Limb Rehabilitation Device Research Articles

Validating Questionnaires for Lower Limb Rehabilitation Systems and Devices: A Scoping Review.

This article aims to make a scoping review of Validating Questionnaires used in the field of lower limb (LL) rehabilitation in which systems, devices or exergames are used. Its main objective is to provide a more comprehensive understanding of the results obtained in the validation of questionnaires, as well as to identify specific criteria for evaluating systems, devices or exergames in the area of LL rehabilitation, through the analysis of validating instruments and their application in different associated contexts. The article details the methodology employed, a PRISMA ScR method review which included database research and an evaluation of the selected studies. Inclusion and exclusion criteria were applied to select all relevant studies, resulting in 81 studies after initial review based on titles and abstracts. Subsequently, the criteria were again applied to read the full text, resulting in 58 final studies. The document distinguishes between standardized and non-standardized validating questionnaires, emphasizing that standardized validating questionnaires have undergone rigorous statistical processes to ensure their validity, reliability and consistency. The information compiled in the tables provides a solid basis for identifying and evaluating validation questionnaires in the above-mentioned context. This resource constitutes an accurate and reliable reference for selecting the most appropriate instruments for future research and comparisons with similar work. This article is a valuable resource for those interested in the validation of questionnaires used in the field of lower limb rehabilitation systems/devices/exergames.

CONTROL OF UPPER LIMB REHABILITATION DEVICES: A BIBLIOMETRIC STUDY

The study analyzes research trends, collaboration patterns, and key focus areas in the field of upper limb rehabilitation devices using bibliometric methods. With advancements in robotics and assistive technologies, these devices have become crucial for individuals with upper limb impairments, particularly stroke survivors. However, the rapid increase in publications necessitates a comprehensive understanding of research directions and influential contributions. This study used the Scopus Analyzer and VOSviewer software to examine a dataset of 1,208 publications. The Scopus analyzer provided insights into publication trends and author productivity. At the same time, VOSviewer was employed to map keyword occurrences and co-authorship networks, revealing the main topics and collaborative linkages across countries. The analysis highlights a steady increase in research output from 2015 to 2024, with a slight decline in the last two years, likely due to shifting research priorities or market saturation. Keywords such as "rehabilitation," "stroke," "upper limb," and "exoskeleton" indicate strong interest in assistive technology for motor recovery, while terms like "adaptive control" and "impedance control" emphasize the importance of control mechanisms tailored to patient needs. Additionally, international collaboration networks are led by countries like China, the United States, and Italy, reflecting their high research impact and extensive partnerships. In conclusion, this bibliometric analysis offers valuable insights into the progress and collaborative efforts within upper limb rehabilitation devices research, highlighting the interdisciplinary nature of the field and identifying potential areas for future exploration. This study serves as a reference for researchers aiming to develop further rehabilitation control solutions that enhance the quality of life for patients with upper limb impairments.

Rehabilitation management of sports athletes’ muscle injury based on OpenSim technology

Due to the rapid development of sports and people’s love for sports, athletes often perform resistance training beyond the body to achieve better results, resulting in frequent muscle injuries. After the injury, the athlete cannot return to the state before the injury in time, which destroys the previous training results and hinders the athlete from improving to the professional level. Therefore, the research of athletes’ post-injury rehabilitation is the central subject of modern sports science research. This paper used OpenSim technology to study the rehabilitation management of sports athletes’ muscle injury. In this paper, the OpenSim skeletal muscle model was first established, followed by muscle modeling and characteristic analysis, and then a muscle rehabilitation system was constructed. The experimental part used the limb rehabilitation device model of this paper to carry out muscle rehabilitation training for patients with muscle injury, and compared it with conventional rehabilitation training. The experimental results showed that the limb rehabilitation device in this paper had a better rehabilitation effect. Compared with the traditional rehabilitation training, the excellent rate of the total active range of motion of the joints and the satisfaction of rehabilitation nursing were both increased by 10%.

Design and Control of Upper Limb Rehabilitation Training Robot Based on a Magnetorheological Joint Damper.

In recent years, rehabilitation robots have been developed and used in rehabilitation training for patients with hemiplegia. In this paper, a rehabilitation training robot with variable damping is designed to train patients with hemiplegia to recover upper limb function. Firstly, a magnetorheological joint damper (MR joint damper) is designed for the rehabilitation training robot, and its structural design and dynamic model are tested theoretically and experimentally. Secondly, the rehabilitation robot is simplified into a spring-damping system, and the rehabilitation training controller for human movement is designed. The rehabilitation robot dynamically adjusts the excitation current according to the feedback speed and human-machine interaction torque, so that the rehabilitation robot always outputs a stable torque. The magnetorheological joint damper acts as a clutch to transmit torque safely and stably to the robot joint. Finally, the upper limb rehabilitation device is tested. The expected torque is set to 20 N, and the average value of the output expected torque during operation is 20.02 N, and the standard deviation is 0.635 N. The output torque has good stability. A fast (0.5 s) response can be achieved in response to a sudden motor speed change, and the average expected output torque is 20.38 N and the standard deviation is 0.645 N, which can still maintain the stability of the output torque.

Implementation of wearable device for upper limb rehabilitation using embedded IoT

Implementation of wearable device for upper limb rehabilitation using embedded IoT

Design and control of a low-cost non-backdrivable end-effector upper limb rehabilitation device.

This paper presents GARD, an upper limb end-effector rehabilitation device developed for stroke patients. GARD offers assistance force along or towards a 2D trajectory during physical therapy sessions. GARD employs a non-backdrivable mechanism with novel motor velocity-control-based algorithms, which offers superior control precision and stability. To our knowledge, this innovative technical route has not been previously explored in rehabilitation robotics. In alignment with the new design, GARD features two novel control algorithms: Implicit Euler Velocity Control (IEVC) algorithm and a generalized impedance control algorithm. These algorithms achieve runtime complexity for any arbitrary trajectory. The system has demonstrated a mean absolute error of 0.023 mm in trajectory-following tasks and 0.14 mm in trajectory-restricted free moving tasks. The proposed upper limb rehabilitation device offers all the functionalities of existing commercial devices with superior performance. Additionally, GARD provides unique functionalities such as area-restricted free moving and dynamic Motion Restriction Map interaction. This device holds strong potential for widespread clinical use, potentially improving rehabilitation outcomes for stroke patients.

A Wearable Device for Upper Limb Rehabilitation and Assistance Based on Fluid Actuators and Myoelectric Control

Wearable exoskeleton solutions for upper limb rehabilitation or assistance, particularly for the hand area, have become increasingly attractive to researchers, proving to be effective over time in treating hand movement impairments following various neurological diseases. Our aim in the present work is to design a wearable exoskeleton device for active hand rehabilitation/assist control based on myoelectric signal (EMG) capture from forearm muscles, which is easy to wear by the user, comfortable, lightweight, and relatively inexpensive to make. The actuators use two different lengths to increase biocompatibility with the anatomy of the hand, and PneuNets fluid actuators are used. Their design to meet force and bending requirements was based on finite element numerical simulations, and the actuators were designed based on a clear design methodology to achieve the best possible quality. Tests on healthy subjects show that the EMG-based control strategy meets the needs of rehabilitation/assistive hand therapy, finding a comfortable and easy-to-use device. Future directions will focus on developing the device to meet rehabilitation needs for the entire upper limb and integrating the device into virtual reality (VR) through immersive devices.

Modeling and control of the linear actuator for the lower limb rehabilitation device

In recent years, the number of stroke patients has increased, which has led to an increased need for motor rehabilitation exercises. The application of automation devices in the rehabilitation of patients is becoming increasingly developed. These devices help reduce the patient training time and workload. Each type of equipment uses different actuators such as electric motors, pneumatic cylinders, and hydraulic cylinders. Different from previous studies, in this paper, a research model of lower extremity rehabilitation devices using a simple actuator which is a linear actuator is presented. The main contribution of this study is that a dynamic model of the linear actuator associated with the action dynamics of the lower extremities of the studied model with three degrees of freedom was established. A mathematical model for this actuator is also presented, simulating the response of the mechanism using the MATLAB/Simulink software. A lower extremity rehabilitation device using a linear actuator was manufactured and tested. The test results for 10 volunteers show that the actuator works and causes miniature angle errors. This experiment demonstrates that the linear actuator can be used in stroke patient rehabilitation equipment and contributes to the diversification of the mechanism in automation equipment.

CURER: A Lightweight Cable-Driven Compliant Upper Limb Rehabilitation Exoskeleton Robot

Upper limb exoskeletons show promise for improving functionalities required for stroke patients. Despite recent progress, most of current upper limb rehabilitation devices are still bulky, heavy, and less compliant to be applied. This article presents a cable-driven compliant upper limb rehabilitation exoskeleton robot (CURER) with a lightweight frame and comfortable human–robot interaction. A modular series elastic actuator (SEA) was designed to provide controlled torque for each active robotic joint, and Bowden cables were applied to transfer controlled torque to distal joints. A six-bar double parallelogram mechanism was designed to implement 3 active degrees of freedom (DOFs) of a shoulder. An actuated elbow with 1 DOF and a wrist with a passive DOF were also developed for CURER. The anthropomorphic shoulder, elbow, and wrist joints can minimize misalignment between human upper limbs and the robot. The length of anthropomorphic arm was adjustable for a wide range of users. It can apply up to a 33 N·m torque in shoulder flexion/extension, abduction/adduction, intra/extra rotation, and elbow flexion/extension, with a range of 7.6–8.0 Hz position bandwidth in each actuation. CURER has a large range of motion and can provide accurate torque control for stroke patients’ requirements. Besides, a comprehensive rehabilitation strategy including robot-in-charge mode and human-in-charge mode was developed for different recovery stages. Experiments carried out on CURER actuation units demonstrated good position and impedance control performance. Finally, a virtual reality training system was developed to assist the subjects to accomplish upper limb rehabilitation efficiently.

Development and simulation of a device for upper limb rehabilitation

Robotics with exoskeletons has opened a new era of research in the field of modern rehabilitation and assistive technologies. The technology promises to improve the functionality of the upper limbs, which are necessary for daily operations. Exoskeleton technology is developing rapidly but requires interdisciplinary research to solve technical problems such as kinematic compatibility and the development of effective human-robot interaction. This article presents a new design of a device that helps to rehabilitate the upper extremities. The proposed design is characterized by a lightweight structure with an adaptable geometry for various users with low cost and easy to wear characteristics. The CAD model is developed for design details and for modeling, the results of which provide data on the feasibility of the proposed design and its characteristics in the main operational characteristics.

Robot-aided Rehabilitation with SREx: A Smart Robotic Exoskeleton for Reducing Therapists' Physical Stress

<h3>Research Objectives</h3> Upper limb dysfunctions (ULD) are common following a neurological insult. Passive range of motion (PROM) exercise of the affected extremity is one of the critical components of current rehabilitation plans of care when treating these patients. Robot-aided rehabilitation is a promising technology for this and comes with the added advantage of reducing therapists' physical burden. This study describes the development of a robot-aided upper limb rehabilitation device, 7 degrees of freedom exoskeleton type robot named SREx. It also shows the preliminary testing results on healthy participants with emulated ULD patients. <h3>Design</h3> Experimental study. <h3>Setting</h3> In the BioRobotics Lab. <h3>Participants</h3> Five healthy male human subjects (age: 26-30 years) participated in this study. <h3>Interventions</h3> Healthy human subjects (n=5) wore the SREx on the lateral side of their right hands while being seated on chair. Isolated, composite joint PROM sessions containing slower, medium, and faster speed cycles. <h3>Main Outcome Measures</h3> Tests were carried out in three settings: (a) subject exerts no effort, (b) resistance to motion equivalent to patient with generalized spasticity resulting from ULD, and (c) sudden jerking/ perturbation during motion emulating real patients' muscle spasm. During all exercises human-robot interaction was measured with force-torque sensor. Collected ROM data was statistically analyzed. <h3>Results</h3> The robot was able to provide therapeutic PROM to all subjects' UL with a maximum ROM error of ∼3.6 degrees even under external perturbation of force at 6.8 lbs. The preliminary testing showed that the robot was able to provide PROM exercise without the need for physical intervention from anyone else, in an effective manner for emulated patient conditions. <h3>Conclusions</h3> The SREx can provide safe and measurable PROM exercises to healthy patients. The next step is to receive feedback from individuals suffering from ULD. <h3>Author(s) Disclosures</h3> The authors declare no conflict of interest.

A technical report on a novel robotic lower limb rehabilitation device - Is ROBERT a cost-effective solution for rehabilitation in Hong Kong?

A shortage of physiotherapist (PT) manpower is a barrier for providing better rehabilitation service in Hong Kong. Quality training can benefit patients with better recovery, on the contrary, insufficient training may cause a longer length of stay, readmission, and thus the burden of healthcare system. The estimated cost for PT services in Hospital Authority was HK$7.0 Billion in 2020. A novel Danish robot with a 7-joint robotic arm became popular in Denmark and Germany in the last two years. The robot is designed for lower limb patient rehabilitation. It can enhance the mobility of patients. Based on the experience of a university hospital in Denmark, this robotic rehabilitation was well accepted by both patients and PTs. Function-wise, the robot provides many clinical benefits to patients, especially stroke ones. A physiotherapist's time can be saved when the robot is being used. The cost-effectiveness of ROBERT is better than PT performing repetitive exercises for lower limbs. The robot potentially provides a cost-effective solution to the Hong Kong healthcare system.

Design of a 6-DoF Cost-effective Differential-drive based Robotic system for Upper-Limb Stroke Rehabilitation.

This paper discusses the design, construction, and characteristics of a six degree of freedom (6-DoF) robotic upper limb stroke rehabilitation device. The device is primarily designed to be used by stroke survivors suffering from hemi-paresis, post stroke therapy. The proposed device is aimed to substitute upper limb exoskeletons or end-effector robotic arm based rehabilitation systems, which are generally bulky, expensive due to customized design, and are used only in clinical settings. The device is capable of aiding patients perform rehabilitation exercises involving abduction, adduction, flexion, and extension movements for the wrist, shoulder joints and flexion, extension, pronation, supination for the elbow joint. The device has a mobile base and uses differential drive principles for movement. The device provides an end-effector plate having force-sensitive resistors (FSRs) on which the patient can rest their hand. The mobile base of the rehabilitation system enables it to aid for a greater range of movements when compared to other end-effector-based upper limb rehabilitation devices. Additionally, a camera is mounted on top of the 6-DoF robotic system to enable finger tracking from a remote system using the MediaPipe framework, and measure the hand instability metric over time to assess patient's performance. Clinical relevance - The 6-DoF rehabilitation system is capable of aiding different range of motions for upper limb. The low-cost generic system is applicable for different physical personalities, enabling quick adoption for large patient populations who are in need of rehabilitation systems. The 6-DoF system is aimed towards clinical, and domestic usage by patients.

User Participatory Design of a Wearable Focal Vibration Device for Home-Based Stroke Rehabilitation.

Stroke often leads to the significant impairment of upper limb function and is associated with a decreased quality of life. Despite study results from several interventions for muscle activation and motor coordination, wide-scale adoption remains largely elusive due to under-doses and low user compliance and participation. Recent studies have shown that focal vibration has a greater potential to increase and coordinate muscle recruitment and build muscle strength and endurance. This form of treatment could widely benefit stroke survivors and therapists. Thus, this study aimed to design and develop a novel wearable focal vibration device for upper limb rehabilitation in stroke survivors. A user participatory design approach was used for the design and development. Five stroke survivors, three physical therapists, and two occupational therapists were recruited and participated. This pilot study may help to develop a novel sustainable wearable system providing vibration-based muscle activation for upper limb function rehabilitation. It may allow users to apply the prescribed vibratory stimuli in-home and/or in community settings. It may also allow therapists to monitor treatment usage and user performance and adjust the treatment doses based on progression.

Implementation of wearable device for upper limb rehabilitation using embedded IoT

Implementation of wearable device for upper limb rehabilitation using embedded IoT

A review on design mechanism for self-adapting upper-limb rehabilitation device on finger

Stroke is a common cause which is affecting the lives of elderly. These days such cases are common among young generation also. They may result in damaging the lower or upper limb and oftentimes both. In some cases, the patient can regain their natural range of motion by therapeutic exercises. However, these exercises now involve the use of exoskeleton devices. Therefore, to unveil the different types of self-adapting upper limb rehabilitation devices, an attempt has been made in this paper. The paper will serve as a small inventory of distinct rehabilitation devices available for upper limb with in depth advantages and limitations.[copyright information to be updated in production process]

Enhanced customer requirement classification for product design using big data and improved Kano model

The classification of customer requirements (CRs) has a significant impact on the solution of product design. Existing CRs classification methods such as the Kano model and IPA model are time-consuming and inaccurate. This paper proposes a CRs classification method for product design using big data of online customer reviews of products to classify CRs accurately and efficiently. Comments of customer reviews are matched to CRs using a hierarchical semantic similarity method. Customer satisfaction degrees are defined based on emotional levels of adjectives and adverbs of customer comments using word vectors. The function implementation degree of each product is determined by specifications crawled from online products. Fitting curves are formed by defined customer satisfaction and function implementation of CRs using polynomial modeling and least square methods. Based on the slope of the fitted curves, CRs are classified to provide the minimum and maximum function implementations of CRs in each CR group to guide a product design process. The proposed method is applied in a case study of defining CRs classifications for design of upper limb rehabilitation devices. For verifying the proposed method, CRs defined by the existing methods are compared with CRs from the proposed method in design of an upper limb rehabilitation device.

An Autotuning Cable-Driven Device for Home Rehabilitation.

Out of all the changes to our daily life brought by the COVID-19 pandemic, one of the most significant ones has been the limited access to health services that we used to take for granted. Thus, in order to prevent temporary injuries from having lingering or permanent effects, the need for home rehabilitation device is urgent. For this reason, this paper proposes a cable-driven device for limb rehabilitation, CUBE2, with a novel end-effector (EE) design and autotuning capabilities to enable autonomous use. The proposed design is presented as an evolution of the previous CUBE design. In this paper, the proposed device is modelled and analyzed with finite element analysis. Then, a novel vision-based control strategy is described. Furthermore, a prototype has been manufactured and validated experimentally. Preliminary test to estimate home position repeatability has been carried out.

Structure design and kinematics analysis and simulation of exercise bike type lower limb rehabilitation instrument

This article proposes a structural design of an exercise bike-type lower limb rehabilitation device, and introduces its components and design in detail. Through the organic combination of pedal-type rehabilitation actuators and exoskeleton auxiliary fixation mechanisms, it is safe and effective to maintain or restore old Human’ lower limb exercise ability. By formulating rehabilitation training strategies and using exoskeleton assisted fixation, the training trajectory of the user’s lower limbs can be fixed and sufficient safety guarantees are provided. This design uses SolidWorks for 3D software simulation to complete the part modeling, device assembly drawing and sports simulation of the exercise bike-type lower limb rehabilitation device, which has broad development prospects and practical value.

Robotic Rehabilitation: An Opportunity to Improve Cognitive Functions in Subjects With Stroke. An Explorative Study.

Background: After a stroke, up to three-quarters of acute and subacute stroke survivors exhibit cognitive impairment, with a significant impact on functional recovery, quality of life, and social engagement. Robotic therapy has shown its effectiveness on motor recovery, but its effectiveness on cognitive recovery has not fully investigated.Objective: This study aims to assess the impact of a technological rehabilitation intervention on cognitive functions in patients with stroke, using a set of three robots and one sensor-based device for upper limb rehabilitation.Methods: This is a pilot study in which 51 patients were enrolled. An upper limb rehabilitation program was performed using three robots and one sensor-based device. The intervention comprised motor/cognitive exercises, especially selected among the available ones to train also cognitive functions. Patients underwent 30 rehabilitation sessions, each session lasting 45 minutes, 5 days a week. Patients were assessed before and after the treatment with several cognitive tests (Oxford Cognitive Scale, Symbol Digit Modalities Test, Digit Span, Rey–Osterrieth Complex Figure, Tower of London, and Stroop test). In addition, motor (Fugl–Meyer Assessment and Motricity Index) and disability (modified Barthel Index) scales were used.Results: According to the Oxford Cognitive Scale domains, a significant percentage of patients exhibited cognitive deficits. Excluding perception (with only one patient impaired), the domain with the lowest percentage of patients showing a pathological score was praxis (about 25%), while the highest percentage of impaired patients was found in calculation (about 70%). After the treatment, patients improved in all the investigated cognitive domains, as measured by the selected cognitive assessment scales. Moreover, motor and disability scales confirmed the efficacy of robotics on upper limb rehabilitation in patients with stroke.Conclusions: This explorative study suggests that robotic technology can be used to combine motor and cognitive exercises in a unique treatment session.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04164381.