Posts Tagged Rehabilitation robotics

[ARTICLE] Assist-as-needed control strategy for upper-limb rehabilitation based on subject’s functional ability – Full Text

The assist-as-needed technique in robotic rehabilitation is a popular technique that encourages patients’ active participation to promote motor recovery. It has been proven beneficial for patients with functional motor disability. However, its application in robotic therapy has been hindered by a poor estimation method of subjects’ functional or movement ability which is required for setting the appropriate robotic assistance. Moreover, there is also the need for consistency and repeatability of the functional ability estimation in line with the clinical procedure to facilitate a wider clinical adoption. In this study, we propose a new technique of estimation of subject’s functional ability based on the Wolf Motor Function Test. We called this estimation the functional ability index. The functional ability index enables the modulation of robotic assistance and gives a more consistent indication of subjects’ upper-limb movement ability during therapy session. Our baseline controller is an adaptive inertia-related controller, which is integrated with the functional ability index algorithm to provide movement assistance as when needed. Experimental studies are conducted on three hemiplegic patients with different levels of upper-limb impairments. Each patient is requested to perform reaching task of lifting a can from table-to-mouth according to the guidelines stipulated in the Wolf Motor Function Test. Data were collected using two inertial measurement unit sensors installed at the flexion/extension joints, and the functional ability score of each patient was rated by an experienced therapist. Results showed that the proposed functional ability index algorithm can estimate patients’ functional ability level consistently with clinical procedure and can modify generated robotic assistance in accordance with patients’ functional movement ability.

The assist-as-needed (AAN) robotic strategy is a popular strategy for encouraging patients’ active participation in robot-assisted rehabilitation therapy. Numerous clinical outcomes have suggested the effectiveness of the AAN scheme to induce neuroplasticity in patients with neurological impairment.1 The AAN strategy focuses on providing the minimal amount of robotic assistance necessary for a patient to complete a movement,2 thus a significant effort is required from the patient. If the patient can perform the task flawlessly, robotic assistance is withdrawn. However, if the patient cannot complete the given task, assistance is offered only as much as it is needed.3

Deploying robotic assistance in accordance with the AAN strategy still come with many shortcomings.3,4 One major issue is how to appropriately estimate patients’ functional ability to set the correct level of robotic assistance. Another issue is the consistency of the estimated subject’s functional ability with clinical data and the repeatability across a wide range of subjects. An appropriate estimation of subject’s functional ability consistent with clinical data can give a realistic basis for deploying robotic assistance, since it gives a measure of subject’s actual disability level or recovery progress.5,6

A few strategies of AAN have been proposed recently which have attempted to address the challenges in the scheme. Wolbrecht et al.7 proposed a model-based robotic assistance strategy which can enable a robot to learn the patients’ ability in real time based on a radial-basis function (RBF). The RBF is applied under an adaptive control framework.

Another AAN strategy was proposed by Pehlivan et al.3 The authors introduced a minimal assist-as-needed (mAAN) strategy which uses a Kalman filter to estimate subjects’ functional inputs instead of the RBF technique that is a sensor-less force estimation strategy. Under the scheme, the ANN strategy is achieved in the following two ways: (1) by updating the derivative feedback gain to modify the bounds of allowable error on the desired trajectory and (2) by decaying a feed-forward disturbance rejection term which reduces the constraint on allowable quick movements. The combined effect could vary the robotic assistance according to the subjects’ capability.8 The potential limitation of this approach is the reliance on the robot model for the estimation of subject’s capability. It is well known that model errors always exist and can significantly excite the disturbance term making it difficult to accurately estimate the subject’s input. There is the implication that different robot models would produce different functional ability estimates which will hinder an appropriate standardization or deployment of robotic assistance for clinical purpose.9,10

Pérez-Rodríguez et al.11 also introduced an AAN strategy called anticipatory assistance-as-needed control algorithm capable of ensuring that the deviation from a patients’ desired trajectory is restored by giving an anticipated force assistance. This way, robotic assistance is always given as a restoring force to maintain the subject on the reference (desired) trajectory. With regards to the validity of this strategy, there are however no experimental studies till date.

Other noteworthy AAN strategies include the rule-based assistive strategy proposed by Wang et al.,12 which is applied in Physiotherabot; the hybrid impedance control for wrist and forearm rehabilitation proposed by Akdoğan and Adli,13 which is applied on a 3-degree-of-freedom (3-DOF) upper-limb rehabilitation robot; and the visual error augmentation-based AAN proposed by Akdoğan et al.,14 which can provide robotic assistance as needed by amplifying tracking error to heighten the participant’s motivation.

Efforts in developing an appropriate estimation strategy for AAN robotic assistance are still on course;15 however, there has been less focus on developing appropriate estimation techniques of subject’s functional ability that are consistent with the clinical procedure and that can be integrated in the control loop to provide robotic assistance.15,16

In this paper, we propose an ANN strategy to direct robotic assistance based on a novel functional ability index (FAI). The main originality of this work is the derivation of the new FAI estimation algorithm in accordance with the clinical procedure for the estimation of subject’s motor ability in movement task. As a preliminary investigation, we derive our FAI following the Wolf Motor Function Test (WMFT), a popular motor function test with consistency over a wide range of neurologically impaired patients. The FAI serves as input to a decay algorithm under the adaptive control law which consequently varies the robotic assistance according to the subject’s functional ability. The FAI is independent on the robot model or controller adaptation law and thus it is unaffected by modelling uncertainties.

The rest of the paper is organized as follows: section ‘System dynamic and control’ presents the dynamics for the robotic rehabilitation system, the proposed FAI, and the proposed control algorithm. Section ‘Experimental study’ presents the data collection and simulation study; section ‘Results’ describes the results; section ‘Discussion’ presents the discussion; and section ‘Conclusion’ concludes the paper.

The mechanical system

The proposed prototype of the exoskeleton system is shown in Figure 1. The system is an upper-limb rehabilitation robotic device with two active degrees of freedom (DOFs) at the shoulder and elbow joint, respectively. If actively controlled, the exoskeleton can permit abduction/adduction (AA) movement of the shoulder joint and flexion/extension (FE) movement of the elbow, thus allowing the possibility of performing the table to mouth reaching task.


Figure 1. Exoskeleton device is of 2 degrees of freedom (DOFs).

Continue —> Assist-as-needed control strategy for upper-limb rehabilitation based on subject’s functional ability – Shawgi Younis Ahmed Mounis, Norsinnira Zainul Azlan, Fatai Sado,

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[Abstract] Exoskeleton design and adaptive compliance control for hand rehabilitation

An adaptive robotic system has been developed to be used for hand rehabilitation. Previously developed exoskeletons are either very complex in terms of mechanism, hardware and software, or simple but have limited functionality only for a specific rehabilitation task. Some of these studies use simple position controllers considering only to improve the trajectory tracking performance of the exoskeleton which is inadequate in terms of safety and health of the patient. Some of them focus only on either passive or active rehabilitation, but not both together. Some others use EMG signals to assist the patient, but this time active rehabilitation is impossible unless different designs and control strategies are not developed. The proposed mechanical structure is extremely simple. The middle and the proximal phalanxes are used as a link of consecutively connected two 4-bar mechanisms, respectively. The PIP and MCP joints are actuated by a single electro mechanical cylinder to produce complex flexion and extension movements. It is simpler than similar ones from aspect with the mechanical structure and the biodynamic fit of the hand, making it practicable in terms of production and personal usage. Simple design lets to implement adaptive compliance controller for all active and passive rehabilitation tasks, instead of developing complex and different strategies for different rehabilitation tasks. Furthermore, using the Luenberger observer for unmeasured velocity state variable, an on-line estimation method is used to estimate the dynamic parameters of the system. This makes possible to estimate the force exerted by the patient as well, without a force sensor.


via Exoskeleton design and adaptive compliance control for hand rehabilitation – Gazi Akgun, Ahmet Emre Cetin, Erkan Kaplanoglu,

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[Abstract] An Elbow Exoskeleton for Upper Limb Rehabilitation With Series Elastic Actuator and Cable-Driven Differential


Movement impairments resulting from neurologic injuries, such as stroke, can be treated with robotic exoskeletons that assist with movement retraining. Exoskeleton designs benefit from low impedance and accurate torque control. We designed a two-degrees-of-freedom tethered exoskeleton that can provide independent torque control on elbow flexion/extension and forearm supination/pronation. Two identical series elastic actuators (SEAs) are used to actuate the exoskeleton. The two SEAs are coupled through a novel cable-driven differential. The exoskeleton is compact and lightweight, with a mass of 0.9 kg. Applied rms torque errors were less than 0.19 Nm. Benchtop tests demonstrated a torque rise time of approximately 0.1 s, a torque control bandwidth of 3.7 Hz, and an impedance of less than 0.03 Nm/° at 1 Hz. The controller can simulate a stable maximum wall stiffness of 0.45 Nm/°. The overall performance is adequate for robotic therapy applications and the novelty of the design is discussed.

via An Elbow Exoskeleton for Upper Limb Rehabilitation With Series Elastic Actuator and Cable-Driven Differential – IEEE Journals & Magazine

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[Abstract + References] Design and Kinematics Analysis of a Bionic Finger Hand Rehabilitation Robot Mechanism


The rehabilitation process of human fingers is a coupling movement of wearable hand rehabilitation equipment and human fingers, and its design must be based on the kinematics of human fingers. In this paper, the forward kinematics and inverse kinematics models are established for the index finger. Kinematics analysis is carried out. Then a bionic finger rehabilitation robot is designed according to the movement characteristics of the finger, A parallelogram linkage mechanism is proposed to make the joint independent drive, realize the flexion/extension movement, and perform positive kinematics and inverse kinematics analysis on the mechanism. The results show that it conforms to the kinematics of the index finger and can be used as the mechanism model of the finger rehabilitation robot.
1. Ibrahim Yildiz, “A Low-Cost and Lightweight Alternative to Rehabilitation Robots: Omnidirectional Interactive Mobile Robot for Arm Rehabilitation” in Arabian Journal for Science & Engineering, Springer Science & Business Media B.V., vol. 43, no. 3, pp. 1053-1059, 2018.

2. Bai Shaoping, Gurvinder S. Virk, Thomas G. Sugar, Wearable Exoskeleton Systems: Design control and applications[M], Institution of Engineering and Technology Control, pp. 1-406, 2018.

3. Kai Zhang, Xiaofeng Chen et al., “System Framework of Robotics in Upper Limb Rehabilitation on Poststroke Motor Recovery”, Behavioural Neurology, vol. 12, pp. 1-14, 2018.

4. Yang Haile, Zhu Huiying, Lin Xingyu, “Review of Exoskeleton Wearable Rehabilitation System[J]”, Metrology and testing technology, vol. 46, no. 03, pp. 40-44, 2019.

5. Xiang Shichuan, Meng Qiaoling, Yu Hongliu, Meng Qingyun, “Research status of compliant exoskeleton rehabilitation manipulator [J]”, Chinese Journal of Rehabilitation Medicine, vol. 33, no. 04, pp. 461-465+474, 2018.

6. Wu Hongjian, Li Lina, Li Long, Liu Tian, Jue Wang, “Review of comprehensive intervention by hand rehabilitation robot after stroke [J]”, Journal of biomedical engineering, vol. 36, no. 01, pp. 151-156, 2019.

7. Yu Junwei, Xu Hongbin, Xu Taojin, Zhang Chengjie, Lu Shiqing, “Structure Design and Finite Element Analysis of a Rope Traction Upper Limb Rehabilitation Robot [J]”, Mechanical transmission, vol. 42, no. 12, pp. 93-97, 2018.

8. Chang Ying, Meng Qingyun, Yu Hongliu, “Research progress on the development of hand rehabilitation robot [J]”, Beijing Biomedical Engineering, vol. 37, no. 06, pp. 650-656, 2018.

9. N A I M Rosli, M A A Rahman, S A Mazlan et al., “Electrocardiographic (ECG) and Electromyographic (EMG) signals fusion for physiological device in rehab application[C]”, IEEE Student Conference on Research and Development, pp. 1-5, 2015.

10. K O Thielbar, K M Triandafilou, H C Fischer et al., “Benefits of using a voice and EMG- Driven actuated glove to support occupational therapy for stroke survivors”, IEEE Trans Neural Syst Rehabil Eng, vol. 25, no. 3, pp. 297-305, 2017.


via Design and Kinematics Analysis of a Bionic Finger Hand Rehabilitation Robot Mechanism – IEEE Conference Publication

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[Abstract] Remote Upper Limb Exoskeleton Rehabilitation Training System Based on Virtual Reality


According to the present situation that the treatment means for apoplectic patients is lagging and weak, a set of long-distance exoskeleton rehabilitation training system with 5 DOF for upper limb was developed. First, the mechanical structure and control system of the training system were designed. Then a new kind of building method for virtual environment was proposed. The method created a complex model effectively with good portability. The new building method was used to design the virtual training scenes for patients’ rehabilitation in which the virtual human model can move following the trainer on real time, which can reflect the movement condition of arm of patient factually and increase the interest of rehabilitation training. Finally, the network communication technology was applied into the training system to realize the remote communication between the client-side of doctor and training system of patient, which makes it possible to product rehabilitation training at home.

via Remote Upper Limb Exoskeleton Rehabilitation Training System Based on Virtual Reality – IEEE Conference Publication

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[REVIEW ARTICLE] Robot-Assisted Therapy in Upper Extremity Hemiparesis: Overview of an Evidence-Based Approach – Full Text

Robot-mediated therapy is an innovative form of rehabilitation that enables highly repetitive, intensive, adaptive, and quantifiable physical training. It has been increasingly used to restore loss of motor function, mainly in stroke survivors suffering from an upper limb paresis. Multiple studies collated in a growing number of review articles showed the positive effects on motor impairment, less clearly on functional limitations. After describing the current status of robotic therapy after upper limb paresis due to stroke, this overview addresses basic principles related to robotic therapy applied to upper limb paresis. We demonstrate how this innovation is an evidence-based approach in that it meets both the improved clinical and more fundamental knowledge-base about regaining effective motor function after stroke and the need of more objective, flexible and controlled therapeutic paradigms.


Robot-mediated rehabilitation is an innovative exercise-based therapy using robotic devices that enable the implementation of highly repetitive, intensive, adaptive, and quantifiable physical training. Since the first clinical studies with the MIT-Manus robot (1), robotic applications have been increasingly used to restore loss of motor function, mainly in stroke survivors suffering from an upper limb paresis but also in cerebral palsy (2), multiple sclerosis (3), spinal cord injury (4), and other disease types. Thus, multiple studies suggested that robot-assisted training, integrated into a multidisciplinary program, resulted in an additional reduction of motor impairments in comparison to usual care alone in different stages of stroke recovery: namely, acute (57), subacute (18), and chronic phases after the stroke onset (911). Typically, patients engaged in the robotic therapy showed an impairment reduction of 5 points or more in the Fugl-Meyer assessment as compared to usual care. Of notice, rehabilitation studies conducted during the chronic stroke phase suggest that a 5-point differential represents the minimum clinically important difference (MCID), i.e., the magnitude of change that is necessary to produce real-world benefits for patients (12). These results were collated in multiple review articles and meta-analyses (1317). In contrast, the advantage of robotic training over usual care in terms of functional benefit is less clear, but there are recent results that suggest how best to organize training to achieve superior results in terms of both impairment and function (18). Indeed, the use of the robotic tool has allowed us the parse and study the ingredients that should form an efficacious and efficient rehabilitation program. The aim of this paper is to provide a general overview of the current state of robotic training in upper limb rehabilitation after stroke, to analyze the rationale behind its use, and to discuss our working model on how to more effectively employ robotics to promote motor recovery after stroke.

Upper Extremity Robotic Therapy: Current Status

Robotic systems used in the field of neurorehabilitation can be organized under two basic categories: exoskeleton and end-effector type robots. Exoskeleton robotic systems allow us to accurately determine the kinematic configuration of human joints, while end-effector type robots exert forces only in the most distal part of the affected limb. A growing number of commercial robotic devices have been developed employing either configuration. Examples of exoskeleton type include the Armeo®Spring, Armeo®Power, and Myomo® and of end-effector type include the InMotion™, Burt®, Kinarm™ and REAplan®. Both categories enable the implementation of intensive training and there are many other devices in different stages of development or commercialization (1920).

The last decade has seen an exponential growth in both the number of devices as well as clinical trials. The results coalesced in a set of systematic reviews, meta-analyses (1317) and guidelines such as those published by the American Heart Association and the Veterans Administration (AHA and VA) (21). There is a clear consensus that upper limb therapy using robotic devices over 30–60-min sessions, is safe despite the larger number of movement repetitions (14).

This technic is feasible and showed a high rate of eligibility; in the VA ROBOTICS (911) study, nearly two thirds of interviewed stroke survivors were enrolled in the study. As a comparison the EXCITE cohort of constraint-induced movement therapy enrolled only 6% of the screened patients participated (22). On that issue, it is relevant to notice the admission criteria of both chronic stroke studies. ROBOTICS enrolled subjects with Fugl-Meyer assessment (FMA) of 38 or lower (out of 66) while EXCITE typically enrolled subjects with an FMA of 42 or higher. Duret and colleagues demonstrated that the target population, based on motor impairments, seems to be broader in the robotic intervention which includes patients with severe motor impairments, a group that typically has not seen much benefit from usual care (23). Indeed, Duret found that more severely impaired patients benefited more from robot-assisted training and that co-factors such as age, aphasia, and neglect had no impact on the amount of repetitive movements performed and were not contraindicated. Furthermore, all patients enrolled in robotic training were satisfied with the intervention. This result is consistent with the literature (24).

The main outcome result is that robotic therapy led to significantly more improvement in impairment as compared to conventional usual care, but only slightly more on motor function of the limb segments targeted by the robotic device (16). For example, Bertani et al. (15) and Zhang et al. (17) found that robotic training was more effective in reducing motor impairment than conventional usual care therapy in patients with chronic stroke, and further meta-analyses suggested that using robotic therapy as an adjunct to conventional usual care treatment is more effective than robotic training alone (1317). Other examples of disproven beliefs: many rehabilitation professionals mistakenly expected significant increase of muscle hyperactivity and shoulder pain due to the intensive training. Most studies showed just the opposite, i.e., that intensive robotic training was associated with tone reduction as compared to the usual care groups (92526). These results are shattering the resistance to the widespread adoption of robotic therapy as a therapeutic modality post-stroke.

That said, not all is rosy. Superior changes in functional outcomes were more controversial until the very last years as most studies and reviews concluded that robotic therapy did not improve activities of daily living beyond traditional care. One first step was reached in 2015 with Mehrholz et al. (14), who found that robotic therapy can provide more functional benefits when compared to other interventions however with a quality of evidence low to very low. 2018 may have seen a decisive step in favor of robotic as the latest meta-analysis conducted by Mehrholz et al. (27) concluded that robot-assisted arm training may improve activities of daily living in the acute phase after stroke with a high quality of evidence However, the results must be interpreted with caution because of the high variability in trial designs as evidenced by the multicenter study (28) in which robotic rehabilitation using the Armeo®Spring, a non-motorized device, was compared to self-management with negative results on motor impairments and potential functional benefits in the robotic group.

The Robot Assisted Training for the Upper Limb after Stroke (RATULS) study (29) might clarify things and put everyone in agreement on the topic. Of notice, RATULS goes beyond the Veterans Administration ROBOTICS with chronic stroke or the French REM_AVC study with subacute stroke. RATULS included 770 stroke patients and covered all stroke phases, from acute to chronic, and it included a positive meaningful control in addition to usual care.[…]


Continue —->  Frontiers | Robot-Assisted Therapy in Upper Extremity Hemiparesis: Overview of an Evidence-Based Approach | Neurology

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[Abstract] Configuration Optimization of a Dual-Arm Rehabilitation Robot – IEEE Conference Publication


Robotic rehabilitation devices have gained high popularity in upper limb physical therapy for stroke patients. Dual-Arm rehabilitation robot system has advantages in achieving coordinated motions for the upper arm and forearm segments. In this paper, an efficient method for the design and evaluation of the kinematics of a dual-arm robot for upper limb rehabilitation, is presented. First, requirements for an upper limb rehabilitation robot are analyzed and candidate manipulator structures are presented. Then, workspace and manipulability, which are served as the criterion of the optimization configuration of a dual-arm rehabilitation robot, are analyzed. Thereafter, the optimal configuration is modeled and simulated to verify the method. Finally, simulation results are shown.

via Configuration Optimization of a Dual-Arm Rehabilitation Robot – IEEE Conference Publication


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[Abstract] Desktop upper limb rehabilitation robot using omnidirectional drive gear – IEEE Conference Publication


Research and development efforts into small upper limb rehabilitation robots for home-based rehabilitation have been made in order to reduce the patient burden associated with making visits to the hospital. However, currently, there are only a few small upper limb rehabilitation robots capable of providing training that is tailored to account for the differences in individual patients. This is because many robots use omni wheels for their movement mechanism, thus causing problems when measuring patient motor function because it is not possible to accurately estimate the position. To solve this problem, in this study, we propose a new small upper limb rehabilitation robot that switches the driving unit from an omni wheel to an omnidirectional drive gear mechanism, as a mechanism that does not cause slips. Although an omnidirectional drive gear poses problems in terms of machining difficulty and weight, these problems can be solved by using a 3D printer. We show that position errors in small upper limb rehabilitation robots are greatly reduced by introducing a gear mechanism.

via Desktop upper limb rehabilitation robot using omnidirectional drive gear – IEEE Conference Publication

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[Abstract + References] Patient Evaluation of an Upper-Limb Rehabilitation Robotic Device for Home Use – IEEE Conference Publication


The paper presents a user study to compare the performance of two rehabilitation robotic systems, called HomeRehab and PupArm. The first one is a novel tele-rehabilitation system for delivering therapy to stroke patients at home and the second one has been designed and developed to provide rehabilitation therapy to patients in clinical settings. Nine patients with different neurological disorders participated in the study. The patients performed 16 movements with each robotic platform and after that they filled a usability survey. Moreover, to evaluate the patient’s performance with each robotic device, 8 movement parameters were computed from each trial and for the two robotic devices. Based on the analysis of subjective assessments of usability and the data acquired objectively by the robotic devices, we can conclude that the performance and user experience with both systems are very similar. This finding will be the base of more extensive studies to demonstrate that home-therapy with HomeRehab could be as efficient as therapy in clinical settings assisted by PupArm robot.


1. WHO global report. Preventing Chronic Diseases: A Vital Investment, World Health Organization, 2005.

2. J. Mackay, G. A. Mensah, The Atlas of Heart Disease and Stroke, Geneva, Switzerland:World Health Organization, 2004.

3. D. S. Nichols-Larsen, P. C. Clark, A. Zeringue, A. Greenspan, S. Blanton, “Factors Influencing Stroke Survivors Quality of Life during Subacute Recovery”, Stroke, vol. 36, pp. 14801484, 2005.

4. P. Langhorne, F. Coupar, A. Pollock, “Motor Recovery after Stroke: a Systematic Review”, The Lancet Neurology, vol. 8, no. 8, pp. 741754, 2009.

5. C. R. Carnigan, H. I. Krebs, “Telerehabilitation Robotics: Bright Lights Big Future?”, Journal of Rehabilitation Research and Development, vol. 43, no. 5, pp. 695-710, 2006.

6. K. J. Ottenbacher, P. M. Smith, S. B. Illig, R. T. Linn, G. V. Ostir, C. V. Granger, “Trends in Length of Stay Living Setting Functional Outcome and Mortality following Medical Reha-bilitation”, JAMA, vol. 292, no. 14, pp. 1687-1695, 2004.

7. L. Richards, C. Hanson, M. Wellborn, A. Sethi, “Driving Motor Recovery after Stroke”, Topics in Stroke Rehabilitation, vol. 15, no. 5, pp. 397411, 2008.

8. S. M. Linder, A. B. Rosenfeldt, A. Reiss, S. Buchanan, K. Sahu, C. R. Bay, S. L. Wolf, J. L. Alberts, “The Home Stroke Rehabilitation and Monitoring System Trial: A Randomized Controlled Trial”, International Journal of Stroke, vol. 8, no. 1, pp. 1747-4949, 2013.

9. T. Larsen, T. S. Olsen, J. Sorensen, “Early Home-Supported Discharge of Stroke Patients: A Health Technology Assessment”, International Journal of Technology Assessment in Health Care, vol. 22, no. 3, pp. 313-320, 2006.

10. Ifiaki Díaz, José María Catalan, Francisco Javier Badesa, Xabier Justo, Luis Daniel Lledo, Axier Ugartemendia, Jorge juan Gil, Jorge Díez, Nicolás García-Aracil, Development of a robotic device for post-stroke home tele-rehabilitation. Advances in Mechanical Engineering, vol. 10, no. 1, pp. 1-8, 2018.

11. J. Brooke, P. W. Jordan, B. Thomas, B. A. Weerd-meester, J. L. McClealland, “SUS: A quick and dirty usability scale” in Usability Evaluation in Industry, London:Taylor and Francis, pp. 189194, 1996.

12. R. Likert, G. M. Maranell, “A method of constructing an attitude scale” in Scaling: A Sourcebook for Behavioral Scientists, Chicago, IL:Aldine Publishing, pp. 233243, 1974.

13. H. J. Krebs, N. Hogan, M. L. Aisen, B. T. Volpe, “Robot-aided neurorehabilitation”, IEEE Transactions on Rehabilitation Engineering, vol. 6, no. 1, pp. 75-87, Mar 1998.

14. Franciso J Badesa, Ana Llinares, Ricardo Morales, Nicolas Garcia-Aracil, Jose M Sabater, Carlos Perez-Vidal, “Pneumatic planar rehabilitation robot for post-stroke patients”, Biomedical Engineering: Applications Basis and Communications, vol. 26, no. 2, pp. 1450025, 2014.

15. D. Lledo Luis, A. Diez Jorge, Bertomeu-Motos Arturo, Ezquerro Santiago, J. Badesa Francisco, M. Sabater-Navarro Jose, Garca-Aracil Nicolas, “A Comparative Analysis of 2D and 3D Tasks for Virtual Reality Therapies Based on Robotic-Assisted Neurorehabilitation for Post-stroke Patients”, Frontiers in Aging Neuroscience, vol. 8, pp. 205, 2016.

16. A. Llinares, F. J. Badesa, R. Morales, N. Garcia-Aracil, J. Sabater, E. Fernandez, “Robotic assessment of the influence of age on upper-limb sensorimotor function”, Clin. Interv. Aging, vol. 8, pp. 879, 2013.

17. D. S. Dunn, Statistics and data analysis for the behavioral sciences, New York, NY, US:McGraw-Hill, 2001.

18. J. Brooke, P. W. Jordan, B. Thomas, B. A. Weerd-meester, I. L. McClealland, “SUS: A quick and dirty usability scale” in Usability Evaluation in Industry, London:Taylor and Francis, pp. 189194, 1996.

19. AM Coderre, AA Zeid, SP Dukelow et al., “Assessment of upper-limb sensorimotor function of subacute stroke patients using visually guided reaching”, Neurorehabil Neural Repair., vol. 24, no. 6, pp. 528541, 2010.

via Patient Evaluation of an Upper-Limb Rehabilitation Robotic Device for Home Use – IEEE Conference Publication

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[Abstract + References] A Tendon-driven Upper-limb Rehabilitation Robot – IEEE Conference Publication


Rehabilitation robots are playing an increasingly important role in daily rehabilitation of patients. In recent years, exoskeleton rehabilitation robots have become a research hotspot. However, the existing exoskeleton rehabilitation robots are mainly rigid exoskeletons. During rehabilitation training using such exoskeletons, the patient’s joint rotation center is fixed, which cannot adapt to the actual joint movements, resulting in secondary damage to the patients. Therefore, in this paper, a tendon-driven flexible upper-limb rehabilitation robot is proposed; the structure and connectors of the rehabilitation robot are designed considering the physiological structure of human upper limbs; we also built the prototype and performed experiments to validate the designed robot. The experimental results show that the proposed upper-limb rehabilitation robot can assist the human subject to conduct upper-limb rehabilitation training.

I. Introduction

Central nervous system diseases, such as stroke, spinal cord injury and traumatic brain injury, tend to cause movement disorder [1]. Clinical studies have shown that intensive rehabilitation training after cerebral injury help patients recover motoric functions because of the brain plasticity [1], [2]. Traditional movement therapy is highly dependent on physiotherapists and the efficacy is limited by professional knowledge and skill levels of physiotherapists [3]. Upper-limbs recover more slowly than lower limbs because of the complex function of neurons. Meanwhile, the rehabilitation therapies are unaffordable for most patients. Robotic rehabilitation opened another way of rehabilitation training and its efficacy has been validated in clinical trials [3], [4]. Many upper-limb robot devices have been developed for rehabilitation or assistance in various forms. One of the famous devices was MIT-MANUS developed by MIT. This kind of devices are stationary external system where the patient inserts their hand or arm and is robotically assisted or resisted in completing predetermined tasks [3], [5]. Other examples of this type of devices include Lum et al.^{\prime}s MIME [6], Kahn et al.’s ARM Guide [7] and a 2-DOF upper-limb rehabilitation robot developed by Tsinghua



1. M. Hallett, “Plasticity of the human motor cortex and recovery from stroke”, Brain Research Reviews, vol. 36, pp. 169-174, 2001.

2. J. D. Schaechter, “Motor rehabilitation and brain plasticity after hemiparetic stroke”, Progress in Neurobiology, vol. 73, pp. 61-72, 2004.

3. Q. Yang, D. Cao, J. Zhao, “Analysis on State of the Art of upper-limb Rehabilitation Robots”, Jiqiren/robot, vol. 35, pp. 630, 2013.

4. P. Maciejasz, J. Eschweiler, K. Gerlach-Hahn, A. Jansen-Troy, S. Leonhardt, “A survey on robotic devices for upper-limb rehabilitation”, Journal of Neuroengineering & Rehabilitation, vol. 11, pp. 3, 2014.

5. C. J. Nycz, M. A. Delph, G. S. Fischer, “Modeling and design of a tendon actuated flexible robotic exoskeleton for hemiparetic upper-limb rehabilitation”, International Conference of the IEEE Engineering in Medicine and Biology Society, pp. 3889-3892, 2015.

6. P. S. Lum, C. G. Burgar, P. C. Shor, “Use of the MIME robotic system to retrain multijoint reaching in post-stroke hemiparesis: why some movement patterns work better than others”, Engineering in Medicine and Biology Society 2003. Proceedings of the International Conference of the IEEE, vol. 2, pp. 1475-1478, 2003.

7. D. J. Reinkensmeyer, L. E. Kahn, M. Averbuch, A. Mckenna-Cole, B. D. Schmit, W. Z. Rymer, “Understanding and treating arm movement impairment after chronic brain injury: progress with the ARM guide”, Journal of Rehabilitation Research & Development, vol. 37, pp. 653-662.

8. Y. Zhang, Z. Wang, L. Ji, S. Bi, “The clinical application of the upper extremity compound movements rehabilitation training robot”, International Conference on Rehabilitation Robotics, pp. 91-94, 2005.

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via A Tendon-driven Upper-limb Rehabilitation Robot – IEEE Conference Publication

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