Design Process of Exoskeleton Rehabilitation Device and Implementation of Bilateral Upper Limb Motor Movement

With the development of neurorehabilitation, physical rehabilitation strategies for the upper limbs have become gradually accepted by therapists and researchers. These strategies include intensive intervention, task-oriented training, and bilateral training. Most upper limb rehabilitation systems have been developed for unilateral training. This paper develops an upper limb exoskeleton rehabilitation device (ULERD) that can be used for bilateral training. The device has three active degrees of freedom (DoFs) in the elbow and wrist joints, and an additional four passive DoFs at these joints to correct any misalignment between the human and device joints. A bilateral training strategy is implemented with the developed ULERD and a haptic device according to neurorehabilitation theory. In a preliminary study, a healthy user was able to manipulate the haptic device with one hand (intact hand for hemiplegic patients) when the upper arm was fixed, and the ULERD assisted in moving the other hand (impaired upper limb for hemiplegic patients). To implement bilateral training, the kinematics of one upper limb (intact limb) and the haptic device is analyzed, respectively. The angles of the three active DoFs are determined via integration. An inertia sensor is used to evaluate the kinematics resolution. The ULERD was evaluated by experienced therapists during the design process to determine its potential for clinic application. Experimental results indicate that the kinematics resolution is effective and that this type of bilateral movement can be implemented using the ULERD and the haptic device.

[1]  Alex Mihailidis,et al.  A haptic-robotic platform for upper-limb reaching stroke therapy: Preliminary design and evaluation results , 2007, Journal of NeuroEngineering and Rehabilitation.

[2]  William S. Harwin,et al.  Upper Limb Robot Mediated Stroke Therapy—GENTLE/s Approach , 2003, Auton. Robots.

[3]  J. Kleim,et al.  Synaptogenesis and FOS Expression in the Motor Cortex of the Adult Rat after Motor Skill Learning , 1996, The Journal of Neuroscience.

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

[5]  R. Riener,et al.  Effects of intensive arm training with the rehabilitation robot ARMin II in chronic stroke patients: four single-cases , 2009, Journal of NeuroEngineering and Rehabilitation.

[6]  W. Rymer,et al.  Robotic Devices for Movement Therapy After Stroke: Current Status and Challenges to Clinical Acceptance , 2002, Topics in stroke rehabilitation.

[7]  Gary Dudley,et al.  Methods for a Randomized Trial of Weight-Supported Treadmill Training Versus Conventional Training for Walking During Inpatient Rehabilitation after Incomplete Traumatic Spinal Cord Injury , 2003, Neurorehabilitation and neural repair.

[8]  Shuxiang Guo,et al.  Development of a Master-slave system for Upper Limb Rehabilitation , 2010 .

[9]  D. Reinkensmeyer,et al.  Arm-Training with T-WREX After Chronic Stroke: Preliminary Results of a Randomized Controlled Trial , 2007, 2007 IEEE 10th International Conference on Rehabilitation Robotics.

[10]  Ferdinand Freudenstein,et al.  Kinematic Synthesis of Linkages , 1965 .

[11]  Anton Arndt,et al.  Variation in the position of the elbow flexion axis after total joint replacement with three different prostheses. , 2008, Journal of shoulder and elbow surgery.

[12]  Shuxiang Guo,et al.  Development of an upper extremity motor function rehabilitation system and an assessment system , 2011, Int. J. Mechatronics Autom..

[13]  Shuxiang Guo,et al.  Development of a real-time upper limb's motion tracking exoskeleton device for active rehabilitation using an inertia sensor , 2011, 2011 9th World Congress on Intelligent Control and Automation.

[14]  Mark Hallett,et al.  Constraint-Induced Therapy in Stroke: Magnetic-Stimulation Motor Maps and Cerebral Activation , 2003, Neurorehabilitation and neural repair.

[15]  Winston D. Byblow,et al.  Spontaneous and intentional dynamics of bimanual coordination in Parkinson's disease , 2000 .

[16]  S.J. Ball,et al.  A planar 3DOF robotic exoskeleton for rehabilitation and assessment , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[17]  E. Taub,et al.  Effects of constraint-induced movement therapy on patients with chronic motor deficits after stroke: a replication. , 1999, Stroke.

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

[19]  Tao Liu,et al.  A NEW MASTER-SLAVE CONTROL METHOD FOR IMPLEMENTING FORCE SENSING AND ENERGY RECYCLING IN A BILATERAL ARM TRAINING ROBOT , 2010 .

[20]  M. Moskowitz,et al.  Neurogenesis and apoptotic cell death. , 2003, Stroke.

[21]  S. Rathore,et al.  Characterization of Incident Stroke Signs and Symptoms: Findings From the Atherosclerosis Risk in Communities Study , 2002, Stroke.

[22]  W. Rymer,et al.  Adaptive assistance for guided force training in chronic stroke , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[23]  N. Ward Neural plasticity and recovery of function. , 2005, Progress in brain research.

[24]  Joshua Wilson,et al.  Automated Variable Resistance System for Upper Limb Rehabilitation , 2009 .

[25]  A. Vermeer,et al.  Bimanual circle drawing in children with spastic hemiparesis: effect of coupling modes on the performance of the impaired and unimpaired arms. , 2002, Acta psychologica.

[26]  G. Paraskevas,et al.  Study of the carrying angle of the human elbow joint in full extension: a morphometric analysis , 2004, Surgical and Radiologic Anatomy.

[27]  Makoto Sasaki,et al.  Development of a 3DOF mobile exoskeleton robot for human upper-limb motion assist , 2008, Robotics Auton. Syst..

[28]  E.J. Perreault,et al.  An Assessment of Robot-Assisted Bimanual Movements on Upper Limb Motor Coordination Following Stroke , 2009, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[29]  Peter Levine,et al.  Stroke patients' and therapists' opinions of constraint-induced movement therapy , 2002, Clinical rehabilitation.

[30]  E. Taub,et al.  Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review. , 1999, Journal of rehabilitation research and development.

[31]  Stephen J Page,et al.  Intensity versus task-specificity after stroke: how important is intensity? , 2003, American journal of physical medicine & rehabilitation.

[32]  Shuxiang Guo,et al.  Development of a new compliant exoskeleton device for elbow joint rehabilitation , 2011, The 2011 IEEE/ICME International Conference on Complex Medical Engineering.

[33]  Giulio Sandini,et al.  Journal of Neuroengineering and Rehabilitation Performance Adaptive Training Control Strategy for Recovering Wrist Movements in Stroke Patients: a Preliminary, Feasibility Study , 2009 .

[34]  R. Nudo Adaptive plasticity in motor cortex: implications for rehabilitation after brain injury. , 2003, Journal of rehabilitation medicine.

[35]  N. Hogan,et al.  Increasing productivity and quality of care: robot-aided neuro-rehabilitation. , 2000, Journal of rehabilitation research and development.

[36]  Kyle B. Reed,et al.  Symmetric motions for bimanual rehabilitation , 2010, 2010 IEEE/RSJ International Conference on Intelligent Robots and Systems.