# Posts Tagged Exoskeleton

### [VIDEO] Watch a robotic exoskeleton help a stroke patient walk – YouTube

Although it’s a far cry from the exosuits of science fiction, researchers have developed a robotic exoskeleton that can help stroke victims regain use of their legs. Nine out of 10 stroke patients are afflicted with partial paralysis, leaving some with an abnormal gait. The exosuit works by pulling cords attached to a shoe insole, providing torque to the ankle and correcting the abnormal walking motion. With the suit providing assistance to their joints, the stroke victims are able to maintain their balance, and walk similarly to the way they had prior to their paralysis, the team reports today in Science Translational Medicine. The exosuit is an adaptation of a previous design developed for the Defense Advanced Research Projects Agency Warrior Web program, a Department of Defense plan to develop assistive exosuits for military applications. Although similar mechanical devices have been built in the past to assist in gait therapy, these were bulky and had to be kept tethered to a power source. This new suit is light enough that with a decent battery, it could be used to help patients walk over terrain as well, not just on a treadmill. The researchers say that although the technology needs long-term testing, it could start to decrease the time it takes for stroke patients to recover in the near future.

## Abstract

Rehabilitation robots play an important role in rehabilitation treatment. Unlike conventional rehabilitation approach, the rehabilitation robotics provides an intensive rehabilitation motion with different modes (passive, active and active-assisted) based on the ability of the exoskeleton robot to perform assistive motion for a long period. However, this technology is still an emerging field. In this chapter, we present a Cartesian adaptive control based on a robust proportional sliding mode combined with time delay estimation for controlling a redundant exoskeleton robot called ETS-MARSE subject to uncertain nonlinear dynamics and external forces. The main objective of this research is to allow the exoskeleton robot to perform both rehabilitation modes, passive and active assistive motions with real subjects. The stability of the closed loop system is solved systematically, ensuring asymptotic convergence of the output tracking errors. Experimental results confirm the efficiency of the proposed control to provide an excellent performance despite the presence of dynamic uncertainties and external disturbances.

## References

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## Abstract

Control of a exoskeleton with different sensors using a microcontroller and Matlab: This project will be used the exoskeleton for wrist rehabilitation and evaluation designed in the RoboticsLab. This device is actuated with SMA (Shape Memory Alloys) wires and it has two DOF. The objectives of the work will be: to integrate position and pressure sensors into the exoskeleton; to use the information of these sensors to control in position and / or strength the exoskeleton in repetitive tasks for the flexion-extension movement of the wrist; collect data on the execution of the task that could be used by the doctor to evaluate the patient’s progression.

### [WEB SITE] Quix Powered Exoskeleton Becomes Finalist of the Mobility Unlimited Challenge Exoskeleton Report

The powered lower-body exoskeleton Quix by IHMC and MYOLYN is now one of five finalists of the Mobility Unlimited Challenge by the Toyota Mobility Foundation in partnership with the Nesta’s Challenge Prize Centre.  Each finalist receives a $500,000 grant for further development, and a shot at the$1M grand prize.

The Quix hip-knee-ankle wearable robot is joined by the other four finalists:

• The Evowalk – sensory/electrical stimulation sleeve
• Moby – shared powered wheelchair
• Phoenix Ai Ultralight Wheelchair – intelligent wheelchair
• Qolo – wheeled platform with a sit-to-stand powered brace with tilt control

The five finalists were selected amongst teams from 28 countries by a group of eleven judges.

“Current personal mobility devices are often unable to fully meet the needs of users due to limitations affecting functionality and usability. Historically, the pace of innovation is slow, due to small and fragmented markets and difficulties in getting new technology funded by health-care systems and insurers. This can make the field unattractive to the very people who could help change the world. We hope that challenges like this can inspire innovation and are excited to see how the five finalists use this opportunity to develop their ideas further.” – Charlotte Macken of Nesta’s Challenge Prize Centre

The main focus on the Quix wearable robot is on a superior control system that utilizes onboard sensors.  Potentially, the exoskeleton would be able to sense its environment to supplement its balancing capabilities.

The Quix exoskeleton is created by IHMC and MYOLYN, both of which competed at the 2016 Cybathlon.  MYOLYN is a leading manufacturer of FES (Functional Electric Stimulation) bicycles and exercise equipment.

IHMC Robotics Lab is no stranger to exoskeleton development.  The Robotics Lab has worked with NASA on the X1 Mina exoskeleton and took second place at the 2016 Cybathlon Exoskeleton Race (see IHMC’s practice run video).

“We’re delighted to have made it through as one of the five finalists of the Mobility Unlimited Challenge. In the business world, developing technologies for people with lower-limb paralysis has been extraordinarily hard. We’ve constantly struggled against people saying the market is too small and because of that people aren’t putting in the effort, research or investment this field deserves, meaning there hasn’t been enough advancement…” – Peter Neuhaus, IHMC

The Mobility Unlimited Challenge focuses on individuals with complete lower limb paralysis.  The challenge operates under the premise that there isn’t an affordable or proliferated technology that presently restores full movement while research and development efforts are scattered.  The challenge aims to bring together creative individuals from around the world in order to accelerate innovation and promote collaboration to create solutions that increase personal independence. [more…]

Toyota Mobility Foundation Unveils Five Visions for the Future of Mobility at CES, Press Release, http://toyotamobilityfoundation.org/pdf/press_release_20190107_en.pdf

IHMC (Florida Institue for Human and Machine Cognition) Robotics Lab, http://robots.ihmc.us

MYOLYN, Company Website, https://www.myolyn.com

Qolo (Quality of Life with Locomotion), James Dyson Award Entry, Aug 6, 2014, YouTube, https://www.youtube.com/watch?time_continue=2&v=eavedBGY2VE

## Abstract

Motivating game-based training have the potential to improve therapy for people with neurological impairments. In recent years, the serious games have become extremely useful tools in rehabilitation field. They aim to stimulate the mobility of the body through an immersive experience that puts the user in interactive virtual environment. This paper is concerned about developing a customized augmented reality system for stroke rehabilitation. This will be done through integrating an interactive serious game interface with a hand exoskeleton device. This game-based rehabilitation system allows users to carry out physical rehabilitation therapies using a natural user interface based on Kinect’s skeletal tracking features and the electromyography (EMG) sensor. During game playing, the interactive user interface provides useful real-time feedback information such as the time required to grasp a desired dynamic virtual object, and the assigned score and thus the ability of the proposed system to provide a compensatory action regarding the dynamic behavior of the virtual target. The main goal of the developed virtual environment is to create positive influences on the rehabilitation process. Patient movement information and signals obtained from the developed exoskeleton device are used together to monitor the rehabilitation progress. The developed exoskeleton hand is a 3D printed low cost device suitable for grasping tasks that can be used even for domestic stroke patients. The developed exoskeleton device is not only a mechanical system able to perform the rehabilitation act but also it presents an effective tracking and traceability software solution. The EMG signals measured during hand motion are used to detect the intention of hand opening or closing which in turn will actuate the mechanical structure to accomplish the desired task. Parameters and results of patients’ exercises are stored and analyzed when needed to evaluate patients’ progress. The developed system is tested experimentally and it is able to restore the functions of the upper limb and mainly give patients more motivation to undergo the rehabilitation exercises.

## Supplementary material

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10846_2018_966_MOESM2_ESM.mp4 (412 kb)

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### [ARTICLE] System Framework of Robotics in Upper Limb Rehabilitation on Poststroke Motor Recovery – Full Text

#### Abstract

Neurological impairments such as stroke cause damage to the functional mobility of survivors and affect their ability to perform activities of daily living. Recently, robotic treatment for upper limb stroke rehabilitation has received significant attention because it can provide high-intensity and repetitive movement therapy. In this review, the current status of upper limb rehabilitation robots is explored. Firstly, an overview of mechanical design of robotics for upper-limb rehabilitation and clinical effects of part robots are provided. Then, the comparisons of human-machine interactions, control strategies, driving modes, and training modes are described. Finally, the development and the possible future directions of the upper limb rehabilitation robot are discussed.

#### 1. Introduction

Stroke is one of the leading causes for disability. In China, there are more than 2 million new cases every year. More than 1.5 million people die from stroke each year, and three quarters of the survivors have varying degrees of sequelae [1]. The weakness and loss of the control of the upper limb that arise from nerve damage are the main symptoms [2]. This disease not only brings pain and heavy financial burden to patients and families but also brings huge economic losses and some social problems to the country.

With the development of robot technology, the application of robot in rehabilitation has aroused wide concern in the international community. A series of intelligent rehabilitation robots including artificial prosthesis and external mechanical auxiliary system have successfully developed to help patients to achieve functional recovery or compensation for the loss of motor function [35].

There are two types of rehabilitation robot for upper extremity: one is end-effector upper limb rehabilitation robots, another is exoskeleton rehabilitation robot [6]. These robots can provide rehabilitation training tasks used to guide the patients to complete targeted rehabilitation training (Figure 1). At the same time, the provision of repetitive and intensive physical therapy greatly reduces the burden of physical therapists [710].

[…]

## Abstract

Hand injuries are common but if left untreated, it may result in loss of function. Common causes of upper limb injuries are Post Stroke or Trauma. Trauma include falls, cuts from knives or glass as well as workplace injuries. The impairment of finger movements after injures results in a significant deficit in hands everyday performances.

Rehabilitation helps the patient to regain the hands full functionality. Hand therapy is the art that fills the gap between surgery and practical life. It helps the patient to regain the hands full functionality after a certain injury, surgery or Stroke. Hand therapy could be a very tedious process that implies physical exhaustion. Rehabilitation at home is a long process . And it should be done under therapist control. Also finding appointments with the therapist frequent enough for an efficient healing process, is difficult and costly.

Since trying new technologies is usually exciting to people, using the advancements in the field of artificial intelligence could be a solution to this. Different rehabilitation techniques have been developed, nevertheless, they require the presence of a tutor to be executed. To overcome this issue have been designed several apparatuses that allow the patient to perform the training by itself. Trying new technologies is exciting to people.

Hand exoskeleton was implemented to help the patients do their exercises at home in an engaging gamified environment. The objective is to design a portable, lightweight exoskeleton with adjustment fast assemble system. The device support fingers and excluding second injuries. It reproduce pinch exercise. Thus, an easy to use and effective device is needed to provide the right training and complete the rehabilitation techniques in the best way.

In this paper, a review of state of the art in this field is provided, along with an introduc- tion to the problems caused by a hand injuries and the consequences for the mobility of the hand. Then follows a complete review of the exoskeleton project design. The objective is to design a device that can be used at home, with a lightweight and affordable structure and a fast mounting system. For implementing all these features, many aspects have been analysed, starting from the rehabilitation requirements and the ergonomic issues. This device should be able to reproduce the training movements on an injured hand without the need for assistance by an external tutor.

The control system is based on Arduino UNO board, and the user interface is based on UNITY, the objective is to create an online media that allows the patient to exploit the capabilities of the exoskeleton, following the indication of its medic. On the other side, this interface should provide all the data related to the performances of the patient to allow a more precise therapy.

### [WEB PAGE] Robotic Hand Orthosis for Therapy and Assistance in Activities of Daily Living

tenoexo is a compact and lightweight hand exoskeleton which has been developed in collaboration with Jumpei Arata at Kyushu University. The EMG-controlled device assists patients with moderate to severe hand motor impairment during grasping tasks in rehabilitation training and during activities of daily living. Its soft mechanism allows for grasping of a variety of objects. Thanks to 3D-rapid prototyping, it can be tailored to the each individual user.

Stroke, spinal cord injury and muscular atrophy are just few examples of diseases leading to persistent hand impairment. No matter the cause, the inability to use the affected hand in activities of daily living will affect independence and quality of life. Wearable robotic devices can support the use of the impaired limb in activities of daily living, and provide at-home rehabilitation training. In collaboration with the groups of Prof. Jumpei Arata at Kyushu University, Japan, and Gregory Fischer at Worcester Polytechnic Institute, USA, we have developed a highly compact and lightweight hand exoskeleton.

Our exoskeleton aims to assist patients in grasping tasks during physiotherapy and in activities of daily living such as eating or grooming. Various grasp types, intuitive control based on electromyography (Ryser et al., 2017) and numerous usability features should increase the independence of the user. The current prototype, RELab tenoexo, is fully wearable and consists of a lightweight hand module (148 g) as well as an actuation box including motors, power source and controllers (720 g), all located in a compact backpack. tenoexo’s remote actuation system (Hofmann et al., 2018) and its compliant 3-layered sliding spring mechanism (Arata et al., 2013) ensure safe operation and inherent adaptation to the shape of the grasped objects. The palmar side of the hand is minimally covered to allow for natural somatosensory feedback during object manipulation. The actuated thumb module allows for both opposition and lateral grasps. tenoexo is fabricated to a large extent by 3D-printing technology. With an underlying automatic tailoring algorithm it can be adapted to the individual user within a few minutes. The maximal fingertip force of 4.5 N per finger allows for grasping and lifting of most everyday objects, up to 0.5-liter water bottles.

Our current focus is on the evaluation of tenoexo with several individuals suffering from stroke or spinal cord injury and exploring its potential as both assistive and therapeutic device in these populations. In related projects, we are investigating intention detection through functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) to allow for cortically-triggered assistance. Our vision is to realize a thought-controlled robotic hand exoskeleton for upper limb therapy and assistance in the clinic and at home.

ReHand

## Funding

• Swiss National Science Foundation through the National Center of Competence in Research (NCCR) Robotics
• Strategic Japanese-Swiss Cooperative Research Program on “Medicine for an Aging Society”
• Japan Society for the Promotion of Science

## Publications

Hofmann, U.A., Bützer, T., Lambercy, O., and Gassert, R. (2018). Design and Evaluation of a Bowden-Cable-Based Remote Actuation System for Wearable Robotics. IEEE Robotics and Automation Letters, 3(3):2101–2108.

Ryser, F., Bützer, T., Held, J.P., Lambercy, O., and Gassert, R. (2017). Fully embedded myoelectric control for a wearable robotic hand orthosisIEEE International Conference on Rehabilitation Robotics (ICORR).

Nycz, Ch., Bützer, T., Lambercy, O., Arata, J., Fischer, G.S., and Gassert, R. (2016). Design and Characterization of a Lightweight and Fully Portable Remote Actuation System for Use with a Hand Exoskeleton. IEEE Robotics and Automation Letters, 1(2):976–983.

Lambercy, O., Schröder, D., Zwicker, S. and Gassert, R. (2013). Design of a thumb exoskeleton for hand rehabilitation (PDF, 1.1 MB). Proc. International Convention on Rehabilitation Engineering and Assistive Technology (i-CREATe).

Arata, J., Ohmoto, K., Gassert, R., Lambercy, O., Fujimoto, H. and Wada, I. (2013). A new hand exoskeleton device for rehabilitation using a three-layered sliding spring mechanism. IEEE International Conference on Robotics and Automation, pp. 3902–3907.

### [WEB SITE] Hong Kong researchers create robotic arm to help stroke patients

A research team at Hong Kong Polytechnic University (PolyU) has developed a robotic arm to facilitate self-help and upper-limb mobile rehabilitation for stroke patients after discharge from hospital.

Referred to as a mobile exo-neuro-musculo-skeleton, the robotic arm enables intensive and effective self-help rehabilitation exercise.

The lightweight device is said to be the first of its kind to combine exo-skeleton, soft robot and exo-nerve stimulation technologies. It is intended to cater to the increasing need for outpatient rehabilitation service for stroke patients.

“Referred to as a mobile exo-neuro-musculo-skeleton, the robotic arm enables intensive and effective self-help rehabilitation exercise.”

PolyU Department of Biomedical Engineering researcher Hu Xiaoling said: “We are confident that with our mobile exo-neuro-musculo-skeleton, stroke patients can conduct rehabilitation training anytime and anywhere, turning the training into part of their daily activities.

“We hope such flexible self-help training can well supplement traditional outpatient rehabilitation services, helping stroke patients achieve a much better rehabilitation progress.”

Designed to be flexible and easy-to-use, the robotic arm is compact in size, has fast responses and requires a minimal power supply.

It comprises different components for the wrist/hand, elbow, and fingers that can be worn separately or together for various functional training needs. The device can also be connected to a mobile application, where users can manage their training.

The exo-skeleton and soft robot components of the device offer external mechanical forces guided by voluntary muscle signals in order to facilitate the desired joint movement for the patients.

PolyU improved the rehabilitation by adding its Neuro-muscular Electrical Stimulation (NMES) technology, which allows the robotic arm to contract user’s muscles when electromyography signals are detected.

When tested in a clinical trial involving ten stroke patients, the robotic arm is reported to have led to better muscle coordination, wrist and finger functions, and lower muscle spasticity following 20 two-hour training sessions.

The researchers plan to collaborate with hospitals and clinics for conducting additional trials.

## Highlights

• To adapt glenohumeral (GH) movements and improve exoskeletal compatibility, six passive joints were introduced into the connecting interfaces based on optimal configuration principles.
• The optimal configuration of the passive joints can effectively reduce the gravitational influences of the exoskeleton device and the upper extremities.
• A new approach is presented to compensate vertical GH movements.
• A comparison of the theoretical and measured results confirms that the passive joints exhibited good human-machine compatibility for GH movements.
• The wearable comfort of Co-Exos was improved significantly.

## Abstract

The upper-limb rehabilitation exoskeleton is a critical piece of equipment for stroke patients to compensate for deficiencies of manual rehabilitation and reduce physical therapists’ workloads. In this paper, configuration synthesis of an exoskeleton is completed using advanced mechanism theory. To adapt glenohumeral (GH) movements and improve exoskeletal compatibility, six passive joints were introduced into the connecting interfaces based on optimal configuration principles. The optimal configuration of the passive joints can effectively reduce the gravitational influences of the exoskeleton device and the upper extremities. A compatible exoskeleton (Co-Exos) with 11 degrees of freedom was developed while retaining a compact volume. A new approach is presented to compensate vertical GH movements. The theoretical displacements of translational joints were calculated by the kinematic model of the shoulder loop  Θs. A comparison of the theoretical and measured results confirms that the passive joints exhibited good human–machine compatibility for GH movements. The hysteresis phenomenon of translational joints appeared in all experiments due to the elasticoplasticity of the upper arm and GH. In comparable experiments, the effective torque of the second active joint was reduced by an average of 41.3% when passive joints were released. The wearable comfort of Co-Exos was thus improved significantly.