Robotic Rehabilitation Devices Research Articles

Traditional versus progressive robot-assisted gait training in people with multiple sclerosis and severe gait disability: study protocol for the PROGR-EX randomised controlled trial

Gait disorders are the most frequent symptoms associated to multiple sclerosis (MS). Robot-assisted gait training (RAGT) in people with MS (PwMS) has been proposed as a possible effective treatment option...

User Needs for a Robotic Hand Rehabilitation Device in Home-based Therapy Following a Stroke: A User-centered Approach

User Needs for a Robotic Hand Rehabilitation Device in Home-based Therapy Following a Stroke: A User-centered Approach

A Review of Wrist Rehabilitation Robots and Highlights Needed for New Devices

Various conditions, including traffic accidents, sports injuries, and neurological disorders, can impair human wrist movements, underscoring the importance of effective rehabilitation methods. Robotic devices play a crucial role in this regard, particularly in wrist rehabilitation, given the complexity of the human wrist joint, which encompasses three degrees of freedom: flexion/extension, pronation/supination, and radial/ulnar deviation. This paper provides a comprehensive review of wrist rehabilitation devices, employing a methodological approach based on primary articles sourced from PubMed, ScienceDirect, Scopus, and IEEE, using the keywords “wrist rehabilitation robot” from 2007 onwards. The findings highlight a diverse array of wrist rehabilitation devices, systematically organized in a tabular format for enhanced comprehension. Serving as a valuable resource for researchers, this paper enables comparative analyses of robotic wrist rehabilitation devices across various attributes, offering insights into future advancements. Particularly noteworthy is the integration of serious games with simplified wrist rehabilitation devices, signaling a promising avenue for enhancing rehabilitation outcomes. These insights lay the groundwork for the development of new robotic wrist rehabilitation devices or to make improvements to existing prototypes incorporating a forward-looking approach to improve rehabilitation outcomes.

Redesign of Leg Assembly and Implementation of Reinforcement Learning for a Multi-Purpose Rehabilitation Robotic Device (RoboREHAB)

Patients who are suffering from neuromuscular disorders or injuries that impair motor control need to undergo rehabilitation to regain mobility. Gait training is commonly prescribed to patients to regain muscle memory. Automated-walking training devices were created to aid this process; while these devices establish accurate ankle-path trajectories, the knee and hip movements are inaccurate. In this work, a redesign of the leg assembly in a multi-purpose rehabilitation robotic device (RoboREHAB) was explored to improve hip- and knee-movement accuracy by adding an extra link and rollers to the assembly. Motion analysis was employed to test feasibility, reinforcement learning was utilized to train the new leg assembly to walk, and the joint motions achieved with the redesign were compared to those achieved by motion-capture (mocap) data. As a key result, the motion analysis showed an improvement in the knee- and hip-path trajectories due to the added roller/joint segment. The redesigned leg assembly, under the reinforcement-learning policy, showed a 5% deviation from the motion-capture joint trajectories with a maximum deviation of 51.177 mm but maintained a similar profile to the mocap trajectory data. This is an improvement over the original two-segment design, which achieved a maximum deviation of 72.084 mm. These results in the knee- and hip-joint movements more closely reflect the mocap and motion-analysis results, validating the redesign and opening it up to further experimentation and technical improvement.

Design and Development of Portable Wrist Rehabilitation Device for Post-Stroke Subjects: A Pilot Study

Wrist mobility is vital for post-stroke patients to carry out their daily activities. The use of robotic devices in hand rehabilitation has increased significantly in recent years, allowing patients to get training at home and effectively compensating for the therapist-to-patient ratio. Nevertheless, rehabilitation devices are expensive, cumbersome, immobile, and difficult to wear and operate. This work proposes a new method for designing a wrist rehabilitation device that uses airbag technology to minimize device weight and size. A triangular prism-shaped Neoprene (synthetic rubber) airbag is utilized in the experiment; which is inflated and deflated using a DC motorized air pump. An accelerometer sensor serves as the control input for the wrist rehabilitation exercise device. The proposed device trains the impaired hand of ten hemiplegic post-stroke patients. A goniometer and Fugl-Meyer Assessment (FMA) are used to measure wrist motion before and after the training regimen to evaluate the results. The mean angle (in degree) of wrist flexion increases from 8.6 ± 2.59 to 18.4 ± 5.19 (p = 0.005). Likewise, an increase in the wrist extension angle from 12.3 ± 3.62 to 17.7 ± 6.2 (p = 0.008) is noted. The wrist rehabilitation device is lightweight, portable, and simple to use, producing good results for hemiplegic individuals with hand disability. The suggested invention enables the user to extend their wrist’s range of motion.

An original hybrid-architecture finger mechanism for wearable hand exoskeletons

Robotic devices for rehabilitation and assistance are becoming crucial tools for improving the life quality of people with disabilities. The hand is one of the most affected upper-limb parts, but also fundamental for the subject’s interaction with the external environment. Wearability and portability, safety and comfort, lightness and small sizes, independent finger movement, efficacy in daily activities, sense-of-touch preservation, and affordability are the main features such devices should have. This paper will present an in-depth study of a thumb module for wearable hand exoskeletons, designed as a base concept to be adapted to the other fingers. Specifically, it exploits a new hybrid architecture (meaning that rigid and soft elements are included in the finger mechanism) to reduce the overall dimensions while remaining effective in force transmission. An embodiment of the mechanism is also presented and tested. As well as turning out to be small, light, and cheap, the new concept design demonstrates a minimum coverage of the finger range of motion of about 84% and an exerted force up to 16.78 N.

Робототехнические средства реабилитации двигательной активности пациентов в постинсультном периоде

Stroke prevalence is one of the most acute problems in the medical and social aspects of society: strokes are the second most common in the mortality statistics of the population. In the Russian Federation, stroke occurs annually in almost 500,000 people and is the first among the causes of death from neurological diseases and the second most common cause of death after heart disease. The most common consequences of stroke are motor disorders of varying severity, manifested as changes in muscle tone, paresis and paralysis, and impaired walking function. This paper is an overview of the current state of robotic rehabilitation devices used for post-stroke limb paresis and of expected trends of their development. The existing variants of their construction, conditions of kinesiotherapy sessions for obtaining the greatest effect are considered. The authors are of the opinion that the nearest prospect for the development of high-tech devices of this type is not only complex stationary universal complexes for clinics, but also simple mobile specialized simulators with remote medical control for outpatient use.

A novel approach of multi-loop control based-ADRC for improving lower knee position exoskeleton system

AbstractThis study revealed the system of a lower limb exoskeleton created for knee rehabilitation. The exoskeleton has been extensively used in rehabilitation robotic device research, but its practical applicability is limited due to its high nonlinearity and uncertain behavior. As a result, the control technique is critical in increasing the efficacy of rehabilitation devices. For the rehabilitation and help of a patient with a lower-limb condition, a sliding mode control (SMC) with proportional derivative (PD) control approach are used as parallel loops. Active disturbances rejection control (ADRC) is used by these controllers to cancel any external influences. To overcome the degradation of disturbance rejection and robustness caused by a failure to fully adjust for the entire disturbance, a (SMC) loop was introduced to the control regulation. By assessing performance indices related to the estimated inaccuracy, the results demonstrate the effectiveness of the suggested controller. Simulink is used for simulation and analysis.

Assist-as-needed control with a soft robotic glove based on human-object contact estimation

Assist-as-needed control with a soft robotic hand glove for active rehabilitation is studied in this work. There are two resources of the grasping force, the robotic glove and the subject. Compared with traditional passive rehabilitation where the grasping force is merely provided by a robotic hand rehabilitation device (such as hand exoskeleton, robotic glove), assist-as-needed control accounts for the user contribute to performing grasping tasks collaboratively. In this control method, the human muscle strength for grasping is estimated through the myoelectrical signals of the human forearm collected by the MYO armband. A neural network is used for the recognition of human-object contact estimation. The assist-as-needed control is finally implemented to assist humans in grasping tasks. Experiment results on a soft robotic glove show the effectiveness of the proposed assistive control method.

Algorithm for Controlling the Movement of the Actuator of the Device for Active-Passive Mechanotherapy of the Ankle Join

Purpose of research. The article is devoted to the development of an algorithm for controlling the movement of a controlled mobile platform of a passive mechanotherapy ankle joint apparatus. One of the most common injuries sustained by humans is damage to the ankle joint in sports, domestic, industrial exercises, and as a result of car accidents. Falls from heights with a landing on the feet, including parachute jumps, also often result in ankle injuries. In order to increase the effectiveness of rehabilitation, mechanotherapy is usually used. The relevance of the topic is related to the high efficiency of robotic rehabilitation devices, which, thanks to back-linking and electrically controlled actuators, can perform lower limb movements in an optimal way.Methods. The structural diagram of the device control system has been developed. The proposed algorithm uses the strategy of paralleling control actions with the use of corrective and reference controls to calculate control voltages. Presence of force-moment feeling system enables to estimate change of reaction value in time and timely fix the moment of spastic effects appearance, muscle contracture and automatically make changes in foot movement laws in order to exclude patient's traumatisation and pain syndrome elimination.Results. A methodology for constructing the desired dependence of foot rotation angles on time in the sagittal and frontal planes is proposed. We have developed an operating algorithm for the laws of motion and decision-making block, an algorithm for generating control voltages from the reference model, an operating algorithm for the voltage correction block, and an operating algorithm for the reference model correction block. As a result of virtual tests on the mathematical model of the device, we obtained the basic patterns of motion of the actuator in the form of dependences of the rotation angle of the platform from the time.Conclusion. The results of testing the device show that controlling the movement of the actuator for active-passive mechanotherapy of the ankle joint using the algorithms described in the article is reasonable.

Biopsychosocial effects and experience of use of robotic and virtual reality devices in neuromotor rehabilitation: A study protocol.

Robot-assisted therapy (RAT) and virtual reality (VR)-based neuromotor rehabilitation have shown promising evidence in terms of patient's neuromotor recovery, so far. However, still little is known on the perceived experience of use of robotic and VR devices and the related psychosocial impact. The present study outlines a study protocol aiming to investigate the biopsychosocial effects and the experience of use of robotic and non-immersive VR devices in patients undergoing neuromotor rehabilitation. Adopting a prospective, two-arm, non-randomized study design, patients with different neuromotor diseases (i.e., acquired brain injury, Parkinson's Disease, and total knee/hip arthroplasty) undergoing rehabilitation will be included. In a real-world clinical setting, short- (4 weeks) and long-term (6 months) changes in multiple patient's health domains will be investigated, including the functional status (i.e., motor functioning, ADLs, risk of falls), cognitive functioning (i.e., attention and executive functions), physical and mental health-related quality of life (HRQoL), and the psychological status (i.e., anxiety and depression, quality of life satisfaction). At post-intervention, the overall rehabilitation experience, the psychosocial impact of the robotic and VR devices will be assessed, and technology perceived usability and experience of use will be evaluated through a mixed-methods approach, including both patients' and physiotherapists' perspectives. Repeated measures within-between interaction effects will be estimated, and association analyses will be performed to explore the inter-relationships among the variables investigated. Data collection is currently ongoing. The biopsychosocial framework adopted will contribute to expanding the perspective on patient's recovery within the technology-based rehabilitation field beyond motor improvement. Moreover, the investigation of devices experience of use and usability will provide further insight into technology deployment in neuromotor rehabilitation programs, thereby maximising therapy engagement and effectiveness. ClinicalTrials.gov ID: NCT05399043.

Developing of a wearable ankle rehabilitation robotic device

People with walking disorders caused by accidents or stroke can undergo treatment to restore their mobility. Traditional therapy is time-consuming and time-consuming. Therefore, a new trend was born – to facilitate rehabilitation and reduce the patient’s time. Rehabilitation robotics is an area that is constantly evolving, and new mechanisms have recently been developed to help people regain their mobility. This paper presents a 3-RPS parallel manipulator for the restoration of the ankle joint with three degrees of freedom. Parallel manipulator 3-RPS with three degrees of freedom, which was introduced by K. Hunt in 1983 as one of the sedentary parallel manipulators. Since then, 3-RPS has attracted a lot of attention from robotics and biomedical engineering engineers.

The identification of interacting brain networks during robot-assisted training with multimodal stimulation

Objective. Robot-assisted rehabilitation training is an effective way to assist rehabilitation therapy. So far, various robotic devices have been developed for automatic training of central nervous system following injury. Multimodal stimulation such as visual and auditory stimulus and even virtual reality technology were usually introduced in these robotic devices to improve the effect of rehabilitation training. This may need to be explained from a neurological perspective, but there are few relevant studies. Approach. In this study, ten participants performed right arm rehabilitation training tasks using an upper limb rehabilitation robotic device. The tasks were completed under four different feedback conditions including multiple combinations of visual and auditory components: auditory feedback; visual feedback; visual and auditory feedback (VAF); non-feedback. The functional near-infrared spectroscopy devices record blood oxygen signals in bilateral motor, visual and auditory areas. Using hemoglobin concentration as an indicator of cortical activation, the effective connectivity of these regions was then calculated through Granger causality. Main results. We found that overall stronger activation and effective connectivity between related brain regions were associated with VAF. When participants completed the training task without VAF, the trends in activation and connectivity were diminished. Significance. This study revealed cerebral cortex activation and interacting networks of brain regions in robot-assisted rehabilitation training with multimodal stimulation, which is expected to provide indicators for further evaluation of the effect of rehabilitation training, and promote further exploration of the interaction network in the brain during a variety of external stimuli, and to explore the best sensory combination.

Single-Channel sEMG-Based Estimation of Knee Joint Angle Using a Decomposition Algorithm With a State-Space Model.

Accurate human motion estimation is crucial for effective and safe human-robot interaction when using robotic devices for rehabilitation or performance enhancement. Although surface electromyography (sEMG) signals have been widely used to estimate human movements, conventional sEMG-based methods, which need sEMG signals measured from multiple relevant muscles, are usually subject to some limitations, including interference between sEMG sensors and wearable robots/environment, complicated calibration, as well as discomfort during long-term routine use. Few methods have been proposed to deal with these limitations by using single-channel sEMG (i.e., reducing the sEMG sensors as much as possible). The main challenge for developing single-channel sEMG-based estimation methods is that high estimation accuracy is difficult to be guaranteed. To address this problem, we proposed an sEMG-driven state-space model combined with an sEMG decomposition algorithm to improve the accuracy of knee joint movement estimation based on single-channel sEMG signals measured from gastrocnemius. The effectiveness of the method was evaluated via both single- and multi-speed walking experiments with seven and four healthy subjects, respectively. The results showed that the normal root-mean-squared error of the estimated knee joint angle using the method could be limited to 15%. Moreover, this method is robust with respect to variations in walking speeds. The estimation performance of this method was basically comparable to that of state-of-the-art studies using multi-channel sEMG.

Design and hybrid impedance control of a new compliant wrist rehabilitation device

Over a decade, wrist rehabilitation robots have been proved to be efficient in the rehabilitation of patients with stroke or wrist injuries. Wrist rehabilitation devices compensate for deficiencies in manual rehabilitation training and reduce the workload of physiotherapists with their repetitive and gradual training necessary to rehabilitate patients with wrist impairments properly. Two design approaches have been reported in literature for wrist rehabilitation robotic devices. In one design approach, the strategy of placing the actuators, either linear or rotary, on the forearm to minimise the weight and inertia has been proposed. This necessitates a use of sophisticated transmission systems. In the other design approach, rotary motors have been proposed to be placed directly on the wrist joints, which results in a high weight and inertia. In this paper, a new 2-DOF compliant wrist rehabilitation device that can achieve the flexion-extension and radial-ulnar rehabilitation movements compliantly is proposed. In the proposed design, two series elastic actuators (SEAs), each consists of a servomotor and a custom-designed series elastic unit, are proposed to be placed directly on the wrist joints. In order to minimise the inertia and the required torques, the device is counterweight balanced by optimising the centre of mass of the device in the SolidWorks model. Based on the device dynamics modelled by ADAMS software, hybrid position and force tracking impedance control with the incorporation of a disturbance observer controller for the rotary SEA is developed for position and force tracking through the different therapeutic exercises. The disturbance observer controller is incorporated for high precision force control and robustness against exogenous disturbances. Simulation results demonstrate high performance of the proposed wrist rehabilitation device in terms of precise position and force trajectories tracking and robustness against exogenous disturbance as well as patient safety during all therapeutic exercises.

Решение задачи формирования безопасной конфигурации роботического протеза верхней конечности человека

This study aimed to develop a method allowing to improve safety of use of robotic medical rehabilitation devices by designing and testing an algorithm for calculation of the angular positions of rehabilitation robotic manipulators or robotic prostheses and allowing to reproduce the natural arc of a human arm under control of a CVS. The Introduction section supports the urgency of development of the methods granting control over positioning of robotic manipulators with the help of a computer vision system (CVS) and thus guarantee safety of patients and medical personnel in the context of work with medical robotic rehabilitation devices. The Materials and Methods section contains a brief description of the robotic arm used in this study, a description of the existing approaches to calculation of angular positions of drives, and a description of the proposed algorithm. The final sections compare application of the proposed algorithm and existing methods of calculation of angular positions of drives of robotic manipulators (robotic prostheses) and outline the possible directions for further improvement.

Experiences of patients who had a stroke and rehabilitation professionals with upper limb rehabilitation robots: a qualitative systematic review protocol

IntroductionEmerging evidence suggests that robotic devices for upper limb rehabilitation after a stroke may improve upper limb function. For robotic upper limb rehabilitation in stroke to be successful, patients’ experiences...

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.

Application of elastic actuators with torsion spring of variable stiffness in robotic rehabilitation devices

Application of elastic actuators with torsion spring of variable stiffness in robotic rehabilitation devices

A review on the application of autonomous and intelligent robotic devices in medical rehabilitation

A review on the application of autonomous and intelligent robotic devices in medical rehabilitation