Recent development of mechanisms and control strategies for robot-assisted lower limb rehabilitation

The number of people with a mobility disorder caused by stroke, spinal cord injury, or other related diseases is increasing rapidly. To improve the quality of life of these people, devices that can assist them to regain the ability to walk are of great demand. Robotic devices that can release the burden of therapists and provide effective and repetitive gait training have been widely studied recently. By contrast, devices that can augment the physical abilities of able-bodied humans to enhance their performances in industrial and military work are needed as well. In the past decade, robotic assistive devices such as exoskeletons have undergone enormous progress, and some products have recently been commercialized. Exoskeletons are wearable robotic systems that integrate human intelligence and robot power. This paper first introduces the general concept of exoskeletons and reviews several typical lower extremity exoskeletons (LEEs) in three main applications (i.e. gait rehabilitation, human locomotion assistance, and human strength augmentation), and provides a systemic review on the acquisition of a wearer's motion intention and control strategies for LEEs. The limitations of the currently developed LEEs and future research and development directions of LEEs for wider applications are discussed.

Recent developments and challenges of lower extremity exoskeletons.

Rehabilitation robots, by necessity, have direct physical interaction with humans. Physical interaction affects the controlled variables and may even cause system instability. Thus, human–robot interaction control design is critical in rehabilitation robotics research. This paper presents an interaction control strategy for a gait rehabilitation robot. The robot is driven by a novel compact series elastic actuator, which provides intrinsic compliance and backdrivablility for safe human–robot interaction. The control design is based on the actuator model with consideration of interaction dynamics. It consists mainly of human interaction compensation, friction compensation, and is enhanced with a disturbance observer. Such a control scheme enables the robot to achieve low output impedance when operating in human-in-charge mode and achieve accurate force tracking when operating in force control mode. Due to the direct physical interaction with humans, the controller design must also meet the stability requirement. A theoretical proof is provided to show the guaranteed stability of the closed-loop system under the proposed controller. The proposed design is verified with an ankle robot in walking experiments. The results can be readily extended to other rehabilitation and assistive robots driven with compliant actuators without much difficulty.

Human–Robot Interaction Control of Rehabilitation Robots With Series Elastic Actuators

Stroke significantly affects thousands of individuals annually, leading to considerable physical impairment and functional disability. Gait is one of the most important activities of daily living affected in stroke survivors. Recent technological developments in powered robotics exoskeletons can create powerful adjunctive tools for rehabilitation and potentially accelerate functional recovery. Here, we present the development and evaluation of a novel lower limb robotic exoskeleton, namely H2 (Technaid S.L., Spain), for gait rehabilitation in stroke survivors. H2 has six actuated joints and is designed to allow intensive overground gait training. An assistive gait control algorithm was developed to create a force field along a desired trajectory, only applying torque when patients deviate from the prescribed movement pattern. The device was evaluated in 3 hemiparetic stroke patients across 4 weeks of training per individual (approximately 12 sessions). The study was approved by the Institutional Review Board at the University of Houston. The main objective of this initial pre-clinical study was to evaluate the safety and usability of the exoskeleton. A Likert scale was used to measure patient’s perception about the easy of use of the device. Three stroke patients completed the study. The training was well tolerated and no adverse events occurred. Early findings demonstrate that H2 appears to be safe and easy to use in the participants of this study. The overground training environment employed as a means to enhance active patient engagement proved to be challenging and exciting for patients. These results are promising and encourage future rehabilitation training with a larger cohort of patients. The developed exoskeleton enables longitudinal overground training of walking in hemiparetic patients after stroke. The system is robust and safe when applied to assist a stroke patient performing an overground walking task. Such device opens the opportunity to study means to optimize a rehabilitation treatment that can be customized for individuals. Trial registration: This study was registered at ClinicalTrials.gov (
 https://clinicaltrials.gov/show/NCT02114450
 ).

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The H2 robotic exoskeleton for gait rehabilitation after stroke: early findings from a clinical study

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Intervention of robotic devices in the field of physical gait therapy can help in providing repetitive, systematic, and economically viable training sessions. Interactive or assist-as-needed (AAN) gait training encourages patient voluntary participation in the robotic gait training process which may aid in rapid motor function recovery. In this paper, a lightweight robotic gait training orthosis with two actuated and four passive degrees of freedom (DOFs) is proposed. The actuated DOFs were powered by pneumatic muscle actuators. An AAN gait training paradigm based on adaptive impedance control was developed to provide interactive robotic gait training. The proposed adaptive impedance control scheme adapts the robotic assistance according to the disability level and voluntary participation of human subjects. The robotic orthosis was operated in two gait training modes, namely, inactive mode and active mode, to evaluate the performance of the proposed control scheme. The adaptive impedance control scheme was evaluated on ten neurologically intact subjects. The experimental results demonstrate that an increase in voluntary participation of human subjects resulted in a decrease of the robotic assistance and vice versa. Further clinical evaluations with neurologically impaired subjects are required to establish the therapeutic efficacy of the adaptive-impedance-control-based AAN gait training strategy.

Adaptive Impedance Control of a Robotic Orthosis for Gait Rehabilitation

This paper presents the development of a novel adaptive wearable ankle robot for the treatments of ankle sprain through physical rehabilitation. The ankle robot has a bioinspired design, devised after a careful study of the improvement opportunities in the existing ankle robots. Robot design is adaptable to subjects of varying physiological abilities and age groups. Ankle robot employs lightweight but powerful pneumatic muscle actuators (PMA) which mimics skeletal muscles in actuation. To address nonlinear characteristics of PMA, a fuzzy-based disturbance observer (FBDO) has been developed. Another instance of an adaptive fuzzy logic controller based on Mamdani inference has been developed and appended with the FBDO to compensate for the transient nature of the PMA. With the proposed control scheme, it is possible to simultaneously control four parallel actuators of the ankle robot and achieve three rotational degrees of freedom. To evaluate the robot design, the disturbance observer, and the adaptive fuzzy logic controller, experiments were performed. The ankle robot was used by a neurologically intact subject. The robot-human interaction was kept as active-passive while the robot was operated on predefined trajectories commonly adopted by the therapists. Trajectory tracking results are reported in the presence of an unpredicted human user intervention, use of compliant and nonlinear actuators, and parallel kinematic structure of the ankle robot.

An Adaptive Wearable Parallel Robot for the Treatment of Ankle Injuries

Robot-aided physical therapy should encourage subject’s voluntary participation to achieve rapid motor function recovery. In order to enhance subject’s cooperation during training sessions, the robot should allow deviation in the prescribed path depending on the subject’s modified limb motions subsequent to the disability. In the present work, an interactive training paradigm based on the impedance control was developed for a lightweight intrinsically compliant parallel ankle rehabilitation robot. The parallel ankle robot is powered by pneumatic muscle actuators (PMAs). The proposed training paradigm allows the patients to modify the robot imposed motions according to their own level of disability. The parallel robot was operated in four training modes namely position control, zero-impedance control, nonzero-impedance control with high compliance, and nonzero-impedance control with low compliance to evaluate the performance of proposed control scheme. The impedance control scheme was evaluated on 10 neurologically intact subjects. The experimental results show that an increase in robotic compliance encouraged subjects to participate more actively in the training process. This work advances the current state of the art in the compliant actuation of parallel ankle rehabilitation robots in the context of interactive training.

Shahid Hussain

Papers

Adaptive Impedance Control of a Robotic Orthosis for Gait Rehabilitation

An Adaptive Wearable Parallel Robot for the Treatment of Ankle Injuries

Impedance Control of an Intrinsically Compliant Parallel Ankle Rehabilitation Robot

Robot assisted treadmill training: Mechanisms and training strategies

Motion characteristics of bilayered extensible Timoshenko microbeams