Robotic Rehabilitation System Research Articles

Modeling and analysis of a parallel robotic system for lower limb rehabilitation with predefined operational workspace

The paper presents the mathematical modeling and analysis of LegUp, a novel parallel robotic system for lower limb rehabilitation of bedridden patients. The operational workspace of the robotic system is defined based on a set of parameters that describe the motion of the lower limb joints, which is natural in the rehabilitation task. To comply with this representation of the operational workspace, the parallel robot kinematic models describe the dependency between the robotic system actuators and the lower limb joints. Furthermore, the singularity analysis is achieved in the joint space, which shows whether the operational workspace is singularity-free. To achieve a feasible mechanical design for the prescribed operational workspace and to ensure safe operation, the design parameters of the parallel robotic system are determined based on a multi-objective optimization problem. Numerical simulations show that the operational workspace is singularity-free for the selected design parameters, which are then used to construct the experimental model of LegUp.

Soft Robotic Bilateral Rehabilitation System for Hand and Wrist Joints

Upper limb functionality is essential to perform activities of daily living. It is critical to investigate neurorehabilitation therapies in order to improve upper limb functionality in post-stroke patients. This paper presents a soft-robotic bilateral system to provide rehabilitation therapy for hand and wrist joints. A sensorized glove that tracks finger and wrist joint movements is worn on the healthy limb, which guides the movement of the paretic limb. The input of sensors from the healthy limb is provided to the soft robotic exoskeleton attached to the paretic limb to mimic the motion. A proportional derivative flow-based control algorithm is used to perform bilateral therapy. To test the feasibility of the developed system, two different applications are performed experimentally: (1) Wrist exercise with a dumbbell, and (2) Object pick-and-place task. The initial tests of the developed system verified its capability to perform bilateral therapy.

Mechanical design of an upper limb robotic rehabilitation system

Physical diseases have become an alarming social problem worldwide. Several conditions related to limb mobility are more frequent due to a high level of demand in the repetitive execution of activities. Assistive technologies have been proposed to improve the experience of physical rehabilitation. This paper presents a framework with the mechanical design criteria for an upper limb assistive robotic system. We define the design specifications and construction characteristics of an assistive system. As a result, a 7-degree-of-freedom system for upper limb physical rehabilitation is designed with a novel characteristic of arm-switching configuration for the treatment of both arms.

Development of a portable and compact robotic ankle rehabilitation system

As part of this study, an ankle rehabilitation device was developed for patients suffering from motor disorders caused by incomplete spinal cord injury (ISCI), stroke, or cerebral palsy. First, the research models and dynamic equations of the device were considered. Secondly, the prototype ankle rehabilitation device is made of PLA plastic and uses linear actuators to simulate outward and inward flexion exercises (dorsiflexion and plantar flexion) for the patient. The advantages of the device are its simple design, low cost, and the possibility of installation on recovery equipment. The device can work quickly in experiments, in addition, the rehabilitation robot can work stably and is convenient to use for patients.

A 2DoF robotic system for home-based upper limb rehabilitation

A 2DoF robotic system for home-based upper limb rehabilitation

Development of a Novel Robotic Rehabilitation System Using Electrical Stimulation for Upper Limb Motor Recovery

To improve the quality of life for people with neurological disorders or accidents, it is important to create therapy tools for upper limb movement recovery that work and are easy for everyone to use. This study suggests a new artificial therapy device that uses electrical stimulation to help people recover their upper limb movement skills. The technology uses both artificial help and electrical treatment at the same time to help the brain change and learn new skills. The robotic therapy system is made up of a suit that moves with the upper limbs and supports them mechanically. It has sensors that can figure out what the user wants and change the amount of help based on that. In addition, the system has electrical activation probes that are put to target specific muscles or groups of muscles that help move the upper limbs. A closed-loop control system makes the system work. The user's moves are constantly tracked, and the robotic help and electrical stimulation are changed in real time. This flexible method lets recovery plans be made just for each person, based on their wants and results. A pilot study with people who have trouble moving their upper limbs was used to test how well the planned method would work. When the method was used for six weeks, the data showed big gains in motor function, muscle strength, and range of motion. Participants were also very happy with how easy the method was to use and how well it helped them improve their movement skills.

An LMI-based robust state-feedback controller design for the position control of a knee rehabilitation exoskeleton robot: Comparative analysis

Rehabilitation exoskeleton robots play a crucial role in restoring functional lower limb movements for individuals with locomotor disorders. Numerous research studies have concentrated on adapting the control of these rehabilitation robotic systems. In this study, we investigate an affine state-feedback control law for robust position control of a knee exoskeleton robot, taking into account its nonlinear dynamic model that includes solid and viscous frictions. To ensure robust stabilization, we employ the Lyapunov approach and propose three methods to establish stability conditions using the Schur complement, the Young inequality, the matrix inversion lemma, and the S-procedure lemma. These conditions are formulated as Linear Matrix Inequalities (LMIs). Furthermore, we conduct a comprehensive comparison among these methods to determine the most efficient approach. At the end of this work, we present simulation results to validate the developed LMI conditions and demonstrate the effectiveness of the adopted control law in achieving robust position control of the knee exoskeleton robot.

Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments.

The robotics discipline is exploring precise and versatile solutions for upper-limb rehabilitation in Multiple Sclerosis (MS). People with MS can greatly benefit from robotic systems to help combat the complexities of this disease, which can impair the ability to perform activities of daily living (ADLs). In order to present the potential and the limitations of smart mechatronic devices in the mentioned clinical domain, this review is structured to propose a concise SWOT (Strengths, Weaknesses, Opportunities, and Threats) Analysis of robotic rehabilitation in MS. Through the SWOT Analysis, a method mostly adopted in business management, this paper addresses both internal and external factors that can promote or hinder the adoption of upper-limb rehabilitation robots in MS. Subsequently, it discusses how the synergy with another category of interaction technologies - the systems underlying virtual and augmented environments - may empower Strengths, overcome Weaknesses, expand Opportunities, and handle Threats in rehabilitation robotics for MS. The impactful adaptability of these digital settings (extensively used in rehabilitation for MS, even to approach ADL-like tasks in safe simulated contexts) is the main reason for presenting this approach to face the critical issues of the aforementioned SWOT Analysis. This methodological proposal aims at paving the way for devising further synergistic strategies based on the integration of medical robotic devices with other promising technologies to help upper-limb functional recovery in MS.

Design and motion control of exoskeleton robot for paralyzed lower limb rehabilitation.

Patients suffering from limb movement disorders require more complete rehabilitation treatment, and there is a huge demand for rehabilitation exoskeleton robots. Flexible and reliable motion control of exoskeleton robots is very important for patient rehabilitation. This paper proposes a novel exoskeleton robotic system for lower limb rehabilitation. The designed lower limb rehabilitation exoskeleton robot mechanism is mainly composed of the hip joint mechanism, the knee joint mechanism and the ankle joint mechanism. The forces and motion of the exoskeleton robot were analyzed in detail to determine its design parameters. The robot control system was developed to implement closed-loop position control and trajectory planning control of each joint mechanism. Multiple experiments and tests were carried out to verify robot's performance and practicality. In the robot angular response experiments, the joint mechanism could quickly adjust to different desired angles, including 15°, 30°, 45°, and 60°. In the trajectory tracking experiments, the exoskeleton robot could complete tracking movements of typical actions such as walking, standing up, sitting down, go upstairs and go downstairs, with a maximum tracking error of ±5°. Robotic wearing tests on normal people were performed to verify the assistive effects of the lower limb rehabilitation exoskeleton at different stages. The experimental results indicated that the exoskeleton robot has excellent reliability and practicality. The application of this exoskeleton robotic system will help paralyzed patients perform some daily movements and sports.

Optimal Design of Lower Limb Rehabilitation System Based on Parallel and Serial Mechanisms

This paper presents the structure and model of a hybrid modular structure of a robotic system for lower limb rehabilitation. It is made of two modules identical in structure, including an active 3-PRRR manipulator for moving the patient’s foot and a passive orthosis based on the RRR mechanism for supporting the lower limb. A mathematical model has been developed to describe the positions for the links of the active and passive mechanisms of two modules, as a function of the angles in the joints of the passive orthosis, considering constraints for attaching the active manipulators to the moving platform and their configurations. A method has been formulated for a parametric synthesis of the hybrid robotic system proposed with modular structure, taking into account the generated levels of parametric constraints depending on the ergonomic and manufacturability features. The proposed design is based on a criterion in the form of a convolution, including two components, one of which is based on minimizing unattainable points of the trajectory, considering the characteristics of anthropometric data, and the other is based on the compactness of the design. The results of the mathematical modeling are discussed as well as the analysis results towards a prototype validation.

Resist-as-Needed ADL Training With SPINDLE for Patients With Tremor.

Individuals with neurological disorders often exhibit altered manual dexterity and muscle weakness in their upper limbs. These motor impairments with tremor lead to severe difficulties in performing Activities of Daily Living (ADL). There is a critical need for ADL-focused robotic training that improves individual's strength when engaging with dexterous ADL tasks. This research introduces a new approach to training ADLs by employing a novel robotic rehabilitation system, Spherical Parallel INstrument for Daily Living Emulation (SPINDLE), which incorporates Virtual Reality (VR) to simulate ADL tasks. The study results present the feasibility of training individuals with movements similar to ADLs while interacting with the SPINDLE. A new game-based robotic training paradigm is suggested to perform ADL tasks at various intensity levels of resistance as needed. The proposed system can facilitate the training of various ADLs requiring 3-dimensional rotational movements by providing optimal resistance and visual feedback. We envision this system can be utilized as a table-top home device by restoring the impaired motor function of individuals with tremor and muscle weakness, guiding to improved ADL performance and quality of life.

Rehabilitation Evaluation of Upper Limb Motor Function for Stroke Patients Based on Belief Rule Base.

In the process of rehabilitation treatment for stroke patients, rehabilitation evaluation is a significant part in rehabilitation medicine. Researchers intellectualized the evaluation of rehabilitation evaluation methods and proposed quantitative evaluation methods based on evaluation scales, without the clinical background of physiatrist. However, in clinical practice, the experience of physiatrist plays an important role in the rehabilitation evaluation of patients. Therefore, this paper designs a 5 degrees of freedom (DoFs) upper limb (UL) rehabilitation robot and proposes a rehabilitation evaluation model based on Belief Rule Base (BRB) which can add the expert knowledge of physiatrist to the rehabilitation evaluation. The motion data of stroke patients during active training are collected by the rehabilitation robot and signal collection system, and then the upper limb motor function of the patients is evaluated by the rehabilitation evaluation model. To verify the accuracy of the proposed method, Back Propagation Neural Network (BPNN) and Support Vector Machines (SVM) are used to evaluate. Comparative analysis shows that the BRB model has high accuracy and effectiveness among the three evaluation models. The results show that the rehabilitation evaluation model of stroke patients based on BRB could help physiatrists to evaluate the UL motor function of patients and master the rehabilitation status of stroke patients.

Design and analysis of a compatible exoskeleton rehabilitation robot system based on upper limb movement mechanism.

Rehabilitation robots are used to promote structural and functional recovery of the nervous system with repetitive, task-oriented training and have been gradually applied to clinical rehabilitation training. This paper proposes an upper limb exoskeleton rehabilitation robot system that could realize shoulder-elbow-wrist joint rehabilitation training. Firstly, a motion equivalent model was established based on the upper limb movement mechanism, the robot mechanism configuration was designed, and the optimization algorithm and spatial mechanism theory were used to optimize and analyze the structural parameters and human-machine compatibility of the robot, which will guide the design of the robot's model. Then, the robot kinematics were solved, and its maximum motion range, dexterity distribution, and daily motion trajectory were simulated. Finally, a system prototype was built to test the maximum range of robot-assisted human upper limb training by laser tracker, while the pressure of human-machine interaction during training was captured and analyzed by flexible sensors. The results show that the proposed rehabilitation robot could nearly completely cover the range of motion of upper limb joints and meet the needs of trajectory training, and the linear velocity dexterity and angular velocity dexterity in the motion space are maximum 0.55 and 0.89, and the human-machine interaction pressures during the training process are all less than 10kPa. Besides, this paper also conducted a system evaluation based on the fuzzy comprehensive evaluation model, and the evaluation result was 0.39, with an excellent evaluation grade, it indirectly indicates that the robot's overall performance was good.

Evaluation of finger strength and spasticity in hemiplegic patients using hand-finger robotic device: A validity and reliability study.

We aimed to investigate the validity, reliability, and clinical relevance of Amadeo hand-finger robotic rehabilitation system measurements for evaluating spasticity and strength in hemiplegic patients. In total, 161 participants (107 hemiplegic patients and 54 sex- and age-matched healthy controls) were included in this study. Spasticity was evaluated using the Modified Ashworth Scale, hand motor functions were evaluated using the Fugl-Meyer Assessment Hand Subscale, and hand grip and pinch strength were evaluated using the Jamar hand grip and pinch dynamometer. The Amadeo (Tyromotion) hand-finger robotic rehabilitation system was used to evaluate finger spasticity and strength of the participants. A statistically significant difference was found between the median values of the Modified Ashworth Scale (both clinical and robotic evaluation results) and the mean values of hand flexor and extensor strength measured with the robotic device in patients compared to healthy subjects (P < .01). Statistically, excellent agreement was obtained between the clinical and robotic test-retest results of the scale (P < .01) (intra-class correlation coefficient, ICC = .98-.99; ICC = .98-.99, respectively). There was a statistically significant positive correlation between the clinical and robotic device results of the Modified Ashworth Scale (r = .72; P < .01). There was a statistically significant positive correlation between the hand strength values measured with the robotic device, Jamar grip, pinch, and Fugl-Meyer Assessment Hand Subscale scores (P < .01) in the patient group. Hand finger spasticity and strength measurements of the Amadeo hand-finger robotic rehabilitation system were valid, reliable, and clinically correlated in stroke patients.

Adaptive neural tracking control for upper limb rehabilitation robot with output constraints

AbstractThe authors investigate the trajectory tracking control problem of an upper limb rehabilitation robot system with unknown dynamics. To address the system's uncertainties and improve the tracking accuracy of the rehabilitation robot, an adaptive neural full‐state feedback control is proposed. The neural network is utilised to approximate the dynamics that are not fully modelled and adapt to the interaction between the upper limb rehabilitation robot and the patient. By incorporating a high‐gain observer, unmeasurable state information is integrated into the output feedback control. Taking into consideration the issue of joint position constraints during the actual rehabilitation training process, an adaptive neural full‐state and output feedback control scheme with output constraint is further designed. From the perspective of safety in human–robot interaction during rehabilitation training, log‐type barrier Lyapunov function is introduced in the output constraint controller to ensure that the output remains within the predefined constraint region. The stability of the closed‐loop system is proved by Lyapunov stability theory. The effectiveness of the proposed control scheme is validated by applying it to an upper limb rehabilitation robot through simulations.

Trends of Robotic Systems for Hand Rehabilitation

Trends of Robotic Systems for Hand Rehabilitation

A novel robotic system enabling multiple bilateral upper limb rehabilitation training via an admittance controller and force field

Patients with hemiplegia are usually restricted to performing general bilateral activities of daily life (gbADLs). Bilateral training has been verified to contribute to the rehabilitation of physical functions. Although robotic systems are gradually being employed in the field of rehabilitation, few studies have performed simulations with regards to gbADLs for training. Therefore, a novel end-effector bilateral rehabilitation robotic system (EBReRS) for the upper limb is developed in this article for the task rendering of gbADLs, in which the gbADL-corresponding workspace is obtained via modularly designed bilateral parallelogram mechanisms. In addition, the interaction rendering of multiple bimanual modes (uncoupled, trans-soft-coupled, trans-semi-coupled, and rotation-coupled) is achieved by implementing the admittance model, the inner force field between robotic end-effectors, and the outer force field distributed around. Experiments of the proposed four rehabilitation training modes were carried out on the healthy subject, with the results showing a feasible method of the EBReRS in the simulation of multiple bimanual coordinated rehabilitation training tasks. In the future, the constructed EBReRS is expected to be exploited for home rehabilitation as a coordinated training device.

A Portable Robotic System for Ankle Joint Rehabilitation

A Portable Robotic System for Ankle Joint Rehabilitation

Design of a Flexible mechatronic system for mechanical impedance measurement of the wrist as one step towards robotic rehabilitation

Abstract Home rehabilitation is a great complement to inpatient rehabilitation, because it allows for more regular training, especially in rural areas, where the access to physiotherapists is limited. However, unsupervised training carries the risk of deviation from the prescribed protocol. An obvious solution is to introduce a technical means for rehabilitation and continuous monitoring of performance. This paper presents a robotic system for rehabilitation of three degrees of freedom of the wrist independently, implemented with only one actuator, optimizing the design and size of the system. The device provides measurements of joint torque-position dependence, allowing objective assessment of mechanical impedance and range of motion to evaluate the progress of rehabilitation. Derived from research on haptic devices, a measurement method was implemented to measure hand impedance in the high frequency range between 100 and 200 Hz using a combination of exciters and accelerometers in the handles. This allows continuous monitoring of gripping forces without the need for complex contact-based force sensors. In collaboration between the authors’ technical and medical universities, a set of two-level passive and active safety measures was implemented to ensure the safety of the system’s users. Therefore, the presented system shows the potential to evaluate the mechanical impedance of the wrist at both low and high frequencies and to monitor the progress during rehabilitation. In the next step, a baseline of wrist impedance will be measured in a target group of healthy volunteers in order to prepare for studies in motion-restricted subjects.

Special Issue on Exoskeleton Robotic Systems

Over the past 20 years, the therapies available in rehabilitation clinics have improved substantially, aided by robotic rehabilitation systems, which have seen rapid progress and increased performance [...]