Robot Assisted Shoulder Rehabilitation: Biomechanical Modelling, Design and Performance Evaluation

The upper limb rehabilitation robots have made it possible to improve the motor recovery in stroke survivors while reducing the burden on physical therapists. Compared to manual arm training, robot-supported training can be more intensive, of longer duration, repetitive and task-oriented. To be aligned with the most biomechanically complex joint of human body, the shoulder, specific considerations have to be made in the design of robotic shoulder exoskeletons. It is important to assist all shoulder degrees-of-freedom (DOFs) when implementing robotic exoskeletons for rehabilitation purposes to increase the range of motion (ROM) and avoid any joint axes misalignments between the robot and human’s shoulder that cause undesirable interaction forces and discomfort to the user. The main objective of this work is to design a safe and a robotic exoskeleton for shoulder rehabilitation with physiologically correct movements, lightweight modules, self-alignment characteristics and large workspace. To achieve this goal a comprehensive review of the existing shoulder rehabilitation exoskeletons is conducted first to outline their main advantages and disadvantages, drawbacks and limitations. The research has then focused on biomechanics of the human shoulder which is studied in detail using robotic analysis techniques, i.e. the human shoulder is modelled as a mechanism. The coupled constrained structure of the robotic exoskeleton connected to a human shoulder is considered as a hybrid human-robot mechanism to solve the problem of joint axes misalignments. Finally, a real-scale prototype of the robotic shoulder rehabilitation exoskeleton was built to test its operation and its ability for shoulder rehabilitation

Comfort-Centered Design of a Lightweight and Backdrivable Knee Exoskeleton

This paper presents design principles for comfort-centered wearable robots and their application in a lightweight and backdrivable knee exoskeleton. The mitigation of discomfort is treated as mechanical design and control issues and three solutions are proposed in this paper: 1) a new wearable structure optimizes the strap attachment configuration and suit layout to ameliorate excessive shear forces of conventional wearable structure design; 2) rolling knee joint and double-hinge mechanisms reduce the misalignment in the sagittal and frontal plane, without increasing the mechanical complexity and inertia, respectively; 3) a low impedance mechanical transmission reduces the reflected inertia and damping of the actuator to human, thus the exoskeleton is highly-backdrivable. Kinematic simulations demonstrate that misalignment between the robot joint and knee joint can be reduced by 74% at maximum knee flexion. In experiments, the exoskeleton in the unpowered mode exhibits 1.03 Nm root mean square (RMS) low resistive torque. The torque control experiments demonstrate 0.31 Nm RMS torque tracking error in three human subjects.Comment: 8 pages, 16figures, Journa

Mechanical design and friction modelling of a cable-driven upper-limb exoskeleton

This paper presents a lightweight and low-inertia cable-driven upper-limb exoskeleton powerful enough to meet the requirements for activities of daily living. It presents the mechanical design, kinematic structure,the underlying actuation system, sensors, other electronic components as well as the controller of the exoskeleton. The extensive effect of friction on cable-driven designs, such as the one presented in this paper, requires proper mathematical modelling for controller design. Thus, we propose a current actuator model that describes the relationship between the motor current, velocity, and external load. The model relies on an underlying Stribeck+Coulomb friction representation and an additional parameter that modifies its Coulomb friction representation with an offset to represent adhesion between a cable and sheath. The model has been validated based on experimental data collected with the exoskeleton. The results show that the proposed model better captures the non-linear behaviour of the exoskeleton’s actuation system, increasing overall descriptive performance by 15%. However, adding the adhesion offset to extend the relation of static friction, does not improve the model

Modeling & Analysis of Design Parameters for Portable Hand Orthoses to Assist Upper Motor Neuron Syndrome Impairments and Prototype Design

Wearable assistive robotics have the potential to address an unmet medical need of reducing disability in individuals with chronic hand impairments due to neurological trauma. Despite myriad prior works, few patients have seen the benefits of such devices. Following application experience with tendon-actuated soft robotic gloves and a collaborator\u27s orthosis with novel flat-spring actuators, we identified two common assumptions regarding hand orthosis design. The first was reliance on incomplete studies of grasping forces during activities of daily living as a basis for design criteria, leading to poor optimization. The second was a neglect of increases in muscle tone following neurological trauma, rendering most devices non-applicable to a large subset of the population. To address these gaps, we measured joint torques during activities of daily living with able-bodied subjects using dexterity representative of orthosis-aided motion. Next, we measured assistive torques needed to extend the fingers of individuals with increased flexor tone following TBI. Finally, we applied this knowledge to design a cable actuated orthosis for assisting finger extension, providing a basis for future work focused on an under-represented subgroup of patients

Impact of Ear Occlusion on In-Ear Sounds Generated by Intra-oral Behaviors

We conducted a case study with one volunteer and a recording setup to detect sounds induced by the actions: jaw clenching, tooth grinding, reading, eating, and drinking. The setup consisted of two in-ear microphones, where the left ear was semi-occluded with a commercially available earpiece and the right ear was occluded with a mouldable silicon ear piece. Investigations in the time and frequency domains demonstrated that for behaviors such as eating, tooth grinding, and reading, sounds could be recorded with both sensors. For jaw clenching, however, occluding the ear with a mouldable piece was necessary to enable its detection. This can be attributed to the fact that the mouldable ear piece sealed the ear canal and isolated it from the environment, resulting in a detectable change in pressure. In conclusion, our work suggests that detecting behaviors such as eating, grinding, reading with a semi-occluded ear is possible, whereas, behaviors such as clenching require the complete occlusion of the ear if the activity should be easily detectable. Nevertheless, the latter approach may limit real-world applicability because it hinders the hearing capabilities.</p

Dynamic modelling and simulation of a cable-driven parallel robot for rehabilitation applications

The aim of this work, in collaboration with the ROAR Lab of the Columbia University in the city of New York, is to build a simulation model of a new cable-driven parallel robot for rehabilitation applications, being able to compute the effort given by the patient while the system is working on him/her. The model was built on a multi-body dynamic software called Adams, which is able to simulate the behavior of the mechanism. Some theoretical issues about cable-driven parallel robots will be described, in order to familiarize with the application and introduce the state of the art of the topic. General foundations, dealing with kinematics, statics, dynamics will be detailed and a short introduction to control will be given. In the second chapter, a brief overview of the state of the art regarding rehabilitation cable-driven robotics will be outlined, first dealing with general applications possible to be found in literature, and then introducing the Columbia University work about this particular topic, with several examples and cutting edge devices. The third chapter is about the design description of the Stand Trainer, a 8-cable-driven parallel robot used for rehabilitation. Its mechanical system is introduced, while dealing especially with the issue of computing the cable tensions and the way it can be done in terms of sensors positioning. A new way of tension measurement will be explained. It will take the place of the previous one, bringing several advantages to the system. The last chapter deals with the dynamic simulations on Adams. After having introduced all the simplifications regarding three different models, an accurate description of them will be given and their comparison with the real device will be outlined. The post-process activity will be carried out explaining and discussing the final results. Finally, different points for future developments will be discussed, showing the novelty of this approach for rehabilitative treatments and applications

Novel Design and Implementation of a Knee Exoskeleton for Gait Rehabilitation with Impedance Control Strategy

This paper presents a novel cable-driven robotic joint for a gait exoskeleton robot. We discussed in detail a lightweight, low inertia, and highly back-drivable, 1-DOF tension amplification mechanism based on a pulley system and block-and-tackle technique. The exoskeleton is controlled using an impedance controller under the active-assistive and resistive approaches. Four experiments were conducted to evaluate the proposed exoskeleton’s safety and controller performance: mechanical transparency analysis, active-assistive trajectory tracking, resistance of trajectory tracking, and gait rehabilitation. The exoskeleton demonstrated high transparency with the root mean square (RMS) torque of 0.457 Nm under no-load condition, suggesting that the mechanism is highly back-drivable, has a low moment of inertia, and is mechanically safe to operate. The active-assistive trajectory tracking experiment indicated that the output torque was generated under assist-as-needed approach, as the average robotic-assistance torque was lowered by more than 73% when the user provided assistance force to complete the task on their own. &nbsp;Additionally, the resistance experiment revealed the feasibility of employing the exoskeleton to strengthen muscles with adjustable resistive torque from 0.94 Nm and 2.25 Nm. Finally, the result of gait rehabilitation experiment demonstrated that the robot was able to provide adequate torque to assist users in completing their gait cycle without causing any negative effects during or after the experiment

Design, Fabrication, and Control of an Upper Arm Exoskeleton Assistive Robot

Stroke is the primary cause of permanent impairment and neurological damage in the United States and Europe. Annually, about fifteen million individuals worldwide suffer from stroke, which kills about one third of them. For many years, it was believed that major recovery can be achieved only in the first six months after a stroke. More recent research has demonstrated that even many years after a stroke, significant improvement is not out of reach. However, economic pressures, the aging population, and lack of specialists and available human resources can interrupt therapy, which impedes full recovery of patients after being discharged from hospital following initial rehabilitation. Robotic devices, and in particular portable robots that provide rehabilitation therapy at home and in clinics, are a novel way not only to optimize the cost of therapy but also to let more patients benefit from rehabilitation for a longer time. Robots used for such purposes should be smaller, lighter and more affordable than the robots currently used in clinics and hospitals. The common human-machine interaction design criteria such as work envelopes, safety, comfort, adaptability, space limitations, and weight-to-force ratio must still be taken into consideration.;In this work a light, wearable, affordable assistive robot was designed and a controller to assist with an activity of daily life (ADL) was developed. The mechanical design targeted the most vulnerable group of the society to stroke, based on the average size and age of the patients, with adjustability to accommodate a variety of individuals. The novel mechanical design avoids motion singularities and provides a large workspace for various ADLs. Unlike similar exoskeleton robots, the actuators are placed on the patient\u27s torso and the force is transmitted through a Bowden cable mechanism. Since the actuators\u27 mass does not affect the motion of the upper extremities, the robot can be more agile and more powerful. A compact novel actuation method with high power-to-weight ratio called the twisted string actuation method was used. Part of the research involved selection and testing of several string compositions and configurations to compare their suitability and to characterize their performance. Feedback sensor count and type have been carefully considered to keep the cost of the system as low as possible. A master-slave controller was designed and its performance in tracking the targeted ADL trajectory was evaluated for one degree of freedom (DOF). An outline for proposed future research will be presented