Design and Development of a Wearable Exoskeleton System for Stroke Rehabilitation

For more than a decade, many countries have been actively developing robotic assistive devices to assist in the rehabilitation of individuals with limb disability to regain function in the extremities. The exoskeleton assistive device in this study has been designed primarily for hemiplegic stroke patients to aid in the extension of fingers to open up the palm to simulate the effects of rehabilitation. This exoskeleton was designed as an anterior-support type to achieve palmar extension and acts as a robotic assistive device for rehabilitation in bilateral upper limb task training. Testing results show that this wearable exoskeleton assistive device with human factor consideration using percentile dimensions can provide comfortable wear on patients as well as adequate torque to pull individual fingers into flexion towards the palm for rehabilitation. We hope this exoskeleton device can help stroke patients with loss of function in the upper extremities to resume motor activities in order to maintain activities of daily living.

[1]  C. Winstein,et al.  A randomized controlled comparison of upper-extremity rehabilitation strategies in acute stroke: A pilot study of immediate and long-term outcomes. , 2004, Archives of physical medicine and rehabilitation.

[2]  J.C. Perry,et al.  Upper-Limb Powered Exoskeleton Design , 2007, IEEE/ASME Transactions on Mechatronics.

[3]  Y. Hsieh,et al.  Effects of robot-assisted upper limb rehabilitation on daily function and real-world arm activity in patients with chronic stroke: a randomized controlled trial , 2012, Clinical rehabilitation.

[4]  Qiang Cao,et al.  Improvement of human-machine compatibility of upper-limb rehabilitation exoskeleton using passive joints , 2019, Robotics Auton. Syst..

[5]  Juan J. Castillo,et al.  Evolutionary synthesis of mechanisms applied to the design of an exoskeleton for finger rehabilitation , 2016 .

[6]  Jiping He,et al.  RUPERT: An exoskeleton robot for assisting rehabilitation of arm functions , 2008, 2008 Virtual Rehabilitation.

[7]  Heidi Sveistrup,et al.  Feasibility, Motivation, and Selective Motor Control: Virtual Reality Compared to Conventional Home Exercise in Children with Cerebral Palsy , 2006, Cyberpsychology Behav. Soc. Netw..

[8]  Mark Hallett,et al.  Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study. , 2005, Archives of physical medicine and rehabilitation.

[9]  T. Elbert,et al.  New treatments in neurorehabiliation founded on basic research , 2002, Nature Reviews Neuroscience.

[10]  Qining Wang,et al.  BioKEX: A bionic knee exoskeleton with proxy-based sliding mode control , 2015, 2015 IEEE International Conference on Industrial Technology (ICIT).

[11]  Nikos G. Tsagarakis,et al.  A novel exoskeleton robotic system for hand rehabilitation - Conceptualization to prototyping , 2014 .

[12]  Jeffery J. Summers,et al.  Neural plasticity and bilateral movements: A rehabilitation approach for chronic stroke , 2005, Progress in Neurobiology.

[13]  André J. Szameitat,et al.  Cortical activation during executed, imagined, observed, and passive wrist movements in healthy volunteers and stroke patients , 2012, NeuroImage.

[14]  Qiang Cao,et al.  Position solution of a novel four-DOFs self-aligning exoskeleton mechanism for upper limb rehabilitation , 2019, Mechanism and Machine Theory.

[15]  D. De Clercq,et al.  Bi-articular Knee-Ankle-Foot Exoskeleton Produces Higher Metabolic Cost Reduction than Weight-Matched Mono-articular Exoskeleton , 2018, Front. Neurosci..

[16]  P. Langhorne,et al.  Occupational therapy for patients with problems in activities of daily living after stroke. , 2006, The Cochrane database of systematic reviews.

[17]  Bram Vanderborght,et al.  Safe and Compliant Guidance by a Powered Knee Exoskeleton for Robot-Assisted Rehabilitation of Gait , 2011, Adv. Robotics.

[18]  L. Stone,et al.  Rehabilitation of hemiparesis after stroke with a mirror , 1999, The Lancet.

[19]  J. Schaechter.  Motor rehabilitation and brain plasticity after hemiparetic stroke , 2004, Progress in Neurobiology.

[20]  Frederic Marin,et al.  Morphogenesis of the human palma arch using three‐dimensional geometric modeling , 2011, Clinical anatomy.

[21]  E. A. Susanto,et al.  Efficacy of robot-assisted fingers training in chronic stroke survivors: a pilot randomized-controlled trial , 2015, Journal of NeuroEngineering and Rehabilitation.

[22]  M. Tomizuka,et al.  A Compact Rotary Series Elastic Actuator for Human Assistive Systems , 2012, IEEE/ASME Transactions on Mechatronics.

[23]  H. Karbe,et al.  Mirror Therapy Promotes Recovery From Severe Hemiparesis: A Randomized Controlled Trial , 2009, Neurorehabilitation and neural repair.

[24]  Fumio Miyazaki,et al.  Muscle synergy analysis of human adaptation to a variable-stiffness exoskeleton: Human walk with a knee exoskeleton with pneumatic artificial muscles , 2012, 2012 12th IEEE-RAS International Conference on Humanoid Robots (Humanoids 2012).

[25]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2010 update: a report from the American Heart Association. , 2010, Circulation.

[26]  S. Hesse,et al.  Machines to support motor rehabilitation after stroke , 2009 .

[27]  Jeffery J. Summers,et al.  Bilateral and unilateral movement training on upper limb function in chronic stroke patients: A TMS study , 2007, Journal of the Neurological Sciences.

[28]  Robert Riener,et al.  ARMin III --arm therapy exoskeleton with an ergonomic shoulder actuation , 2009 .

[29]  Wei-Hsin Liao,et al.  Design and control of a powered knee orthosis for gait assistance , 2013, 2013 IEEE/ASME International Conference on Advanced Intelligent Mechatronics.

[30]  Marion Smits,et al.  The neuronal correlates of mirror therapy: an fMRI study on mirror induced visual illusions in patients with stroke , 2010, Journal of Neurology, Neurosurgery & Psychiatry.

[31]  M. Owolabi,et al.  Stroke: a global response is needed , 2016, Bulletin of the World Health Organization.

[32]  N. Hogan,et al.  A paradigm shift for rehabilitation robotics , 2008, IEEE Engineering in Medicine and Biology Magazine.

[33]  Jen-Yuan Chang,et al.  Design and development of the wearable hand exoskeleton system for rehabilitation of hand impaired patients , 2014, 2014 IEEE International Conference on Automation Science and Engineering (CASE).

[34]  Jerry E. Pratt,et al.  The RoboKnee: an exoskeleton for enhancing strength and endurance during walking , 2004, IEEE International Conference on Robotics and Automation, 2004. Proceedings. ICRA '04. 2004.

[35]  Roland Siegwart,et al.  The hand of the DLR Hand Arm System: Designed for interaction , 2012, Int. J. Robotics Res..

[36]  P. Schwenkreis,et al.  Hybrid Assistive Limb Exoskeleton HAL in the Rehabilitation of Chronic Spinal Cord Injury: Proof of Concept; the Results in 21 Patients. , 2017, World neurosurgery.

[37]  Rong Song,et al.  A Comparison Between Electromyography-Driven Robot and Passive Motion Device on Wrist Rehabilitation for Chronic Stroke , 2009, Neurorehabilitation and neural repair.

[38]  A. Geurts,et al.  Motor recovery after stroke: a systematic review of the literature. , 2002, Archives of physical medicine and rehabilitation.

[39]  Sheng Quan Xie,et al.  Exoskeleton robots for upper-limb rehabilitation: state of the art and future prospects. , 2012, Medical engineering & physics.

[40]  Nikolaos G. Tsagarakis,et al.  Tele-Impedance based stiffness and motion augmentation for a knee exoskeleton device , 2013, 2013 IEEE International Conference on Robotics and Automation.

[41]  Henning Schmidt,et al.  Machines to support motor rehabilitation after stroke: 10 years of experience in Berlin. , 2006, Journal of rehabilitation research and development.