rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0044-197X-2021-65-3-287-294rfhealth-449Research ArticleОБЗОРЫREVIEWSПерспективы и значение аппаратов внешнего управления (экзоскелетов) для эффективной реабилитации пациентов с нарушениями двигательной функцииPerspectives and value of external control devices (exoskeletons) for effective rehabilitation of patients with impaired motor functionhttps://orcid.org/0000-0002-5972-4412РомановА. И.RomanovAlexandr I.noemail@neicon.ruhttps://orcid.org/0000-0002-9522-8061СтупинВ. А.StupinVictor A.noemail@neicon.ruhttps://orcid.org/0000-0002-0246-5149СилинаЕкатерина ВладимировнаSilinaEkaterina V.

Доктор мед. наук, профессор, профессор каф. патологии человека Сеченовского Университета, 119991, Москва.

e-mail: silinaekaterina@mail.ru

Professor, Doctor Med. Sci., Professor of the Department of Human Pathology, Sechenov University, Moscow, 119991, Russian Federation.

e-mail: silinaekaterina@mail.ru

silinaekaterina@mail.ruАссоциация клинических реабилитологовРоссияAssociation of Clinical RehabilitologistsRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202127072021653287294Copyright © Романов А.И., Ступин В.А., Силина Е.В., 20212021Романов А.И., Ступин В.А., Силина Е.В.Romanov A.I., Stupin V.A., Silina E.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/449

Цель работы – изучить перспективы разработки и применения экзоскелетов (роботизированных аппаратов внешнего управления) для реабилитации пациентов с нарушением двигательной функции. Авторы рассматривают актуальную тему – создание комплексного устройства для эффективной реабилитации пациентов с нарушенной двигательной функцией, включая пациентов, перенёсших инсульт и травмы позвоночника и потерявших способность самостоятельно передвигаться и продолжать профессиональную и социальную деятельность. Поиск литературы проводился по базам данных Scopus, Web of Science, MedLine, PubМed, The Cochrane Library, EMBASE, РИНЦ, Elibrary с основными критериями включения: двигательная или нейромоторная реабилитация; экзоскелеты; мобильные роботизированные устройства. Установлено, что в последние 5 лет произошло существенное увеличение публикаций, а основная тенденция в исследованиях – разработка носимых роботизированных экзоскелетов и объединение данных, собранных с нескольких датчиков, которые обогащают обучение интеллектуальных алгоритмов. Однако пока не опубликовано работ, показывающих результаты использования таких самообучающихся систем. Проведён анализ имеющихся в мире успешных разработок экзоскелетов, получивших допуски на рынках своих стран и показавших достоверно лучшие результаты в процессе проведения реабилитационных курсов. Обсуждаются неоднозначные результаты 34 систематических  обзоров и метаанализов. Следует с осторожностью относиться к опубликованным результатам, т.к. большинство исследований имеют ошибки в протоколах и отсутствуют достаточные многоцентровые исследования. Обсуждены возможные новые формы индивидуального и коллективного использования роботизированных устройств. Определены наиболее важные для развития этого направления вопросы, касающиеся разработки мозг-компьютерных нейроинтерфейсов. Намечены перспективные пути для дальнейших исследований в области оптимальной реабилитации пациентов с нарушенной двигательной функцией и их ресоциализации.

Участие авторов

Участие авторов:

Романов А

Романов А.И. — концепция и дизайн исследования, написание текста, редактирование; 

Ступин В

Ступин В.А. — концепция и дизайн исследования, сбор и обработка материала, написание текста, редактирование;

Силина Е

Силина Е.В. — сбор и обработка материала, написание текста, составление списка литературы, редактирование.

Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

The purpose of this work is to study the prospects for the development and use of exoskeletons (robotic external control devices) for the rehabilitation of patients with impaired motor function. The authors consider the modern topical task – creating a complex device for the most effective rehabilitation of patients with impaired motor function. S such cases include patients who suffered from a stroke and spinal injury or have lost the abi-lity to move independently and continue their professional and social activities. The literature search was carried out in the Scopus, Web of Science, MedLine, Pubmed, The Cochrane Library, EMBASE, RSCI, Elibrary databases, with main inclusion criteria: (a) motor or neuromotor rehabilitation, (b) exoskeletons, (c) mobile robotic devices. The significant gain in the report number on this topic has been registered in the last five years. The primary trend in research is both the development of wearable robotic exoskeletons and the combination of data collected from several sensors. This can promote the development of intelligent algorithms. However, no papers have yet been published showing the results of using such self-learning systems. The analysis of the successful development of exoskeletons available globally has received admissions on their countries’ markets and have shown the best results reliably in conducting rehabilitation courses. The controversial results of 34 systematic reviews and meta-analyzes are discussed. Published results should be viewed with caution, as most studies have protocol errors and preliminary multicenter studies. Possible new forms of individual and collective use of robotic devices are discussed. The most important for developing this direction are identified issues related to the development of brain-computer neuro interfaces. Prospective ways for further research in optimal rehabilitation of patients with impaired motor function and their resocialization are outlined.

Contribution of the authors:

Romanov A

Romanov A.I. — the concept and design of the study, writing the text, editing;

Stupin V

Stupin V.A. — the concept and design of the study, collection and processing of material, writing the text, editing;

Silina E

Silina E.V. — collection and processing of material; writing the text, compilation of the list of literature, editing.

All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgments

Acknowledgments. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

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The authors declare that there are no conflicts of interest present.