Engineers speak to therapists: Development of rehabilitation robotics

Abstract

Initially developed for industrial applications, in particular to assist or replace humans in dangerous, strenuous or repetitive, robots today have applications in many other fields, including in healthcare [1]. In the specific context of the rehabilitation of brain-injured patients, the robots have the advantage of being able to repeat the movements with high intensity and frequency, and in an attractive environment for the patient [2]. They also provide assistance to therapists by relieving them physically, but also by providing a quantitative and objective assessment of the patient's performance. First robots for upper limb rehabilitation were industrial manipulators diverted from their original use [1]. Since then, these robots have evolved and can be classified in two categories: end-effector robots which mobilize the arm through the hand or the forearm, and exoskeletons placed parallel to the osteological chain which drive independently all upper limb joints. The technical development of rehabilitation robots has gone hand in hand with an intensification of the collaboration between engineers and therapists. This led to the development of solutions always better addressing the clinical needs but also to the identification of the pros and cons specific to each of the two categories of robots. Such multidisciplinary collaboration is established since 2006 at the Universite catholique de Louvain between the Center for Research in Mechatronics and the Cliniques universitaires Saint-Luc and has led to the development of two robotic devices. The first one, REAplan, is an end-effector robot which has undergone numerous evolutions after several clinical trials to fit at best to the clinical environment. The second one, AFREXOS, is an exoskeleton robot for the shoulder complex whose innovative mechanical structure results from taking into account the clinical needs during the early stages of the design process.