Feasibility of Manual Teach-and-Replay and Continuous Impedance Shaping for Robotic Locomotor Training Following Spinal Cord Injury

Robotic gait training is an emerging technique for retraining walking ability following spinal cord injury (SCI). A key challenge in this training is determining an appropriate stepping trajectory and level of assistance for each patient, since patients have a wide range of sizes and impairment levels. Here, we demonstrate how a lightweight yet powerful robot can record subject-specific, trainer-induced leg trajectories during manually assisted stepping, then immediately replay those trajectories. Replay of the subject-specific trajectories reduced the effort required by the trainer during manual assistance, yet still generated similar patterns of muscle activation for six subjects with a chronic SCI. We also demonstrate how the impedance of the robot can be adjusted on a step-by-step basis with an error-based, learning law. This impedance-shaping algorithm adapted the robot's impedance so that the robot assisted only in the regions of the step trajectory where the subject consistently exhibited errors. The result was that the subjects stepped with greater variability, while still maintaining a physiologic gait pattern. These results are further steps toward tailoring robotic gait training to the needs of individual patients

Review of control strategies for robotic movement training after neurologic injury

There is increasing interest in using robotic devices to assist in movement training following neurologic injuries such as stroke and spinal cord injury. This paper reviews control strategies for robotic therapy devices. Several categories of strategies have been proposed, including, assistive, challenge-based, haptic simulation, and coaching. The greatest amount of work has been done on developing assistive strategies, and thus the majority of this review summarizes techniques for implementing assistive strategies, including impedance-, counterbalance-, and EMG- based controllers, as well as adaptive controllers that modify control parameters based on ongoing participant performance. Clinical evidence regarding the relative effectiveness of different types of robotic therapy controllers is limited, but there is initial evidence that some control strategies are more effective than others. It is also now apparent there may be mechanisms by which some robotic control approaches might actually decrease the recovery possible with comparable, non-robotic forms of training. In future research, there is a need for head-to-head comparison of control algorithms in randomized, controlled clinical trials, and for improved models of human motor recovery to provide a more rational framework for designing robotic therapy control strategies

Active exoskeleton control systems: State of the art

To get a compliant active exoskeleton controller, the force interaction controllers are mostly used in form of either the impedance or admittance controllers. The impedance or admittance controllers can only work if they are followed by either the force or the position controller respectively. These combinations place the impedance or admittance controller as high-level controller while the force or position controller as low-level controller. From the application point of view, the exoskeleton controllers are equipped by task controllers that can be formed in several ways depend on the aims. This paper presents the review of the control systems in the existing active exoskeleton in the last decade. The exoskeleton control system can be categorized according to the model system, the physical parameters, the hierarchy and the usage. These considerations give different control schemes. The main consideration of exoskeleton control design is how to achieve the best control performances. However, stability and safety are other important issues that have to be considered. © 2012 The Authors

Inteligentno upravljanje paralelnim robotom sa šest stupnjeva slobode korištenim za rehabilitaciju donjih udova

The process of empowering muscles in order to make them to a normal and common value is an expensive and prolonged work, in common available methods. There are some commercial exercise machines used for this purpose called rehabilitation systems. However, due to their insufficient motion freedom and prospect of being expensive, these machines have limited usage. Hence, it is clearly necessary that Mechatronic technologies should be used in this area. In this paper, an algorithm and an improved rule are presented for controlling a rehabilitation system of lower limbs which is implemented on a 6-Degree Of Freedom (DOF) Stewart parallel robot. Impedance control and adaptive control are used for this purpose. Estimation and optimization of control parameters will be done by artificial neural networks and genetic algorithms, respectively (intelligent strategy). Safety is guaranteed since some of controller parameters can be adapted under the stability conditions given by using Routh stability theory. Thereafter, the results of simulations are presented by defining a physiotherapy standard mode on a desired trajectory. MATLAB/SIMULINK is used for simulations. Finally, a comparative discussion between this strategy and common methods is devised.Proces osposobljavanja mišića za normalne funkcije je skup i dugotrajan uz korištenje dostupnih metoda. Postoje komercijalni strojevi za tu svrhu koji se nazivaju sustavi za rehabilitaciju. Zbog njihove nedostatne slobode pokreta i visoke cijene takvi strojevi imaju ograničenu upotrebu. Stoga je jasno da je u području rehabilitiacije potrebno koristiti mehatroničke sustave. U ovom radu prikazan je algoritam i poboljšano pravilo za upravljanje rehabilitacijskog sustava za donje udove koji je implementiran na Stewart paralelnom robotu sa šest stupnjeva slobode. Pritom je korišteno upravljanje impedancijom i adaptivno upravljanje. Za estimaciju i optimiranje parametara upravljanja koriste se neuronske mreže i genetički algoritmi. Sigurnost je garantirana jer se neki parametri regulatora adaptiraju prema uvjetima stabilnosti koji su dobiveni korištenjem Ruthove teorije stabilnosti. Nakon toga, rezultati simulacija prikazani su definiranjem standardnog fizioterapijskog rada na željenoj trajektoriji. Za simulacije se koristi MATLAB/SIMULINK. Konačno, u radu je dana i usporedba predložene strategije s uobičajenim metodama

Human-robot cooperative movement training: Learning a novel sensory motor transformation during walking with robotic assistance-as-needed

BACKGROUND: A prevailing paradigm of physical rehabilitation following neurologic injury is to "assist-as-needed" in completing desired movements. Several research groups are attempting to automate this principle with robotic movement training devices and patient cooperative algorithms that encourage voluntary participation. These attempts are currently not based on computational models of motor learning. METHODS: Here we assume that motor recovery from a neurologic injury can be modelled as a process of learning a novel sensory motor transformation, which allows us to study a simplified experimental protocol amenable to mathematical description. Specifically, we use a robotic force field paradigm to impose a virtual impairment on the left leg of unimpaired subjects walking on a treadmill. We then derive an "assist-as-needed" robotic training algorithm to help subjects overcome the virtual impairment and walk normally. The problem is posed as an optimization of performance error and robotic assistance. The optimal robotic movement trainer becomes an error-based controller with a forgetting factor that bounds kinematic errors while systematically reducing its assistance when those errors are small. As humans have a natural range of movement variability, we introduce an error weighting function that causes the robotic trainer to disregard this variability. RESULTS: We experimentally validated the controller with ten unimpaired subjects by demonstrating how it helped the subjects learn the novel sensory motor transformation necessary to counteract the virtual impairment, while also preventing them from experiencing large kinematic errors. The addition of the error weighting function allowed the robot assistance to fade to zero even though the subjects' movements were variable. We also show that in order to assist-as-needed, the robot must relax its assistance at a rate faster than that of the learning human. CONCLUSION: The assist-as-needed algorithm proposed here can limit error during the learning of a dynamic motor task. The algorithm encourages learning by decreasing its assistance as a function of the ongoing progression of movement error. This type of algorithm is well suited for helping people learn dynamic tasks for which large kinematic errors are dangerous or discouraging, and thus may prove useful for robot-assisted movement training of walking or reaching following neurologic injury

Active interaction control applied to a lower limb rehabilitation robot by using EMG recognition and impedance model

Purpose – The purpose of this paper is to propose a seamless active interaction control method integrating electromyography (EMG)-triggered assistance and the adaptive impedance control scheme for parallel robot-assisted lower limb rehabilitation and training. Design/methodology/approach – An active interaction control strategy based on EMG motion recognition and adaptive impedance model is implemented on a six-degrees of freedom parallel robot for lower limb rehabilitation. The autoregressive coefficients of EMG signals integrating with a support vector machine classifier are utilized to predict the movement intention and trigger the robot assistance. An adaptive impedance controller is adopted to influence the robot velocity during the exercise, and in the meantime, the user’s muscle activity level is evaluated online and the robot impedance is adapted in accordance with the recovery conditions. Findings – Experiments on healthy subjects demonstrated that the proposed method was able to drive the robot according to the user’s intention, and the robot impedance can be updated with the muscle conditions. Within the movement sessions, there was a distinct increase in the muscle activity levels for all subjects with the active mode in comparison to the EMG-triggered mode. Originality/value – Both users’ movement intention and voluntary participation are considered, not only triggering the robot when people attempt to move but also changing the robot movement in accordance with user’s efforts. The impedance model here responds directly to velocity changes, and thus allows the exercise along a physiological trajectory. Moreover, the muscle activity level depends on both the normalized EMG signals and the weight coefficients of involved muscles

Assessing walking ability using a robotic gait trainer: opportunities and limitations of assist-as-needed control in spinal cord injury

Background: Walking impairments are a common consequence of neurological disorders and are assessed with clinical scores that suffer from several limitations. Robot-assisted locomotor training is becoming an established clinical practice. Besides training, these devices could be used for assessing walking ability in a controlled environment. Here, we propose an adaptive assist-as-needed (AAN) control for a treadmill-based robotic exoskeleton, the Lokomat, that reduces the support of the device (body weight support and impedance of the robotic joints) based on the ability of the patient to follow a gait pattern displayed on screen. We hypothesize that the converged values of robotic support provide valid and reliable information about individuals' walking ability.Methods: Fifteen participants with spinal cord injury and twelve controls used the AAN software in the Lokomat twice within a week and were assessed using clinical scores (10MWT, TUG). We used a regression method to identify the robotic measure that could provide the most relevant information about walking ability and determined the test–retest reliability. We also checked whether this result could be extrapolated to non-ambulatory and to unimpaired subjects.Results: The AAN controller could be used in patients with different injury severity levels. A linear model based on one variable (robotic knee stiffness at terminal swing) could explain 74% of the variance in the 10MWT and 61% in the TUG in ambulatory patients and showed good relative reliability but poor absolute reliability. Adding the variable 'maximum hip flexor torque' to the model increased the explained variance above 85%. This did not extend to non-ambulatory nor to able-bodied individuals, where variables related to stance phase and to push-off phase seem more relevant.Conclusions: The novel AAN software for the Lokomat can be used to quantify the support required by a patient while performing robotic gait training. The adaptive software might enable more challenging training conditions tuned to the ability of the individuals. While the current implementation is not ready for assessment in clinical practice, we could demonstrate that this approach is safe, and it could be integrated as assist-as-needed training, rather than as assessment.Trial registration: ClinicalTrials.gov Identifier: NCT02425332

DEVELOPMENT OF A NOVEL INTERACTIVE VISUAL TASK FOR A ROBOT-ASSISTED GAIT TRAINING IN STROKE

The goal of this thesis is to develop an interactive visual task for robot-assisted gait training after stroke. This is designed as a simple soccer-based computer video-game displayed on a screen, played by moving the ankle in dorsiflexion or plantarflexion to guide a soccer ball from its original position towards the goal. This stand-alone game is interfaced with the impedance controlled modular ankle exoskeleton (“Anklebot”) that provides assistance only as-needed, as an augmentative tool to further enhance ankle neuro-motor control and whole-body function after task-oriented robot-assisted treadmill walking. The design and features of the interactive video game, as well as the underlying biomechanical model that relates patient-to-game performance are presented. Simple adaptive performance algorithms are embedded, and bench tested to auto-adjust game parameters in real-time, concomitant to ongoing patient performance during robot-assisted therapy. Human in-loop testing strategies are proposed to validate the video-game performance and its feasibility for clinical use

A subject-specific EMG-driven musculoskeletal model for applications in lower-limb rehabilitation robotics

Robotic devices have great potential in physical therapy owing to their repeatability, reliability and cost economy. However, there are great challenges to realize active control strategy, since the operator’s motion intention is uneasy to be recognized by robotics online. The purpose of this paper is to propose a subject-specific electromyography (EMG)-driven musculoskeletal model to estimate subject’s joint torque in real time, which can be used to detect his/her motion intention by forward dynamics, and then to explore its potential applications in rehabilitation robotics control. The musculoskeletal model uses muscle activation dynamics to extract muscle activation from raw EMG signals, a Hill-type muscle-tendon model to calculate muscle contraction force, and a proposed subject-specific musculoskeletal geometry model to calculate muscular moment arm. The parameters of muscle activation dynamics and muscle-tendon model are identified by off-line optimization methods in order to minimize the differences between the estimated muscular torques and the reference torques. Validation experiments were conducted on six healthy subjects to evaluate the proposed model. Experimental results demonstrated the model’s ability to predict knee joint torque with the coefficient of determination (R2) value of 0.934±0.0130.934±0.013 and the normalized root-mean-square error (RMSE) of 11.58%±1.44%11.58%±1.44%

Electromechanical and robotic devices for gait and balance rehabilitation of children with neurological disability: a systematic review

In the last two decades, a growing interest has been focused on gait and balance robot-assisted rehabilitation in children with neurological disabilities. Robotic devices allow the implementation of intensive, task-specific training fostering functional recovery and neuroplasticity phenomena. However, limited attention has been paid to the protocols used in this research framework. This systematic review aims to provide an overview of the existing literature on robotic systems for the rehabilitation of gait and balance in children with neurological disabilities and their rehabilitation applications. The literature search was carried out independently and synchronously by three authors on the following databases: MEDLINE, Cochrane Library, PeDro, Institute of Electrical and Electronics Engineers, ScienceDirect, and Google Scholar. The data collected included three subsections referring to clinical, technical, and regulatory aspects. Thirty-one articles out of 81 found on the primary literature search were included in the systematic review. Most studies involved children with cerebral palsy. Only one-third of the studies were randomized controlled trials. Overall, 17 devices (nine end-effector systems and eight exoskeletons) were investigated, among which only 4 (24%) were bore the CE mark. Studies differ on rehabilitation protocols duration, intensity, and outcome measures. Future research should improve both rehabilitation protocols\u2019 and devices\u2019 descriptions