Design and Experimental Characterization of a Shoulder-Elbow Exoskeleton With Compliant Joints for Post-Stroke Rehabilitation

This paper presents the design and experimental characterization of a 4-degree-of-freedom shoulder-elbow exoskeleton, NeuroExos Shoulder-elbow Module (NESM), for upper-limb neurorehabilitation and treatment of spasticity. The NESM employs a self-aligning mechanism based on passive rotational joints to smoothly self-align the robot's rotational axes to the user's ones. Compliant yet high-torque series-elastic actuators allow the NESM to safely interact with the user, particularly in response to sudden unpredicted movements, such as those caused by spastic contractions. The NESM control system provides a variety of rehabilitation exercises, enabling the customization of therapy to patients exhibiting a range of movement capabilities. Available exercises include passive mobilization, active-assisted, active-resisted, and active-disturbed training modes. The experimental characterization of two NESM actuation units demonstrated position and torque control performance suitable for use in neurorehabilitation applications, including up to 7 Hz of bandwidth in torque control. An algorithm for online detection of spastic contractions or sudden object collisions has been implemented and tested as well, with results suggesting that the current system can ensure safe interaction with patients.

[1]  J A Sidles,et al.  Translation of the humeral head on the glenoid with passive glenohumeral motion. , 1990, The Journal of bone and joint surgery. American volume.

[2]  Pyung Hun Chang,et al.  Shoulder mechanism design of an exoskeleton robot for stroke patient rehabilitation , 2011, 2011 IEEE International Conference on Rehabilitation Robotics.

[3]  Jorge Jacinto,et al.  Analysis of a 15-years’ experience in including shoulder muscles, when treating upper-limb spasticity post-stroke with botulinum toxin type A , 2018, Topics in stroke rehabilitation.

[4]  Taichi Shiiba,et al.  Realization of all motion for the upper limb by a muscle suit , 2004, RO-MAN 2004. 13th IEEE International Workshop on Robot and Human Interactive Communication (IEEE Catalog No.04TH8759).

[5]  Massimo Bergamasco,et al.  An arm exoskeleton system for teleoperation and virtual environments applications , 1994, Proceedings of the 1994 IEEE International Conference on Robotics and Automation.

[6]  Michelle J. Johnson,et al.  Advances in upper limb stroke rehabilitation: a technology push , 2011, Medical & Biological Engineering & Computing.

[7]  Jasper Reenalda,et al.  The effect of ‘device-in-charge’ versus ‘patient-in-charge’ support during robotic gait training on walking ability and balance in chronic stroke survivors: A systematic review , 2016, Journal of rehabilitation and assistive technologies engineering.

[8]  Hermano I Krebs,et al.  Rehabilitation robotics: pilot trial of a spatial extension for MIT-Manus , 2004, Journal of NeuroEngineering and Rehabilitation.

[9]  Nicola Vitiello,et al.  NEUROExos: A Powered Elbow Exoskeleton for Physical Rehabilitation , 2013, IEEE Transactions on Robotics.

[10]  Davide Piovesan,et al.  Measuring Multi-Joint Stiffness during Single Movements: Numerical Validation of a Novel Time-Frequency Approach , 2012, PloS one.

[11]  Frans C. T. van der Helm,et al.  Self-Aligning Exoskeleton Axes Through Decoupling of Joint Rotations and Translations , 2009, IEEE Transactions on Robotics.

[12]  Kyu-Jin Cho,et al.  Development and evaluation of a soft wearable weight support device for reducing muscle fatigue on shoulder , 2017, PloS one.

[13]  Maarouf Saad,et al.  Development of a whole arm wearable robotic exoskeleton for rehabilitation and to assist upper limb movements , 2014, Robotica.

[14]  Sunil Agrawal,et al.  Series elastic actuator control of a powered exoskeleton , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[15]  Han-Pang Huang,et al.  AVSER — Active variable stiffness exoskeleton robot system: Design and application for safe active-passive elbow rehabilitation , 2012, 2012 IEEE/ASME International Conference on Advanced Intelligent Mechatronics (AIM).

[16]  Jiping He,et al.  Adaptive control of a wearable exoskeleton for upper-extremity neurorehabilitation , 2012 .

[17]  Hyung-Soon Park,et al.  IntelliArm: An exoskeleton for diagnosis and treatment of patients with neurological impairments , 2008, 2008 2nd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics.

[18]  Nikolaos G. Tsagarakis,et al.  Development and Control of a ‘Soft-Actuated’ Exoskeleton for Use in Physiotherapy and Training , 2003, Auton. Robots.

[19]  Silvestro Micera,et al.  Why Effectiveness of Robot-Mediated Neurorehabilitation Does Not Necessarily Influence Its Adoption , 2014, IEEE Reviews in Biomedical Engineering.

[20]  Ronglei Sun,et al.  Control methods for exoskeleton rehabilitation robot driven with pneumatic muscles , 2009, Ind. Robot.

[21]  George K. I. Mann,et al.  Developments in hardware systems of active upper-limb exoskeleton robots: A review , 2016, Robotics Auton. Syst..

[22]  A.H.A. Stienen,et al.  Dampace: dynamic force-coordination trainer for the upper extremities , 2007, 2007 IEEE 10th International Conference on Rehabilitation Robotics.

[23]  Sunil K. Agrawal,et al.  Design of a 7-DOF Cable-Driven Arm Exoskeleton (CAREX-7) and a Controller for Dexterous Motion Training or Assistance , 2017, IEEE/ASME Transactions on Mechatronics.

[24]  Herman van der Kooij,et al.  LIMPACT:A Hydraulically Powered Self-Aligning Upper Limb Exoskeleton , 2015, IEEE/ASME Transactions on Mechatronics.

[25]  Aiguo Song,et al.  International Journal of Advanced Robotic Systems Safety Supervisory Strategy for an Upper-limb Rehabilitation Robot Based on Impedance Control , 2022 .

[26]  W. Rymer,et al.  Understanding and treating arm movement impairment after chronic brain injury: progress with the ARM guide. , 2014, Journal of rehabilitation research and development.

[27]  Craig R. Carignan,et al.  Development of an exoskeleton haptic interface for virtual task training , 2009, 2009 IEEE/RSJ International Conference on Intelligent Robots and Systems.

[28]  Leonardo Cappello,et al.  Special Collection: Affordable Rehabilitation and Assistive Technologies Preliminary design and control of a soft exosuit for assisting elbow movements and hand grasping in activities of daily living , 2017 .

[29]  Simona Crea,et al.  A novel shoulder-elbow exoskeleton with series elastic actuators , 2016, 2016 6th IEEE International Conference on Biomedical Robotics and Biomechatronics (BioRob).

[30]  Chao-Chieh Lan,et al.  Design of an adaptive exoskeleton for safe robotic shoulder rehabilitation , 2016, 2016 IEEE International Conference on Advanced Intelligent Mechatronics (AIM).

[31]  Simona Crea,et al.  Functional Design of a Powered Elbow Orthosis Toward its Clinical Employment , 2016, IEEE/ASME Transactions on Mechatronics.

[32]  Simona Crea,et al.  Validation of a Gravity Compensation Algorithm for a Shoulder-Elbow Exoskeleton for Neurological Rehabilitation , 2017 .

[33]  J. Krakauer.  Motor learning: its relevance to stroke recovery and neurorehabilitation. , 2006, Current opinion in neurology.

[34]  Yupeng Ren,et al.  Characterization of spasticity in cerebral palsy: dependence of catch angle on velocity , 2010, Developmental medicine and child neurology.

[35]  Janne M. Veerbeek,et al.  Effects of Robot-Assisted Therapy for the Upper Limb After Stroke , 2017, Neurorehabilitation and neural repair.

[36]  Shuxiang Guo,et al.  Design of a Novel Telerehabilitation System with a Force-Sensing Mechanism , 2015, Sensors.

[37]  James A. Johnson,et al.  Variability and repeatability of the flexion axis at the ulnohumeral joint , 2003, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[38]  S. Leonhardt,et al.  A survey on robotic devices for upper limb rehabilitation , 2014, Journal of NeuroEngineering and Rehabilitation.

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

[40]  Volkan Patoglu,et al.  ASSISTON-SE: A self-aligning shoulder-elbow exoskeleton , 2012, 2012 IEEE International Conference on Robotics and Automation.

[41]  Matthew M. Williamson,et al.  Series elastic actuators , 1995, Proceedings 1995 IEEE/RSJ International Conference on Intelligent Robots and Systems. Human Robot Interaction and Cooperative Robots.

[42]  M. Rayner,et al.  Cardiovascular disease in Europe: epidemiological update 2016. , 2016, European heart journal.

[43]  George Howard,et al.  Global stroke statistics , 2017, International journal of stroke : official journal of the International Stroke Society.