Lower-Limb Robotic Rehabilitation: Literature Review and Challenges

This paper presents a survey of existing robotic systems for lower-limb rehabilitation. It is a general assumption that robotics will play an important role in therapy activities within rehabilitation treatment. In the last decade, the interest in the field has grown exponentially mainly due to the initial success of the early systems and the growing demand caused by increasing numbers of stroke patients and their associate rehabilitation costs. As a result, robot therapy systems have been developed worldwide for training of both the upper and lower extremities. This work reviews all current robotic systems to date for lower-limb rehabilitation, as well as main clinical tests performed with them, with the aim of showing a clear starting point in the field. It also remarks some challenges that current systems still have to meet in order to obtain a broad clinical and market acceptance.

[1]  Jiping He,et al.  Robotic Gait Trainer Reliability and Stroke Patient Case Study , 2007, 2007 IEEE 10th International Conference on Rehabilitation Robotics.

[2]  G.S. Sawicki,et al.  Powered lower limb orthoses: applications in motor adaptation and rehabilitation , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[3]  A. Wernig,et al.  Laufband Therapy Based on‘Rules of Spinal Locomotion’is Effective in Spinal Cord Injured Persons , 1995, The European journal of neuroscience.

[4]  David J. Reinkensmeyer,et al.  Feasibility of Manual Teach-and-Replay and Continuous Impedance Shaping for Robotic Locomotor Training Following Spinal Cord Injury , 2008, IEEE Transactions on Biomedical Engineering.

[5]  V. Dietz,et al.  Driven gait orthosis for improvement of locomotor training in paraplegic patients , 2001, Spinal Cord.

[6]  Volkan Patoglu,et al.  Design of a reconfigurable ankle rehabilitation robot and its use for the estimation of the ankle impedance , 2009, 2009 IEEE International Conference on Rehabilitation Robotics.

[7]  S. Hesse,et al.  A mechanized gait trainer for restoration of gait. , 2000, Journal of rehabilitation research and development.

[8]  J. Mehrholz,et al.  Improved walking ability and reduced therapeutic stress with an electromechanical gait device. , 2009, Journal of rehabilitation medicine.

[9]  Naoki Tanaka,et al.  Gait rehabilitation system for stair climbing and descending , 2010, 2010 IEEE Haptics Symposium.

[10]  Paolo Bonato,et al.  Gait Rehabilitation therapy using robot generated force fields applied at the pelvis , 2010, 2010 IEEE Haptics Symposium.

[11]  Junji Furusho,et al.  Leg-Robot for Demonstration of Spastic Movements of Brain-Injured Patients with Compact Magnetorheological Fluid Clutch , 2010, Adv. Robotics.

[12]  Heinz W. Schmidt HapticWalker-A novel haptic device for walking simulation , 2004 .

[13]  Sungjae Hwang,et al.  Development of an active ankle foot orthosis for the prevention of foot drop and toe drag , 2006, 2006 International Conference on Biomedical and Pharmaceutical Engineering.

[14]  Yoshiyuki Sankai,et al.  Development of single leg version of HAL for hemiplegia , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[15]  S.K. Agrawal,et al.  Design of a two degree-of-freedom ankle-foot orthosis for robotic rehabilitation , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[16]  Daniel P. Ferris,et al.  Powered lower limb orthoses for gait rehabilitation. , 2005, Topics in spinal cord injury rehabilitation.

[17]  Ming-Shaung Ju,et al.  A Specialized Robot for Ankle Rehabilitation and Evaluation , 2008 .

[18]  V. Dietz,et al.  Treadmill training of paraplegic patients using a robotic orthosis. , 2000, Journal of rehabilitation research and development.

[19]  S.K. Agrawal,et al.  Active Leg Exoskeleton (ALEX) for Gait Rehabilitation of Motor-Impaired Patients , 2007, 2007 IEEE 10th International Conference on Rehabilitation Robotics.

[20]  Constantinos Mavroidis,et al.  Active Knee Rehabilitation Orthotic Device With Variable Damping Characteristics Implemented via an Electrorheological Fluid , 2010, IEEE/ASME Transactions on Mechatronics.

[21]  Reymond Clavel,et al.  A new concept of parallel robot for rehabilitation and fitness: The Lambda , 2009, 2009 IEEE International Conference on Robotics and Biomimetics (ROBIO).

[22]  Yun Ho Tsoi,et al.  Impedance control of ankle rehabilitation robot , 2009, 2008 IEEE International Conference on Robotics and Biomimetics.

[23]  S. Hesse,et al.  Treadmill Training With Partial Body Weight Support and an Electromechanical Gait Trainer for Restoration of Gait in Subacute Stroke Patients: A Randomized Crossover Study , 2002, Stroke.

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

[25]  Reymond Clavel,et al.  The WalkTrainer: A Robotic System for Walking Rehabilitation , 2006, 2006 IEEE International Conference on Robotics and Biomimetics.

[26]  Jungwon Yoon,et al.  A Novel Reconfigurable Ankle/Foot Rehabilitation Robot , 2005, Proceedings of the 2005 IEEE International Conference on Robotics and Automation.

[27]  Jian S. Dai,et al.  Sprained Ankle Physiotherapy Based Mechanism Synthesis and Stiffness Analysis of a Robotic Rehabilitation Device , 2004, Auton. Robots.

[28]  Herman van der Kooij,et al.  Robot aided gait training according to the assist-as-needed principle in chronic stroke survivors , 2009 .

[29]  H. Herr,et al.  Adaptive control of a variable-impedance ankle-foot orthosis to assist drop-foot gait , 2004, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[30]  Daniel P Ferris,et al.  An improved powered ankle-foot orthosis using proportional myoelectric control. , 2006, Gait & posture.

[31]  S. Hesse,et al.  Gait rehabilitation machines based on programmable footplates , 2007, Journal of NeuroEngineering and Rehabilitation.

[32]  Tam Dickson,et al.  Motor relearning programme for stroke patients: a randomized controlled trial. , 2006, Clinical rehabilitation.

[33]  Yasuhisa Hasegawa,et al.  Intention-based walking support for paraplegia patient , 2005, 2005 IEEE International Conference on Systems, Man and Cybernetics.

[34]  D. Brown,et al.  Overground walking speed changes when subjected to body weight support conditions for nonimpaired and post stroke individuals , 2010, Journal of NeuroEngineering and Rehabilitation.

[35]  S.K. Agrawal,et al.  Robot assisted gait training with active leg exoskeleton (ALEX) , 2009, 2008 2nd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics.

[36]  B. Ruthenberg,et al.  An experimental device for investigating the force and power requirements of a powered gait orthosis. , 1997, Journal of rehabilitation research and development.

[37]  Thomas Sugar,et al.  Kinematics of a robotic gait trainer for stroke rehabilitation , 2006, Proceedings 2006 IEEE International Conference on Robotics and Automation, 2006. ICRA 2006..

[38]  J.E. Deutsch,et al.  Technical and Patient Performance Using a Virtual Reality-Integrated Telerehabilitation System: Preliminary Finding , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[39]  S Hesse,et al.  Repetitive locomotor training and physiotherapy improve walking and basic activities of daily living after stroke: a single-blind, randomized multicentre trial (DEutsche GAngtrainerStudie, DEGAS) , 2007, Clinical rehabilitation.

[40]  J. Hidler,et al.  Multicenter Randomized Clinical Trial Evaluating the Effectiveness of the Lokomat in Subacute Stroke , 2009, Neurorehabilitation and neural repair.

[41]  H. van der Kooij,et al.  Design and Evaluation of the LOPES Exoskeleton Robot for Interactive Gait Rehabilitation , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[42]  K. Homma,et al.  Development of Ankle Dorsiflexion/Plantarflexion Exercise Device with Passive Mechanical Joint , 2007, 2007 IEEE 10th International Conference on Rehabilitation Robotics.

[43]  C. Schmitt,et al.  The Motion Maker™ : a Rehabilitation System Combining an Orthosis with Closed-Loop Electrical Muscle Stimulation , 2004 .

[44]  M. Dam,et al.  The Effects of Long‐term Rehabilitation Therapy on Poststroke Hemiplegic Patients , 1993, Stroke.

[45]  Ju-Jang Lee,et al.  The Development of Two Mobile Gait Rehabilitation Systems , 2009, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[46]  Laura Gastaldi,et al.  Pneumatic active gait orthosis , 2001 .

[47]  J. Mehrholz,et al.  Gait training with the newly developed ‘LokoHelp’-system is feasible for non-ambulatory patients after stroke, spinal cord and brain injury. A feasibility study , 2008, Brain injury.

[48]  Bram Vanderborght,et al.  An exoskeleton for gait rehabilitation: Prototype design and control principle , 2008, 2008 IEEE International Conference on Robotics and Automation.

[49]  Jian S. Dai,et al.  Analysis and synthesis of ankle motion and rehabilitation robots , 2009, 2009 IEEE International Conference on Robotics and Biomimetics (ROBIO).

[50]  T. Hornby,et al.  Robotic-assisted, body-weight-supported treadmill training in individuals following motor incomplete spinal cord injury. , 2005, Physical therapy.

[51]  Constantinos Mavroidis,et al.  NUVABAT: Northeastern university virtual ankle and balance trainer , 2010, 2010 IEEE Haptics Symposium.

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

[53]  JungYoon Kim,et al.  Development of an active ankle-foot orthosis for hemiplegic patients , 2007, i-CREATe '07.

[54]  Dragoljub Surdilovic,et al.  STRING-MAN: a new wire robot for gait rehabilitation , 2004, IEEE International Conference on Robotics and Automation, 2004. Proceedings. ICRA '04. 2004.

[55]  Keiko Homma,et al.  Study of a Wire-driven Leg Rehabilitation System , 2003 .

[56]  Jeffrey A. Lewis,et al.  Virtual Reality-based System for Ankle Rehabilitation Post Stroke , 2002 .

[57]  D. Reinkensmeyer,et al.  Robotics for Gait Training After Spinal Cord Injury , 2005 .

[58]  Jungwon Yoon,et al.  A 6-DOF Gait Rehabilitation Robot With Upper and Lower Limb Connections That Allows Walking Velocity Updates on Various Terrains , 2010, IEEE/ASME Transactions on Mechatronics.

[59]  Kelly P Westlake,et al.  Pilot study of Lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke , 2009, Journal of NeuroEngineering and Rehabilitation.

[60]  T W Meade,et al.  Remedial therapy after stroke: a randomised controlled trial. , 1981, British medical journal.

[61]  V. Dietz,et al.  Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial. , 2005, Archives of physical medicine and rehabilitation.

[62]  Daniel P. Ferris,et al.  A pneumatically powered knee-ankle-foot orthosis (KAFO) with myoelectric activation and inhibition , 2009, Journal of NeuroEngineering and Rehabilitation.

[63]  M. Rodgers,et al.  Effects of unilateral robotic limb loading on gait characteristics in subjects with chronic stroke , 2010, Journal of NeuroEngineering and Rehabilitation.

[64]  Nikolaos G. Tsagarakis,et al.  A High-performance Redundantly Actuated Parallel Mechanism for Ankle Rehabilitation , 2009, Int. J. Robotics Res..

[65]  Judith E. Deutsch,et al.  A Stewart Platform-Based System for Ankle Telerehabilitation , 2001, Auton. Robots.

[66]  J.E. Colgate,et al.  KineAssist: a robotic overground gait and balance training device , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[67]  Ruthenberg Bj,et al.  An experimental device for investigating the force and power requirements of a powered gait orthosis. , 1997 .

[68]  Roger Weber,et al.  Tools for understanding and optimizing robotic gait training. , 2006, Journal of rehabilitation research and development.

[69]  Olavi Airaksinen,et al.  Effects of intensive therapy using gait trainer or floor walking exercises early after stroke. , 2009, Journal of rehabilitation medicine.

[70]  Yang Wang,et al.  Lower limb rehabilitation robot , 2009, 2009 ASME/IFToMM International Conference on Reconfigurable Mechanisms and Robots.

[71]  J. De Keyser,et al.  Use of the Barthel index and modified Rankin scale in acute stroke trials. , 1999, Stroke.

[72]  David J. Reinkensmeyer,et al.  A robotic tool for studying locomotor adaptation and rehabilitation , 2002, Proceedings of the Second Joint 24th Annual Conference and the Annual Fall Meeting of the Biomedical Engineering Society] [Engineering in Medicine and Biology.

[73]  S. Hesse,et al.  Connecting research to the needs of patients and clinicians , 2009, Brain Research Bulletin.

[74]  A. Roy,et al.  Measurement of Human Ankle Stiffness Using the Anklebot , 2007, 2007 IEEE 10th International Conference on Rehabilitation Robotics.

[75]  Judith E. Deutsch,et al.  Post-Stroke Rehabilitation with the Rutgers Ankle System: A Case Study , 2001, Presence: Teleoperators & Virtual Environments.

[76]  Yoshiyuki Sankai,et al.  Power Assist System HAL-3 for Gait Disorder Person , 2002, ICCHP.

[77]  Gert Jan Gelderblom,et al.  Rehabilitation robotics in robotics for healthcare; A roadmap study for the European Commission , 2009, 2009 IEEE International Conference on Rehabilitation Robotics.