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We have proposed the walking support method which emphasize walking rhythm. Previously, our walking support system used rhythmic auditory stimuli. While on the other hand, in this study, we studied on methods using device changing gait movement by directly inputting rhythmic proprioception. We proposed a method to intervene in the movement of upper limbs and developed the device which drive elbows rhythmically. We evaluated effects of the device on gait in healthy participants with knee joint fixation orthosis. These experimental results showed that inputting proprioception stimulation through upper limbs has a potential to improve the gait pattern. And we researched an effectivity of the walking support method which changed upper limb movement, complementally. In consequence, we will study on walking support consideration of all limb movement.

パーキンソン病(PD)の歩行リズム生成障害はリズム変動を表す変動係数CVとリズム相互作用を表すスケーリング指数αによって個別に評価されているが, 臨床的評価との関係が明らかでない. そこで，その関係を明らかにすることを目的とした. そのため，健常高齢者とPD患者の歩行周期のCVとαから臨床的評価の指標である改変Hoehn-Yahr分類に基づいて分類した. 歩行障害の有無の分類ではCV, 歩行障害のある中での重症度の軽重の分類ではαの寄与が大きかった. このことは，CVとαの組み合わせにより臨床的評価を行うことができる可能性を示唆する. さらに相互に引き込むリズム音によるスマートフォンを用いた歩行リハビリテーションを行い, αの改善が見られた., Rhythm is an important factor in walking. The magnitude of stride interval (SI) variability of Parkinson's disease (PD) patients was large and long-range correlations of SI of PD patients was low. Magnitude of SI variability can be quantified by coefficient of variation (CV) and long-range correlations of SI can be quantified by scaling exponent α. In this study, we examined which of CV or α can mainly discriminate 1) between presence and absence of gait disorder (GD) in PD patients, and 2) between mild and moderate GD, using linear discriminant analysis. Forty-five PD patients and 17 healthy elderly people walked around 200 meters without any support. The severity of GD was defined by modified Hoehn-Yahr scale (mH-Y). People with mH-Y 2.5 were defined as mild GD, and people with mH-Y 3 or 3.5 were defined as moderate GD. SI was measured by foot switches. As a result, CV mainly contributed on classification of presence and absence of GD, and α mainly contributed on classification of mild GD and moderate GD. Consequently, Combination of CV and α can become an evaluation platform for gait rhythm of PD patients.

我々は、歩行支援システムWalk-Mateを開発し、リハビリテーションへの応用を目指して研究を進めてきた。先行研究において、Walk-Mateはリハビリテーションに対して有用な可能性が示唆されていたが、運用に専門知識を必要とする複数の装置によって構成されており、ユーザビリティーが低かった。本研究では、歩行支援システムWalk-Mateのユーザビリティーの向上を目指し、システムを新たなハードウェアとしてスマートフォンに実装した。特に、我々は既存システムにおける歩行計測手法をスマートフォンで実現するアルゴリズムを考案してWalk-Mateの機能を実現し、既存システムにおける構成装置の機能を統合的に操作できるアプリケーションのインターフェースを開発した。そして、システムを歩行障害の一種であるパーキンソン病患者に適用してWalk-Mate機能と、また、ユーザビリティーの評価を行った。結果として、システムは確かにWalk-Mateとしての機能を実現しており、ユーザビリティーも改善されていた。, We have developed a gait assist system Walk-Mate and have been studying to apply Walk-Mate to rehabilitation. In previous studies, Walk-Mate has been suggested potentially useful for rehabilitation but the usablity of the system has been low because the system is consisted of devices which require some knowledge to operate. In this study,we developed the system on smartphones as a new hardware to improve the usablity of Walk-Mate. In particular, we implemented the function of Walk-Mate by developing an algorithym of gait measuring which has been used in existing system on smartphones,and developed an application interface that can operate funcitons of existing system in an integrated manner. Then, we evaluated Walk-Mate function and the usability of the new system by applying with Parkinson's disease, a type of gait disturbance. As a result,the system has realized the function of Walk-Mate and usablity has been improved.

我々の研究グループでは片麻痺患者に対してリズム聴覚刺激を用いた支援方法で改善効果を示してきた。一方で、神経経路の再構築という観点から、固有感覚刺激利用し歩行動作を直接変化させる方法が有効である可能性がある。我々は、安全性や四肢の協調関係を考慮して上肢にリズムを伝える方法を提案する。疑似片麻痺患者で実験を行い、肘を駆動させることで左右への動きが少なくなり、非対称性の緩和が見られた。, We have reported that gait rehabilitation using auditory stimulation was effective on hemiplegic gait. However, not only auditory stimulation but also proprioception is important for walking. We therefore consider a gait rehabilitation method using device changing gait movement by directly inputting rhythmic proprioception stimulation to the upper limbs. In this study, we measured the trunk trajectory and swing time of pseudo hemiplegic patients with moving elbows under two condition, arm rhythmic movement condition with arm fixed condition. We confirmed that the horizontal amplitude of trunk movement and left-right asymmetry of swing time were decreased in former condition. Consequently, we found that rhythmic upper limb movement during locomotion has a potential to improve the gait pattern.