Wearable Robotics for Impaired Upper-Limb Assistance and Rehabilitation: State of the Art and Future Perspectives

Despite more than thirty-five years of research on wearable technologies to assist the upper-limb and a multitude of promising preliminary results, the goal of restoring pre-impairment quality of life of people with physical disabilities has not been fully reached yet. Whether it is for rehabilitation or for assistance, nowadays robotics is still only used in a few high-tech clinics and hospitals, limiting the access to a small amount of people. This work provides a description of the three major 'revolutions' occurred in the field (end-effector robots, rigid exoskeletons, and soft exosuits), reviewing forty-eight systems for the upper-limb (excluding hand-only devices) used in eighty-nine studies enrolling a clinical population before June 2022. The review critically discusses the state of the art, analyzes the different technologies, and compares the clinical outcomes, with the goal of determine new potential directions to follow

Development and Validation of a Spike Detection and Classification Algorithm Aimed at Implementation on Hardware Devices

Neurons cultured in vitro on MicroElectrode Array (MEA) devices connect to each other, forming a network. To study electrophysiological activity and long term plasticity effects, long period recording and spike sorter methods are needed. Therefore, on-line and real time analysis, optimization of memory use and data transmission rate improvement become necessary. We developed an algorithm for amplitude-threshold spikes detection, whose performances were verified with (a) statistical analysis on both simulated and real signal and (b) Big O Notation. Moreover, we developed a PCA-hierarchical classifier, evaluated on simulated and real signal. Finally we proposed a spike detection hardware design on FPGA, whose feasibility was verified in terms of CLBs number, memory occupation and temporal requirements; once realized, it will be able to execute on-line detection and real time waveform analysis, reducing data storage problems

Brain plasticity mechanisms underlying motor control reorganization: Pilot longitudinal study on post-stroke subjects

Functional Electrical Stimulation (FES) has demonstrated to improve walking ability and to induce the carryover effect, long-lasting persisting improvement. Functional magnetic resonance imaging has been used to investigate effective connectivity differences and longitudinal changes in a group of chronic stroke patients that attended a FES-based rehabilitation program for foot-drop correction, distinguishing between carryover effect responders and non-responders, and in comparison with a healthy control group. Bayesian hierarchical procedures were employed, involving nonlinear models at within-subject level—dynamic causal models—and linear models at between-subjects level. Selected regions of interest were primary sensorimotor cortices (M1, S1), supplementary motor area (SMA), and angular gyrus. Our results suggest the following: (i) The ability to correctly plan the movement and integrate proprioception information might be the features to update the motor control loop, towards the carryover effect, as indicated by the reduced sensitivity to pro-prioception input to S1 of FES non-responders; (ii) FES-related neural plasticity supports the active inference account for motor control, as indicated by the modulation of SMA and M1 connections to S1 area; (iii) SMA has a dual role of higher order motor processing unit responsible for complex movements, and a superintendence role in suppressing standard motor plans as external conditions changes

Upper limb soft robotic wearable devices: a systematic review

Introduction: Soft robotic wearable devices, referred to as exosuits, can be a valid alternative to rigid exoskeletons when it comes to daily upper limb support. Indeed, their inherent flexibility improves comfort, usability, and portability while not constraining the user’s natural degrees of freedom. This review is meant to guide the reader in understanding the current approaches across all design and production steps that might be exploited when developing an upper limb robotic exosuit. Methods: The literature research regarding such devices was conducted in PubMed, Scopus, and Web of Science. The investigated features are the intended scenario, type of actuation, supported degrees of freedom, low-level control, high-level control with a focus on intention detection, technology readiness level, and type of experiments conducted to evaluate the device. Results: A total of 105 articles were collected, describing 69 different devices. Devices were grouped according to their actuation type. More than 80% of devices are meant either for rehabilitation, assistance, or both. The most exploited actuation types are pneumatic (52%) and DC motors with cable transmission (29%). Most devices actuate 1 (56%) or 2 (28%) degrees of freedom, and the most targeted joints are the elbow and the shoulder. Intention detection strategies are implemented in 33% of the suits and include the use of switches and buttons, IMUs, stretch and bending sensors, EMG and EEG measurements. Most devices (75%) score a technology readiness level of 4 or 5. Conclusion: Although few devices can be considered ready to reach the market, exosuits show very high potential for the assistance of daily activities. Clinical trials exploiting shared evaluation metrics are needed to assess the effectiveness of upper limb exosuits on target users

An upper limb Functional Electrical Stimulation controller based on Reinforcement Learning: A feasibility case study.

Controllers for Functional Electrical Stimulation (FES) are still not able to restore natural movements in the paretic arm. In this work, Reinforcement Learning (RL) is used for the first time to control a hybrid upper limb robotic system for stroke rehabilitation in a real environment. The feasibility of the FES controller is tested on one healthy subject during elbow flex-extension in the horizontal plane. Results showed an absolute position error <1.2° for a maximum range of motion of 50°

Reproducing a decision-making network in a virtual visual discrimination task

We reproduced a decision-making network model using the neural simulator software neural simulation tool (NEST), and we embedded the spiking neural network in a virtual robotic agent performing a simulated behavioral task. The present work builds upon the concept of replicability in neuroscience, preserving most of the computational properties in the initial model although employing a different software tool. The proposed implementation successfully obtains equivalent results from the original study, reproducing the salient features of the neural processes underlying a binary decision. Furthermore, the resulting network is able to control a robot performing an in silico visual discrimination task, the implementation of which is openly available on the EBRAINS infrastructure through the neuro robotics platform (NRP)