Cooperative strategies for robot-aided gait neuro-rehabilitation

Task-oriented repetitive movements can improve muscular strength and movement coordination in patients with impairments due to neurological or orthopedic lesions. The application of robotics and automation technology can serve to assist, enhance, evaluate, and document neurological and orthopedic rehabilitation of the lower and upper extremities. This review presentation will give an overview of patient-cooperative techniques to the robot-aided gait rehabilitation of paralyzed patients. Patient-cooperative means that the technical system considers the patient intention and efforts rather than imposing any predefined movement or inflexible strategy. It is hypothesized that cooperative approaches have the potential to improve the therapeutic outcome compared to classical rehabilitation strategies. Three new cooperative strategies are presented in this review. In all three strategies the patient's movement effort is detected and processed in three different ways. First, the data is used to offer the patient an increased freedom of movement by a certain amount of robot compliance. Second, the robot behavior is adapted to the patient movement efforts. In the third strategy the recorded movement data are displayed to the patient in order to improve the patient efforts by biofeedback principles.