A methodology for the Lower Limb Robotic Rehabilitation system

The overall goal of this thesis is to develop a new functional lower limb robot-assisted rehabilitation system for people with a paretic lower limb. A unilateral rehabilitation method is investigated, where the robot acts as an assistive device to provide the impaired leg therapeutic training through simulating the kinematics and dynamics of the ankle and lower leg movements. Foot trajectories of healthy subjects and post-stroke patients were recorded by a dedicated optical motion tracking system in a clinical gait measurement laboratory. A prototype 6 degrees of freedom parallel robot was initially built in order to verify capability of achieving singularity-free foot trajectories of healthy subjects in various exercises. This was then followed by building and testing another larger parallel robot to investigate the real-sized foot trajectories of patients. The overall results verify the designed robot’s capability in successfully tracking foot trajectories during different exercises. The thesis finally proposes a system of bilateral rehabilitation based on the concept of self-learning, where a passive parallel mechanism follows and records motion signatures of the patient’s healthy leg, and an active parallel mechanism provides motion for the impaired leg based on the kinematic mapping of the motion produced by the passive mechanism

Design and Control of Robotic Systems for Lower Limb Stroke Rehabilitation

Lower extremity stroke rehabilitation exhausts considerable health care resources, is labor intensive, and provides mostly qualitative metrics of patient recovery. To overcome these issues, robots can assist patients in physically manipulating their affected limb and measure the output motion. The robots that have been currently designed, however, provide assistance over a limited set of training motions, are not portable for in-home and in-clinic use, have high cost and may not provide sufficient safety or performance. This thesis proposes the idea of incorporating a mobile drive base into lower extremity rehabilitation robots to create a portable, inherently safe system that provides assistance over a wide range of training motions. A set of rehabilitative motion tasks were established and a six-degree-of-freedom (DOF) motion and force-sensing system was designed to meet high-power, large workspace, and affordability requirements. An admittance controller was implemented, and the feasibility of using this portable, low-cost system for movement assistance was shown through tests on a healthy individual. An improved version of the robot was then developed that added torque sensing and known joint elasticity for use in future clinical testing with a flexible-joint impedance controller

serial and parallel robotics: energy saving systems and rehabilitation devices

This thesis focuses on the design and discussion of robotic devices and their applications. Robotics is the branch of technology that deals with the design, construction, operation, and application of robots as well as computer systems for their control, sensory feedback, and information processing [1]. Nowadays, robotics has been an unprecedented increase in applications of industry, military, health, domestic service, exploration, commerce, etc. Different applications require robots with different structures and different functions. Robotics normally includes serial and parallel structures. To have contribution to two kinds of structures, this thesis consisting of two sections is devoted to the design and development of serial and parallel robotic structures, focused on applications in the two different fields: industry and health

Design of a Simple and Modular 2-DOF Ankle Physiotherapy Device Relying on a Hybrid Serial-Parallel Robotic Architecture

The aim of this work is to propose a new 2-DOF robotic platform with hybrid parallel-serial structure and to undertake its parametric design so that it can follow the whole range of ankle related foot movements. This robot can serve as a human ankle rehabilitation device. The existing ankle rehabilitation devices present typically one or more of the following shortcomings: redundancy, large size, or high cost, hence the need for a device that could offer simplicity, modularity, and low cost of construction and maintenance. In addition, our targeted device must be safe during operation, disallow undesirable movements of the foot, while adaptable to any human foot. Our detailed study of foot kinematics has led us to a new hybrid architecture, which strikes a balance among all aforementioned goals. It consists of a passive serial kinematics chain with two adjustable screws so that the axes of the chain match the two main ankle-axes of typical feet. An active parallel chain, which consists of two prismatic actuators, provides the movement of the platform. Thus, the platform can follow the foot movements, thanks to the passive chain, and also possesses the advantages of parallel robots, including rigidity, high stiffness and force capabilities. The lack of redundancy yields a simpler device with lower size and cost. The paper describes the kinematics modelling of the platform and analyses the force and velocity transmission. The parametric design of the platform is carried out; our simulations confirm the platform's suitability for ankle rehabilitation

Design and Development of Ankle-Foot Rehabilitation Exerciser (AFRE) System Using Pneumatic Actuator

This research presents the design and development of a novel strategy for an Ankle-Foot Rehabilitation Exerciser (AFRE) system. AFRE system can be used Continuous Passive Motion (CPM) device and strength endurance training device for early stage functional rehabilitation. The designed mechanism can allow desired maximum and minimum Range of Motion (ROM) for dorsiflexion and plantar flexion (upwards and downwards stretching). This device consists of a new moveable mechanism design prototype using a new double acting Intelligent Pneumatic Actuator (IPA), embedded controller and communication protocol. The drive system consists of a nonlinear moving pneumatic actuator that controls the angle position, force and compliance for stiffness characteristic of the ankle-foot orthosis platform. In addition, the device can be configured through MATLAB via personal computer where the user can adjust the required ROM and resistance for the user in real-time. Analysis carried out during the system validation and testing through selected subjects are presented and discussed. This AFRE system is expected to substitute the traditional therapy and motorized rehabilitation device to increase the healing time of the patient specifically

Effectiveness of Platform-Based Robot-Assisted Rehabilitation for Musculoskeletal or Neurologic Injuries: A Systematic Review

During the last ten years the use of robotic-assisted rehabilitation has increased significantly. Compared with traditional care, robotic rehabilitation has several potential advantages. Platform-based robotic rehabilitation can help patients recover from musculoskeletal and neurological conditions. Evidence on how platform-based robotic technologies can positively impact on disability recovery is still lacking, and it is unclear which intervention is most effective in individual cases. This systematic review aims to evaluate the effectiveness of platform-based robotic rehabilitation for individuals with musculoskeletal or neurological injuries. Thirty-eight studies met the inclusion criteria and evaluated the efficacy of platform-based rehabilitation robots. Our findings showed that rehabilitation with platform-based robots produced some encouraging results. Among the platform-based robots studied, the VR-based Rutgers Ankle and the Hunova were found to be the most effective robots for the rehabilitation of patients with neurological conditions (stroke, spinal cord injury, Parkinson’s disease) and various musculoskeletal ankle injuries. Our results were drawn mainly from studies with low-level evidence, and we think that our conclusions should be taken with caution to some extent and that further studies are needed to better evaluate the effectiveness of platform-based robotic rehabilitation devices

A New Index for Detecting and Avoiding Type II Singularities for the Control of Non-Redundant Parallel Robots

[ES] Los robots paralelos (PR por sus siglas en inglés) son mecanismos donde el efector final está unido a la base, mediante al menos dos cadenas cinemáticas abiertas. Los PRs ofrecen una gran capacidad de carga y alta precisión, lo que los hace adecuados para diversas aplicaciones, entre ellas la interacción persona-robot. Sin embargo, en las proximidades de una singularidad Tipo II (singularidad dentro del espacio de trabajo), un PR pierde el control sobre los movimientos del efector final. La pérdida de control representa un riesgo importante para los usuarios, especialmente en rehabilitación robótica. En las últimas décadas, los PR se han popularizado en la rehabilitación de miembros inferiores debido al aumento del número de personas que viven con limitaciones físicas. Así, esta tesis trata sobre la detección y evitación de singularidades de Tipo II para asegurar total control de un PR no redundante para la rehabilitación y diagnóstico de rodilla, denominado 3UPS+RPU. En la literatura, existen varios índices para detectar y medir la cercanía a una singularidad basados en métodos analíticos y geométricos. Sin embargo, algunos de estos índices carecen de significado físico y son incapaces de identificar los actuadores responsables de la pérdida de control. Esta tesis aporta dos novedosos índices para detectar y medir la proximidad a una singularidad de Tipo II, capaces de identificar el par de actuadores responsables de la singularidad. Los dos índices son los ángulos entre los componentes lineal (T_i,j) y angular (O_i,j) de dos Twist Screw de Salida (OTS por sus siglas en inglés) normalizados i,j. Una singularidad Tipo II es detectada cuando T_i,j = O_i,j = 0 y su proximidad se mide mediante los mínimos ángulos T_i,j (minT) y O_i,j (minO) para los casos plano y espacial, respectivamente. La eficacia de los índices T_i,j y O_i,j se evalúa de forma teórica y experimental en un robot 3UPS+RPU y un mecanismo de cinco barras. Además, se propone un procedimiento experimental para el adecuado establecimiento del límite de cercanía a una singularidad de Tipo II mediante la aproximación progresiva del PR a una singularidad y la medición de la última posición controlable. Posteriormente, se desarrollan dos nuevos algoritmos deterministas para liberar y evitar una singularidad de Tipo II basados en minT y minO para PR no redundantes. minT y minO se utilizan para identificar los dos actuadores a mover para liberar o evitar el PR de una singularidad. Ambos algoritmos requieren una medición precisa de la pose alcanzada por el efector final. El algoritmo para liberar un PR de una configuración singular se aplica con éxito en un controlador híbrido basado en visión artificial para el PR 3UPS+RPU. El controlador utiliza un sistema de fotogrametría para medir la pose del robot debido a la degeneración del modelo cinemático en las proximidades de una singularidad. El algoritmo de evasión de singularidades Tipo II se aplica a la planificación offline y online de trayectorias no singulares para un mecanismo de cinco barras y el PR 3UPS+RPU. Estas aplicaciones verifican el bajo coste computacional y la mínima desviación introducida en la trayectoria original por los nuevos algoritmos. La implementación directa de un controlador de fuerza/posición en el PR 3UPS+RPU es insegura porque el paciente podría llevar involuntariamente al PR a una singularidad. Por lo tanto, esta tesis concluye presentando un novedoso controlador de fuerza/posición complementado con el algoritmo de evasión de singularidades de Tipo II. El nuevo controlador se evalúa durante rehabilitación activa de una pierna de maniquí y una pierna humana no lesionada. Los resultados muestran que el nuevo controlador combinado mantiene el PR 3UPS+RPU lejos de configuraciones singulares con una desviación mínima de la trayectoria original. Por lo tanto, esta tesis habilita el 3UPS+RPU PR para la rehabilitación segura de miembros inferiores lesionados.[CAT] Els robots paral·lels (PR per les seues sigles en anglés) són mecanismes on l'efector final està unit a la base, mitjançant almenys dues cadenes cinemàtiques obertes. Els PRs ofereixen una gran capacitat de càrrega i alta precisió, la qual cosa els fa adequats per a diverses aplicacions, entre elles la interacció persona-robot. No obstant això, en les proximitats d'una singularitat Tipus II (singularitat dins de l'espai de treball), un PR perd el control sobre els moviments de l'efector final. La pèrdua de control representa un risc important per als usuaris, especialment en rehabilitació robòtica. En les últimes dècades, els PR s'han popularitzat en la rehabilitació de membres inferiors a causa de l'augment del nombre de persones que viuen amb limitacions físiques. Així, aquesta tesi tracta sobre la detecció i evació de singularitats de Tipus II per a assegurar total control d'un PR no redundant per a la rehabilitació i diagnòstic de genoll, denominat 3UPS+RPU. En la literatura, existeixen diversos índexs per a detectar i mesurar la proximitat a una singularitat basats en mètodes analítics i geomètrics. No obstant això, alguns d'aquests índexs manquen de significat físic i són incapaços d'identificar els actuadors responsables de la pèrdua de control. Aquesta tesi aporta dos nous índexs per a detectar i mesurar la proximitat a una singularitat de Tipus II, capaços d'identificar el parell d'actuadors responsables de la singularitat. Els dos índexs són els angles entre els components lineal (T_i,j) i angular (O_i,j) de dues Twist Screw d'Eixida (OTS per les seues sigles en engonals) normalitzats i,j. Una singularitat Tipus II és detectada quan T_i,j = O_i,j = 0 i la seua proximitat es mesura mitjançant els minimos angles T_i,j (minT) i O_i,j (minO) per als casos pla i espacial, respectivament. L'eficàcia dels índexs T_i,j i O_i,j es evalua de manera teòrica i experimental en un robot 3UPS+RPU i un mecanisme de cinc barres. A més, es proposa un procediment experimental per a l'adequat establiment del límit de proximitat a una singularitat de Tipus II mitjançant l'aproximació progressiva del PR a una singularitat i el mesurament de l'última posició controlable. Posteriorment, es desenvolupen dos nous algorismes deterministes per a alliberar i evadir una singularitat de Tipus II basats en minT i minO per a PR no redundants. minT i minO s'utilitzen per a identificar els dos actuadors a moure per a alliberar o evadir el PR d'una singularitat. Aquests algorismes requereixen un mesurament precís de la posa aconseguida per l'efector final. L'algorisme per a alliberar un PR d'una configuració singular s'aplica amb èxit en un controlador híbrid basat en visió artificial per al PR 3UPS+RPU. El controlador utilitza un sistema de fotogrametria per a mesurar la posa del robot a causa de la degeneració del model cinemàtic en les proximitats d'una singularitat. L'algorisme d'evació de singularitats Tipus II s'aplica a la planificació offline i en línia de trajectòries no singulars per a un mecanisme de cinc barres i el PR 3UPS+RPU. Aquestes aplicacions verifiquen el baix cost computacional i la mínima desviació introduïda en la trajectòria original pels nous algorismes. La implementació directa d'un controlador de força/posició en el PR 3UPS+RPU és insegura perquè el pacient podria portar involuntàriament al PR a una singularitat. Per tant, aquesta tesi conclou presentant un nou controlador de força/posició complementat amb l'algorisme d'evació de singularitats de Tipus II. El nou controlador s'avalua durant la rehabilitació activa d'una cama de maniquí i una cama humana no lesionada. Els resultats mostren que el nou controlador combinat manté el PR 3UPS+RPU lluny de configuracions singulars amb una desviació mínima de la trajectòria original. Per tant, aquesta tesi habilita el 3UPS+RPU PR per a la rehabilitació segura dels membres inferiors lesionats.[EN] Parallel Robots (PR)s are mechanisms where the end-effector is linked to the base by at least two open kinematics chains. The PRs offer a high payload and high accuracy, making them suitable for various applications, including human robot interaction. However, in proximity to a Type II singularity (singularity within the workspace), a PR loses control over the movements of the end-effector. The loss of control represents a major risk for users, especially in robotic rehabilitation. In the last decades, PRs have become popular in lower limb rehabilitation because of the increment in the number of people living with physical limitations. Thus, this thesis is about the detection and avoidance of Type II singularities to ensure complete control of a non-redundant PR for knee rehabilitation and diagnosis named 3UPS+RPU. In the literature, several indices exist to detect and measure the closeness to a singular configuration based on analytical and geometrical methods. However, some of these indices have no physical meaning, and they are unable to identify the actuators responsible for the loss of control. This thesis contributes two novel indices to detect and measure the proximity to a Type II singularity capable of identifying the pair of actuators responsible for the singularity. The two indices are the angles between the linear (T_i,j) and the angular (O_i,j) components of two i,j normalised Output Twist Screws (OTSs). A Type II singularity is detected when the angles T_i,j = O_i,j = 0 and its closeness is measured by the minimum T_i,j (minT) and minimum O_i,j (minO) for planar and spatial cases, respectively. The effectiveness of the indices T_i,j and O_i,j is evaluated from a theoretical and experimental perspective in a 3UPS+RPU and a five bars mechanism. Moreover, an experimental procedure is proposed for setting a proper limit of closeness to a Type II singularity by the progressive approach of the PR to singular configuration and measuring the last controllable pose. Subsequently, two novel deterministic algorithms for releasing and avoiding Type II singularities based on minT and minO are developed for non-redundant PRs. The minT and minO are used to identify the two actuators to move for release or prevent the PR from the singularity. Both algorithms require an accurate measuring of the pose reached by the end-effector. The algorithm to release a PR from a singular configuration is successfully applied in a vision-based hybrid controller for the 3UPS+RPU PR. The controller uses a photogrammetry system to measure the pose of the robot due to the degeneration of the kinematic model in the vicinity of a singularity. The Type II singularity avoidance algorithm is applied to offline and online free-singularity trajectory planning for a five-bar mechanism and the 3UPS+RPU PR. These applications verify the low computation cost and the minimum deviation introduced in the original trajectory for both novel algorithms. The direct implementation of a force/position controller in the 3UPS+RPU PR is unsafe because the patient could unintentionally drive the PR to a Type II singularity. Therefore, this thesis concludes by presenting a novel force/position controller complemented with the Type II singularity avoidance algorithm. The complemented controller is evaluated during patient-active exercises in a mannequin leg and an uninjured human limb. The results show that the novel combined controller keeps the 3UPS+RPU PR far from singular configurations with a minimum deviation on the original trajectory. Hence, this thesis enables the 3UPS+RPU PR for the safe rehabilitation of injured lower limbs.Pulloquinga Zapata, JL. (2023). A New Index for Detecting and Avoiding Type II Singularities for the Control of Non-Redundant Parallel Robots [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/19427

A New Test Rig for In-Vitro Evaluation of the Knee Joint Behaviour

The evaluation of the knee joint behavior is fundamental in many applications, such as joint modeling, prosthesis and orthosis design. In-vitro tests are important in order to analyse knee behavior when simulating various loading conditions and studying physiology of the joint. A new test rig for in-vitro evaluation of the knee joint behavior is presented in this paper. It represents the evolution of a previously proposed rig, designed to overcome its principal limitations and to improve its performances. The design procedure and the adopted solution in order to satisfy the specifications are presented here. Thanks to its 6-6 Gough-Stewart parallel manipulator loading system, the rig replicates general loading conditions, like daily actions or clinical tests, on the specimen in a wide range of flexion angles. The restraining actions of knee muscles can be simulated when active actions are simulated. The joint motion in response to the applied loads, guided by passive articular structures and muscles, is permitted by the characteristics of the loading system which is force controlled. The new test rig guarantees visibility so that motion can be measured by an optoelectronic system. Furthermore, the control system of the new test rig allows the estimation of the contribution of the principal leg muscles in guaranteeing the equilibrium of the joint by the system for muscle simulation. Accuracy in positioning is guaranteed by the designed tibia and femur fixation systems,which allow unmounting and remounting the specimen in the same pose. The test rig presented in this paper permits the analysis of the behavior of the knee joint and comparative analysis on the same specimen before and after surgery, in a way to assess the goodness of prostheses or surgical treatments

Design of a wearable active ankle-foot orthosis for both sides

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Biomateriais, Reabilitação e Biomecânica)Portugal is the west European country with the highest rate of stroke-related mortality, being that, of those who suffer cerebrovascular accidents, 40% feature an impairment which can manifest itself through motor sequelae, namely drop foot. An ankle-foot orthosis is often recommended to passively accommodate these motor problems; however, active/powered exoskeletons are also a suitable solution for post-stroke patients. Due to the high complexity of the human ankle joint, one of the problems regarding these active devices is the misalignment occurring between the rehabilitation device and the human joint, which is a cause of parasitic forces, discomfort, and pain. The present master dissertation proposes the development of an adjustable wearable active ankle-foot orthosis that is able to tackle this misalignment issue concerning commercially available lower limb orthotic devices. This work is integrated on the SmartOs – Smart, Stand-alone Active Orthotic System – project that proposes an innovative robotic technology (a wearable mobile lab) oriented to gait rehabilitation. The conceptual design of a standard version of the SmartOs wearable active orthosis was initiated with the analysis of another ankle-foot orthosis – Exo-H2 (Technaid) – from which the necessary design changes were implemented, aiming at the improvement of the established device. In order to achieve a conceptual solution, both the practical knowledge of the Orthos XXI design team and several design methods were used to ensure the accomplishment of the defined requirements. The detailed design process of the standard SmartOs wearable active orthosis prototype is disclosed. With the purpose of validating the design, the critical components were simulated with the resources available in SolidWorks®, and the necessary CAD model’s adaptations were implemented to guarantee a reliable and safe design. The presented design is currently set for further production in Orthos XXI, followed by the mandatory mechanical tests.Portugal é o país da Europa ocidental com maior taxa de mortalidade por acidente vascular cerebral (AVC), sendo que, dos que sofrem acidentes vasculares cerebrais, 40% apresentam uma deficiência que pode manifestar-se por sequelas motoras, nomeadamente o pé pendente. Uma ortótese do tornozelo é recomendada frequentemente para acomodar passivamente esses problemas motores; no entanto, exoesqueletos ativos são também uma solução adequada para pacientes pós-AVC. Devido à alta complexidade da articulação do tornozelo humano, um dos problemas associados a esses dispositivos ativos é o desalinhamento que ocorre entre o dispositivo de reabilitação e a articulação humana, que é uma causa de forças parasitas, desconforto e dor. A presente dissertação de mestrado propõe o desenvolvimento de uma ortótese ativa do tornozelo ajustável e vestível, que seja capaz de resolver esse problema de desalinhamento relativo aos dispositivos ortóticos de membros inferiores disponíveis comercialmente. Este trabalho está integrado no projeto SmartOs - Smart, Stand-alone Active Orthotic System - projeto que propõe uma tecnologia robótica inovadora (wearable mobile lab) direcionada para a reabilitação da marcha. O projeto conceptual de uma versão padrão da ortótese ativa vestível do projeto SmartOs foi iniciado com a análise de outra ortótese do tornozelo – Exo-H2 (Technaid) - a partir da qual foram implementadas as alterações de projeto necessárias, visando o aprimoramento do dispositivo estabelecido. Para se chegar a uma solução conceptual, tanto o conhecimento prático da equipa de projeto da Orthos XXI como os diversos métodos de projeto foram utilizados para garantir o cumprimento dos requisitos definidos. O processo do desenho detalhado da versão padrão da ortótese ativa SmartOs será também divulgado. Com o objetivo de validar o projeto, os componentes críticos foram simulados com os recursos disponíveis no SolidWorks® e as adaptações necessárias do modelo CAD foram implementadas para garantir um projeto fidedigno e seguro. O projeto apresentado está atualmente em preparação para produção na empresa Orthos XXI, depois do qual se seguem os ensaios mecânicos obrigatórios