in detail, but the experts in this field of invention can implement this function using suitable units and devices available.

[0084] The controlled movable frame can be equipped with additional fixtures and cushioning elements, as well as customization elements. The controlled movable frame 2, in the design presented as an example in FIGS. 2 and 3, is equipped with a pelvic fixative 13 and a cushioning pad 14 located on the support part 15 of the vertical support frame 16 with the suspension system 17. For example, knee, femoral module, etc. can be made cushioning. The support part 15 of the vertical support frame 16, as part of the initial suspension position fixation device, provides for the lower body support in the perinea region. At the same tine, the experts in this field of invention can generally make the initial suspension position fixation devices with a possible upper body support, for example, in the axillary region. Moreover, support (horizontal) sections of such devices can have cushioning pads. Similarly, the initial suspension position fixation devices can be made with a possible upper body support and lower body support in the perinea region with the possibility to adjust the distribution of the fixation percentage between the upper and lower parts, usually, in the automated or automatic mode through the hardware and software 5. Body fixation devices can also be equipped with cushioning components facilitating passive adduction of the body part towards a target point(s) of the rigid fixed frame 6.

[0085] Customization elements can include length adjustable levers 12, girth adjustable fixatives 4 of the orthopaedic modules 3, girth adjustable pelvic fixative 13, etc. All of these elements can be selected by the experts in the field of invention from the prior art or designed to be used in each particular exoskeleton, depending on its general design, conditions of use, etc.

[0086] To ensure performance of anatomically correct controlled motions, besides the electrical motors 11, orthopaedic modules 3 (knee, femoral, etc.) also have a drive shaft 18, a gear 19, a rate-of-turn sensor 20 of the drive shaft 18, a motor temperature sensor 21, etc. The levers 12 of the orthopaedic modules 3 are interconnected by power transmissions, for example by the joints 22.

[0087] Medical orthosis 23, which is put on the patient, is fixed in certain points 24 to the elements of controlled movable frame 2, for example to the vertical support frame 16 and the like. Generally, medical orthosis 23 is equipped with built-in sensors of the human body physiological indicators 1 (temperature sensor, pressure sensor, heart rate sensor, etc.), that are not shown in the drawings. These sensors are located in the medical orthosis 23 in such a way that the readings are transferred from them via the feedback channel through the controlled movable frame 2, flexible connections 8, the outer rigid fixed frame 6 to the hardware and software 5, where they are processed.

[0088] Item 25 shows the elastic suspension system elements connected (in the embodiment presented in FIGS. 2 and 3) with the outer rigid fixed frame 2.

[0089] FIGS. 4-6 show different projections of the outer external rigid fixed frame in one of possible embodiments.

[0090] The outer rigid stationary frame 6 is made as a three-dimensional frame structure of horizontal and vertical elements 26, 27, respectively, defining a space for changing the position of orthopaedic modules 3. In this case, the horizontal 26 and vertical 27 elements of the outer rigid fixed frame 6 are interconnected by angular 28 and upper 29 means for adjusting the geometric parameters of the space for changing the position of the orthopaedic modules 3. In the presented example, height H, width B, and depth L are considered as the parameters of the space for changing the position of the orthopaedic modules 3. Generally, the experts in this field of invention can choose any design of 28, 29 means, allowing each horizontal 26 and vertical 27 element to move with respect to the other interconnected elements 26, 27 in the direction of three coordinate axes for the angular 28 and two coordinate axes for the upper 29 means for adjusting the geometric parameters of the space for changing the position of the orthopaedic modules 3. In particular, the said 28, 29 means can have a telescopic design, as illustrated in FIGS. 4-6. Electromechanical drives 7 of the electromechanical drives subsystem are placed on the outer rigid fixed frame 6.

[0091] In FIG. 4, electromechanical drives part 7 is shown with no reference to the horizontal 26 and vertical 27 elements to illustrate the possibility of placing any number thereof, almost at any point of the fixed frame 6. Moreover, electromechanical drives 7 placed on the horizontal 26 and vertical 27 elements using special fasteners with articulated mechanisms provide for changing the angle between the respective element 26, 27 and directly the electromechanical drive 7 elements securing setting of the flexible connection 8. Flexible connections 8 and the controlled movable frame 2 are not shown in FIGS. 4-6.

[0092] FIGS. 7 and 8 show the implementation schemes of two basic principles: motor programming and motor control respectively, underlying the claimed method of motor function recovery using adaptive kinesitherapy methods, using the claimed system for motor function recovery. Light arrows show the sensory virtual event display channel, and the dark arrows show the mechanical virtual event repetition channel.

[0093] Roman numbers in FIG. 7 show the following stages of the motor programming principle as part of the claimed method: Icustomization of the two-layer exoskeleton to the patient; IIvirtual script run on the computer with transfer of its main events to the imaging system and controller; IIItransfer of the virtual event to the sensory virtual event display channel and mechanical virtual event repetition channel (electromechanical drives system of the two-layer exoskeleton); IVperception of the performed action.

[0094] Roman numbers in FIG. 8 show the following stages of the motor control principle as part of the claimed method: Imechanic arm(s) activation in response to a virtual event (for example: the need to evade an obstacle); IItransfer of this information to the controller and sensory imaging system; IIIchange in the spatial position of the two-layer exoskeleton and the corresponding visual information; IVassessment of the ongoing sensory changes; Vperception of spatial movement.

[0095] FIG. 9 shows a simplified hardware and software 5 flowchart. Software and hardware include the following main units: personal computer 30, including data collection and analysis unit 31, influence program selection unit 32, spatial position change of each orthopaedic module 3 unit 33 and specific virtual reality environment creation unit 34; imaging subsystem 35; controller 36 and mechanic arm 37. In turn, the virtual reality creation unit 34 includes a number of Assist models 38. The imaging subsystem 35 includes at least one visualizer 39 connected to the virtual reality environment creation unit 34 and sends information to the patient's central nervous system in accordance with the imaged assist-model 38. Controller 36 and mechanic arm 37 are connected to the electromechanical drives subsystem. Data collection and analysis unit 31 is connected to the feedback means, including a number of the human body physiological indicators sensors 41, and via the controller 36 is connected to the electromechanical drives subsystem.

[0096] The control hardware and software 5 for spatial position change of each orthopaedic module 3 are designed to remotely record and/or correct the program for the coordinated functioning of the virtual reality imaging subsystem 35 and the electromechanical drives subsystem using relevant remote controls 42.

[0097] FIG. 10 shows the algorithm for determining the viscoelasticity (the elastic barrier) of the locomotor system articulations by the control software and hardware 5 for spatial position change of each orthopaedic module 3 and feedback means (sensors 41). This algorithm is implemented in data collection and analysis unit 31.

[0098] FIG. 11 shows the algorithm for automatic selection of exercises performed on two legs (two-point exercises) and one leg (one-point exercises), which is also implemented in data collection and analysis unit 31.

[0099] The algorithms shown in FIGS. 10 and 11, are only examples of the functionality of the data collection and analysis unit 31 and the hardware and software 5 as a whole, and do not limit the capabilities of the latter.

[0100] The claimed method of human motor function recovery is implemented using the claimed system as follows.

[0101] The medical orthosis 23, equipped with built-in sensors of the human body physiological indicators, is put on person 1. The controlled movable frame 2 (exoskeleton) is put on the lower limb girdle and the upper shoulder girdle of person 1 and fixed on the human body, in particular in the area of the orthopaedic modules 3 using the corresponding fixatives 4, and also using the pelvic fixative 13. In this case, the medical orthosis 23 is fixed to the controlled movable frame elements 2, in particular to the vertical support frame 16 at the respective fixing point(s) 24 so that the lower body support 1 is formed in the perinea region by a horizontally oriented support part 15 of the vertical support frame 16 with the cushioning pad 14 placed thereon. The suspension system in the embodiments shown in the drawings is fixed to the horizontal elements 26 of the outer rigid fixed frame 6 with the elastic elements 25. The tension of the elastic elements 25, adjusted with the hardware and software 5, provides the gravity load/discharge values set for each particular patient and for each specific case.

[0102] The controlled movable frame 2 is connected (via the flexible connections 8) to the outer rigid fixed frame 6 made as a three-dimensional frame structure of the horizontal and vertical elements 26, 27 respectively, defining a space for changing the position of orthopaedic modules 3 and forming a two-layer exoskeleton together with the controlled movable frame. In this case, the controlled movable frame 2 is connected to the outer rigid fixed frame 6 by the flexible connections 8 via the corresponding electromechanical drives 7 located on the fixed frame 6. The horizontal 26 and vertical 27 elements of the outer rigid fixed frame 6 are interconnected by angular 28 and upper 29 means for adjusting the geometric parameters of the space for changing the position of the orthopaedic modules 3. The angular means 28 for adjusting the geometric parameters of the space for changing the position of the orthopaedic modules 3 allow each of the horizontal 26 and vertical 27 elements to move with respect to the other interconnected horizontal 26 and vertical 27 elements along all three coordinate axes. The upper means 29 for adjusting the geometric parameters of the space for changing the position of the orthopaedic modules 3 allow each of the horizontal 26 and vertical 27 elements to move with respect to the other interconnected horizontal 26 and vertical 27 elements along the two coordinate axes located in a horizontal plane. Due to this, in a wide range of values, the height H, the width B and the depth L of the space for changing the position of the orthopaedic modules 3, and also the spatial position of the electromechanical drives 7 with respect to the human body 1 (controlled movable frame 2/medical orthosis 23) can be changed. In addition, by changing the position on the respective horizontal 26 or vertical 27 elements of the electromechanical drive 7, and also by changing (for example, using the appropriate articulated joint), including the one controlled in automatic/automated mode, the angular position relative to the said element 26 or 27, the unit for fixation of the flexible connection 8 of the electromechanical drive 7, it is possible to set the starting positions and the trajectories of the movement of the flexible communication 8 and the orthopaedic modules 3, as well as other controllable movable frame 2 elements in nearly unlimited range.

[0103] Electromechanical drives 7 are connected to the control unit (controller 36) and, if any, to the control module (mechanic arm) 37 from among the control hardware and software 5. Thus, the exoskeleton (controlled movable frame 2) is connected to the controller 36 and/or the mechanic arm 37, if any, from among the control hardware and software 5, directly activating (turn-on and start of various training motor programs and, accordingly, the change in the position electromechanical drives 7 and other actuators) the elements that change the position of orthopaedic modules 3, moving the body parts in the set mode (according to the requirements of the training program). In this case, the electromechanical drives 7, located on the fixed frame 6 (on the horizontal 26 and vertical 27 elements of the frame 6) form a gravity dosing system, which: [0104] facilitates the patient lifting, [0105] provides the patient's gravity load/discharge dosing by controlling the electromechanical drives 7 position relative to the space to change the position of the orthopaedic modules 3 and tensing the elastics elements 25 and flexible linkages 8, [0106] ensures a certain patient's spatial position and selected directions for the necessary movement, [0107] ensures environmental augmentation with displacement over 6 degrees of freedom (roll, pitch and yaw), [0108] creates a potential connection to a full-fledged virtual reality system.

[0109] The features of the two-layer design of the exoskeleton described above provide a highly effective system for customization to a patient, including his or her anthropometric data, as well as to a wide range of implemented techniques, different requirements, conditions and uses.

[0110] An additional advantage of the claimed system is the presence of feedback means (the human body physiological indicators sensors 41), as well as the rate-of-turn sensor 20 of the shaft from among the electromechanical drives 7, etc., which provide for the possibility to perform diagnostics in the automatic/automated mode, for example in accordance with the algorithm for determining the viscoelasticity of the locomotor system articulations presented in FIG. 10, processing of the data obtained from the feedback means (sensor 41) and the controller 36 in the data collection and analysis unit 31 and selection of the influence program in the corresponding unit 32. Diagnostics can be continuously carried out during the practice (performance of the previously selected influence program) with automatic/automated correction of the influence program based on the results of processing data coming to the data collection and processing unit 31. An example of making an automatic/automated correction of the influence program during practice is shown in FIG. 11 as the algorithm for automatic selection of exercises performed on two legs (two-point) and one leg (one-point). In this case, the diagnostics possibility, in particular the determination of the viscoelasticity of the locomotor system articulations, in automatic/automated mode ensures the preparation and implementation of an individual influence program for each patient, which prevents inefficient and unsafe load forcing, in particular, performance of exercises in the modes (the choice of the range of change in joint angles) which still cannot be performed by this patient.

[0111] The hardware and software 5 also has a specific virtual reality rehabilitative environment creation unit 34 with virtual augmentators as basic Assist models 38, as well as the virtual augmentators integrators as basic assist-models 38 with electrical and electromechanical kinetic trainer parts, made as a spatial position change of each orthopaedic module 3 control unit 33, which transmits via the controller 36 the appropriate control actions to the electromechanical drives subsystem to each electromechanical drive 7 and, further, to the controllable movable frame 2. Presence of these units provides an opportunity for effective spatially oriented simulation of various, primarily complex human motions using the claimed method of motor function recovery, which is positioned by the authors as a Smart Dosing technique of step-by-step creation of rigid matrices of motion pattern in the brain: two-level intelligent methodical training load dosing, made automatically for each patient based on the previous practices results and the current evaluation of the joints viscoelasticity.

[0112] This technique, i.e. the claimed method of human motor function recovery, is based on two functioning principles of the claimed systema robotic kinetic trainerthat are used according to certain schemes, namely: [0113] 1. The motor programming principle shown in FIG. 7. [0114] 2. The motor control principle shown in FIG. 8.
The motor programming principle involves parallel activation of two quasi-technical channels: [0115] 1. The sensory virtual event display channel, shown in FIG. 7 in light arrows, is ensured by the interrelations between the specific virtual reality rehabilitative environment creation unit 34 with the virtual augmentators as basic Assist models 38, the imaging subsystem 35 and the patient/trainee. [0116] 2. The mechanical virtual event repetition channel, shown in FIG. 8 in dark arrows, is ensured by the interrelations between the specific virtual reality rehabilitative environment creation unit 34 with the virtual augmentators as basic Assist models 38, virtual augmentators integrators as basic assist-models 38 with the electrical and electromechanical kinetic trainer parts made as a spatial position change of each orthopaedic module 3 control unit 33, and the patient/trainee.

[0117] The term quasi-technical channel used herein includes both purely technical channels/means and information channels/means, as well as the channels formed by the visual and kinesthetic information perception channels and the patient's/trainee's nervous system pathways, ensuring the basic Assist models 38 are transmitted from the virtual reality rehabilitation environment creation unit 34 to the patient's/trainee's CNS.

[0118] In the course of the motor programming, which, in fact, constitutes the first stage of the claimed method, the following actions (steps) are performed:

[0119] 1. Two-layer exoskeleton customization to the patient (adjustment of the limb coverage by orthopaedic modules 3 by adjusting the fixatives 4; adjustment, if any, of the length of the levers 12; adjustment of the tension of the flexible connections 8; adjustment of the suspension system 17 to provide the necessary gravity load/discharge, etc.).

[0120] 2. Virtual script consisting of the basic Assist models 38 run on the computer 30 with the transfer of its main events to the imaging subsystem 35 and the controller 36.

[0121] 3. Parallel transfer of the virtual event to the sensory virtual event display channel and the mechanical virtual event repetition channel with the transfer of the appropriate control action via the controller 36 to the electromechanical drives subsystem 7 to the electromechanical drives 7 of the two-layer exoskeleton installed on the outer rigid fixed frame 6, and to the electromechanical parts 10 (electric motors 11) of the orthopaedic modules 3.

[0122] 4. The patient's perception of the performed action by comparing the visual and mechanical images of the performed motion(s).

[0123] At the last step during the performance of basic motions, the time-matched information received by brain from the complex receptor device, integrating with the information from virtual reality environment coming via the visual channel, creates an illusion of the motion that is imaged in the virtual reality environment. In the process of such repetitions, the brain starts to create a rigid matrix of the given motion, as of its own. As a result of training, basic motion pattern are neurosensory programmed in the brain. These motion patterns can then be arbitrarily used in various combinations, for the patient creating own motor programs and are the basis for implementing the second principle: the motor control principle.

[0124] As in the motor programming principle, the motor control principle involves successive activation of two quasi-technical channels: [0125] 1. The mechanical virtual event repetition channel, shown in FIG. 8 in dark arrows, is ensured by the interrelations between the specific virtual reality rehabilitative environment creation unit 34 with the virtual augmentators as basic Assist models 38, virtual augmentators integrators as basic Assist models 38 with the electrical and electromechanical kinetic trainer parts made as a spatial position change of each orthopaedic module 3 control unit 33, and the patient/trainee. [0126] 2. The sensory virtual event display channel, shown in FIG. 8 in light arrows, is ensured by the interrelations between the specific virtual reality rehabilitative environment creation unit 34 with the virtual augmentators as basic Assist models 38, the imaging subsystem 35 and the patient/trainee.

[0127] In the course of the motor programming, which, in fact, constitutes the second stage of the claimed method, the following actions (steps) are performed:

[0128] 1. Mechanic arm(s) 37 activation in response to a virtual event (for example, the need to evade an obstacle).

[0129] 2. Transfer of this information to the controller 36 and sensory imaging subsystem 35.

[0130] 3. Change in the spatial position of the two-layer exoskeleton and the corresponding visual information.

[0131] 4. Assessment of the ongoing sensory changes.

[0132] 5. Perception of spatial movement.

[0133] A simplified flowchart of the hardware and software 5 as part of the claimed system for human motor function recovery, shown in FIG. 9, contains only the main units and connections, which have a specific design to solve the tasks set to the claimed system and have the optimal embodiment of the claimed method. In addition to the specific units and connections, the software and hardware 5 as part of the claimed system also include the units and connections standard for control systems that ensure the overall system availability.

[0134] It should also be noted that the author carried out a detailed comparative analysis and assessment of the functionality of Lokomat and ReoAmbulator training devices, discussed above, and the system offered by him as a robotic kinetic trainer called TRiNiTi. Comparison results by a number of essential features and functionality is given in the Table 1 below.

TABLE-US-00001 TABLE 1 Comparison of kinetic trainers features and functionality System of the Lokomat/ FUNCTION invention ReoAmbulator Influence on one joint + Influence on several joints at the same time + + Practice in horizontal position + Practice in vertical position + + Practice under dosed gravity (support + + function dosing) Variety of motor images (Assist models) + Neuro-biomechanical dosing of motor + images intensity Multilevel step-by-step dosing by + physical factors Virtual Trainer function + Remote Trainer function + Multiuser design + + Customization + No unit specificity + Design-provided cushioning action + + Pelvic and thoracic fixation + + Motivational correction + + Spatial orientation practice + + Continuous Passive Motion therapy + Coordination practice + Vibration practice + Complex locomotion/Motion sensors +/+ /+

[0135] Thus, the comparative table clearly shows the advantages of the claimed system and method of motor function recovery in comparison with the closest analogs by a big number of characteristics and confirms the possibility of active and passive kinesitherapy techniques performance using the claimed system, imitating the activation, control and assessment of the results achieved for various motions, complex ones in the first place.

[0136] The implementation of the claimed method of motor function recovery will be further illustrated with some non-limiting examples.

EXAMPLES

Example 1. Method of Motor Function Recovery in Parkinson's Disease

[0137] Patient S. 57 years old with a diagnosis of Parkinson's disease, akinetic-rigid form, stage 2.5 by Hoehn and Yahr, was examined on an outpatient basis. In a calm state, the patient had visual signs of a postural imbalance, manifested by postural changes. Also, the patient had postural instability of retropulsion when performing the jogging test. The patient has clinical signs of hypokinesia, manifested, first of all, by a decrease in the total scope of simple motions performed, as moderate motor deficits and walking disorders.

[0138] The patient had a resting tremora small-amplitude tremor combined with a mild postural tremor. When assessing the muscle tone condition, the patient had a moderately pronounced extrapyramidal change with the left half involvement. There was sufficient direct and consensual pupillary light reflex with a slight weakening of accommodation response to convergence.

[0139] Mild asymmetry of tendon and periosteal reflexes with a positive Puusepp reflex. Prior to adaptive kinesitherapy sessions using the motor function recovery system as part of the implementation of the claimed method of motor function recovery, the quality parameters of the patient's stepping motion were impartially assessed using the claimed system (primarily hardware and software 5) embodied in Step functionally complicated version using a video capture system. At the same time, a sensor in the form of an active LED marker was placed in the common center of gravity projection area. When the diagnostic motion was performed, the spatial movement of the marker was video recorded, further, then the Psign (goal directed motion indicator) and the Pnoise (purposeless motion indicator), as well as the Motion Utility Coefficient were calculated in the data collection and analysis unit . . . (video sequence processing program). The diagnostics had the following indicator values: Psign8,561.5; Pnoise560.6; Motion Utility Coefficient6.6.

[0140] These indicators reflect the effectiveness of a complex, standardized locomotion predominantly stabilized in the frontal and sagittal planes. In this case the reference values for healthy persons are: Psign7,840.1 [10,160.1/5864.6]; Pnoise60.7 [102.9/45.4]; Motion Utility Coefficient0.9 [1.4/0.6].

[0141] Based on the indicators assessment results in accordance with the selection of the unit . . . the influence program selection, 20 adaptive kinesitherapy sessions were prescribed for the patient and conducted according to the following scheme, consisting of two stages:

[0142] Stage 1. Consisted of 12 daily procedures, during which the patient was fixed in a controlled movable frame of a two-layer exoskeleton. Given the peculiarities of the disease associated with the left-sided lateralization of motor disorders and the diagnostics results, the influence program selection unit 32 selected (from the hardware and software 5) a stepping motion (as the initiating unit) with support on the right leg and placing the left leg forward (frontal lunge of the left leg), with its subsequent return to the original position to the supporting leg. In the current training program, this motion was a trained motion pattern, the image of which was restored in the central nervous system. At the same time, via the visualizer 39, a virtual reality environment was transmitted to the patient, where the patient moved forward with each activation of the movable frame 2 elements of the two-layer exoskeleton, by activating the electromechanical drives 7 located on the outer rigid fixed frame 6. The structure of this virtual motion corresponds to the motion forcibly performed in real space. During 12 sessions, the control program individually increased the joint kinematics amplitude and kinematic velocity, according to the developed algorithm.

[0143] Stage 2. Consisted of 8 daily procedures, during which there was a recovery of connections between the surrounding events in the virtual reality environment and the structure of the previously recovered stepping motion pattern. In this case, the patient was fixed in a controlled movable frame 2 of a two-layer exoskeleton. At the same time, a wireless mechanic arm 37, allowing controlling the virtual reality events, was put in the right hand, which was complete in terms of complex motion performance. A task with moving steps, the patient had to step over, was transmitted in the virtual reality environment via the visualizer 39. As the step approaches, the patient moves his right arm forward with the mechanic arm 39, while stepping takes place in the virtual reality, and the movable frame 2 of the exoskeleton activates the stepping motion with a lunge forward and return to its original position. If the patient fails to timely react to the virtual reality environment stimulus, the control program simulated the fall due to activation of the frame drives 7 of the exoskeleton.

[0144] The effectiveness of complex motions was assessed at the end of the course using the video motion analysis. The following results were obtained: Psign7,661.1; Pnoise210.5; Motion Utility Coefficient2.7.

[0145] Thus, adaptive kinesitherapy sessions performed in accordance with the claimed method using the claimed system (kinetic trainer), objectively influenced the qualitative characteristics of complex stepping motion and improved its efficiency, mainly in the sagittal plane. The obtained data indicate that a stable stepping pattern matrix is being created.

Example 2. Method of Motor Function Recovery in the Demyelinating Disease of the Central Nervous System

[0146] Patient V. 36 years old with a diagnosis of demyelinating disease of the central nervous system was examined outside exacerbation on an outpatient basis. The patient had coordination disorders of limb ataxia, asynergic motions, dysdiadochokinesia and hypotonia with predominant left-side involvement. The patient did not have a spastic muscle tone increase, nor any motor impairment. At the same time there was a left-sided pyramidal insufficiency. The patient had pathological reflexes in the form of pathological foot signs. Also, stem structures lesions were identified: binocular nystagmus, mild internuclear ophthalmoplegia. Sensitive disorders were bilateral with an emphasis on the dissociated type. Prior to adaptive kinesitherapy sessions using the kinetic trainer, the quality parameters of the patient's stepping motion were impartially assessed in Step functionally complicated version using a video capture system. The diagnostics had the following indicator values: Psign8,332.9; Pnoise10,257.2; Motion Utility Coefficient123.1.

[0147] The patient had 28 adaptive kinesitherapy sessions according to the following scheme consisting of two stages, the structure of which was described above. Given the peculiarities of the disease and the preliminary diagnosis results, hip abduction motion pattern was selected as the initiating unit at the first stage, which consisted in the right leg abduction to the side (to the right) and returning it to the original position. This motion allows optimizing the support function on the left side. At the second stage, solution of the task associated with deviating away from flying objects was selected as a virtual reality environment. At the same time, the virtual reality mechanic arm 39 was fixed in the common center of gravity projection area.

[0148] The effectiveness of complex motions was assessed at the end of the course using the video motion analysis. The following results were obtained: Psign8,951.5; Pnoise90.3; Motion Utility Coefficient10.

[0149] Thus, adaptive kinesitherapy sessions performed in accordance with the claimed method using the claimed system (kinetic trainer), objectively influenced the qualitative characteristics of the motion associated with hip abduction and building the contralateral limb support function, and improved its efficiency, mainly in the frontal plane. The obtained data indicate that a stable motion pattern matrix is being created.

[0150] Potential areas of use of the claimed system and method of human motor function recovery include: rehabilitation; traumatology and orthopaedics; neurology (child neurology), neurosurgery: neurorehabilitation (post-operative recovery); geriatrics; sports medicine.

[0151] The technological, software and methodological innovations developed and applied in the claimed system and method of human motor function recovery allow using them as hardware and methodical tools of modern kinesitherapy for diseases accompanied by motor disorders such as: infantile cerebral palsy; the effects of brain injury, including the effects of strokes; neurodegenerative diseases (Parkinson's disease, demyelinating disorders); spinal injuries and lower limb injuries; severe movement disorders with spinal disc herniation; congenital neuromuscular and osteoarticular system diseases; osteoporosis (pathologic fractures); degenerative (age) changes in bones and joints (arthroses, osteoarthroses).

INFORMATION SOURCES

[0152] 1. Advanced developments, R&D, inventions. Robotic Arms. Electronic resource Made by Us. [Electronic resource]Jun. 10, 2015.Access mode: http://www.sdelanounas.ru/blogs/35662/2. [0153] 2. Exoskeleton Used in Paraplegia. Electronic resource Eurodoctor.ru. [Electronic resource] Jun. 10, 2015.Access mode: http://rehabilitation.eurodoctor.ru/exoskeletonparaplegia/3. EXOATLETRussian Exoskeleton. ExoAtlet project web-site. [Electronic resource]May 21, 2015.Access mode: http://www.exoatlet.ru/4. [0154] 3. EP Patent No. 1137378 B1, published on Aug. 27, 2003. 5. LokomatPro. Walking Skills Recovery. Rehabilitation and Mechanotherapy. Beka RUS Business Website. [Electronic resource]May 21, 2015. Access mode: http://www.beka.ru/ru/katalog/vosstanovlenie-navykov-khodby/lokomat-pro/6. [0155] 6. Rehabilitation Equipment. Robotic Mechanotherapy with Biofeedback. ReoAmbulator. Electronic resource Medicine and New Technologies. [Electronic resource]Oct. 1, 2015.Access mode: http://www.mednt.ru/catalog/reabilitaciya-posle-insulta/robotizirovannaya-terapiya/reoambulator/