Challenges and Opportunities in Exoskeleton-based Rehabilitation

Robotic systems are increasingly used in rehabilitation to provide high intensity training for patients with motor impairment. The results of controlled trials involving human subjects confirm the effectiveness of robot-enhanced methods and prove them to be marginally superior over standard manual therapy in some cases. Although very promising, this line of research is still in its infancy and further studies are required to fully understand the potential benefits of using robotic devices such as exoskeletons. Exoskeletons have been widely studied due to their capability in providing more control over paretic limb as well as the complexities involved in their design and control. This paper briefly discusses the main challenges in development of rehabilitation exoskeletons and elaborates more on how some of these issues are addressed in the design of CLEVERarm, a recently developed upper limb rehabilitation exoskeleton. The paper is concluded with several remarks on the current challenges in wide-spread use of exoskeletons in medical facilities, and a vision for the future of these technologies in rehabilitation medicine.

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

[2]  Martin Levesley,et al.  Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting , 2014, Journal of NeuroEngineering and Rehabilitation.

[3]  Marcia Kilchenman O'Malley,et al.  Minimal Assist-as-Needed Controller for Upper Limb Robotic Rehabilitation , 2016, IEEE Transactions on Robotics.

[4]  Jiping He,et al.  Design and Control of RUPERT: A Device for Robotic Upper Extremity Repetitive Therapy , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[5]  Hermano Igo Krebs,et al.  MIT-MANUS: a workstation for manual therapy and training. I , 1992, [1992] Proceedings IEEE International Workshop on Robot and Human Communication.

[6]  Yoshiaki Hayashi,et al.  An EMG-Based Control for an Upper-Limb Power-Assist Exoskeleton Robot , 2012, IEEE Transactions on Systems, Man, and Cybernetics, Part B (Cybernetics).

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

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

[9]  J. Daly,et al.  Comparison of robotics, functional electrical stimulation, and motor learning methods for treatment of persistent upper extremity dysfunction after stroke: a randomized controlled trial. , 2015, Archives of physical medicine and rehabilitation.

[10]  Hermano Igo Krebs,et al.  A wrist extension for MIT-MANUS , 2004 .

[11]  Jose L. Contreras-Vidal,et al.  Design and Optimization of an EEG-Based Brain Machine Interface (BMI) to an Upper-Limb Exoskeleton for Stroke Survivors , 2016, Front. Neurosci..

[12]  Reza Langari,et al.  A computational approach for human-like motion generation in upper limb exoskeletons supporting scapulohumeral rhythms , 2017, 2017 International Symposium on Wearable Robotics and Rehabilitation (WeRob).

[13]  Sheng-Feng Sung,et al.  The Impact of Timing and Dose of Rehabilitation Delivery on Functional Recovery of Stroke Patients , 2009, Journal of the Chinese Medical Association : JCMA.

[14]  Reza Langari,et al.  TAMU CLEVERarm: A novel exoskeleton for rehabilitation of upper limb impairments , 2017, 2017 International Symposium on Wearable Robotics and Rehabilitation (WeRob).

[15]  M. Fornage,et al.  Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association , 2017, Circulation.

[16]  Reza Langari,et al.  Reference path generation for upper-arm exoskeletons considering scapulohumeral rhythms , 2017, 2017 International Conference on Rehabilitation Robotics (ICORR).

[17]  G. Kwakkel,et al.  Effects of intensity of rehabilitation after stroke. A research synthesis. , 1997, Stroke.

[18]  David Wu,et al.  Effect of Home-Based Rehabilitation on Access to Cost Effective Therapy for Rural Veteran Stroke Survivors , 2017 .

[19]  Reza Langari,et al.  Design and kinematic analysis of a novel upper limb exoskeleton for rehabilitation of stroke patients , 2017, 2017 International Conference on Rehabilitation Robotics (ICORR).

[20]  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.

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

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

[23]  B. Brewer,et al.  Poststroke Upper Extremity Rehabilitation: A Review of Robotic Systems and Clinical Results , 2007, Topics in stroke rehabilitation.