Keywords: Closed-Loop Control in Brain-Machine Interfaces, Safety in Assistive Robotics, Multifunction Control in Prosthetics/Orthotics
Abstract: Robot-user interfaces have become more intuitive as a direct consequence of the advances in computer interface design. Yet direct brain interfaces, made possible by recent advances in nano-technology and implanted cerebral electrode arrays, have the potential to eliminate these physical interfaces. However, direct brain interfaces may at the same time pose ethical questions related to the enhancement of human function through interpretation of thought processes alone. We have identified three issues that are core in the development of roboethics: how best to direct and pace the deployment and use of the technology; how to distinguish between, and perhaps as necessary redefine, what constitutes enhancement vs. functional compensation; and how to understand responsibility in a system where traditional man-machine boundaries are blurred. This paper discusses some of these issues against the backdrop of today’s multi-cultural society.

Keywords: Neuro-Rehabilitation in Therapeutic Robotics, Upper Extremity in Therapeutic Robotics, Novel Actuators in Prosthetics/Orthotics
Abstract: This paper presents the design, fabrication and preliminary tests of a novel, one degree of freedom, MR compatible, computer controlled, variable resistance hand device that will be used in fMRI studies of the brain and motor performance during rehabilitation after stroke. The device consists of four major subsystems: a) the Electro-Rheological Fluid (ERF) resistive element; b) the gearbox; c) the handles and d) the sensors: one optical encoder and one force sensor attached to the ERF resistive element’s shaft to measure the patient induced motion and force, respectively. A key feature of the device is the use of electro rheological fluids (ERF) to achieve resistive force generation. ERFs are fluids that experience dramatic changes in rheological properties, such as viscosity or yield stress, in the presence of an electric field. Using the electrically controlled rheological properties of ERFs, compact resistive elements with an ability to supply high resistive torques in a controllable and tunable fashion, have been developed. Our preliminary tests demonstrate that the device can apply, on a human hand holding the device handles, resistive forces that exceed 150N. In addition the activated ERF maintain its properties in the magnetic environment without creating degradation of the MR images. The results are encouraging in combining functional Magnetic Resonance Imaging methods, with MR compatible robotic devices for improved effectiveness of rehabilitation therapy.

Keywords: Neuro-Rehabilitation in Therapeutic Robotics, Training Programs in Therapeutic Robotics
Abstract: In 1991, a novel robot named MIT-MANUS was introduced as a test bed to study the potential of using robots to assist in and quantify the neuro-rehabilitation of motor function. It introduced a new brand of therapy, offering a highly backdrivable mechanism with a soft and stable feel for the user. MIT-MANUS proved an excellent fit for shoulder and elbow rehabilitation in stroke patients, showing in clinical trials a reduction of impairment in these joints. The greater reduction in impairment was observed in the group of muscles exercised. This suggests a need for additional robots to rehabilitate other target areas of the body. The focus here is a robot for wrist rehabilitation designed to provide three rotational degrees of freedom. A previous paper at ICORR2003 and its companion book described the basic system design and characterization [1]. In this paper we present clinical results from five (5) stroke patients. A comprehensive review of the wrist robot design, characterization, and initial clinical results are being submitted elsewhere (IEEE Transactions on Neural Systems and Rehabilitation Engineering).

Keywords: Neuro-Rehabilitation in Therapeutic Robotics, Mechanical systems in Hardware/Control, Upper Extremity in Therapeutic Robotics
Abstract: This paper describes the design of a robotic device – the Hand-Wrist Assisting Robotic Device, or HWARD (“Howard”) – that can assist functional grasping and releasing movements of the stroke-impaired hand. The 3 degrees-of-freedom device is pneumatically-actuated and backdriveable. The design of HWARD was guided by neurobiological principles of motor learning, such as sensorimotor integration, movement repetition, environmental complexity, and attention. Specifically, HWARD can assist repetitive grasping and releasing movements while allowing the subject to feel real objects during therapy. The use of real objects having rich sensory and functional characteristics can stimulate sensorimotor cortex activation while enhancing subject motivation and attention – features hypothesized to reduce impairment and disability. A pilot study will test the safety and efficacy of HWARD, with endpoints that include established motor function scales as well as brain mapping with functional MRI (fMRI).

Keywords: Automated Therapy in Therapeutic Robotics, Mobility and Navigation in Assistive Robotics, Neuro-Rehabilitation in Therapeutic Robotics
Abstract: This paper describes an autonomous assistive mobile robot that aids stroke patient rehabilitation by providing monitoring, encouragement, and reminders. The robot navigates autonomously, monitors the patient’s arm activity, and helps the patient remember to follow a rehabilitation program. Our experiments show that patients post-stroke are positive about this approach and that increasingly active and animated robot behavior is positively received by stroke survivors.

Keywords: Novel Techniques in Therapeutic Robotics, Training Programs in Therapeutic Robotics, Workstation in Assistive Robotics
Abstract: In this paper we discuss the possibility of improving eye-hand coordination in children diagnosed with this problem,using a robotic mapping from a haptic user interface to a virtual environment. Our goal is to develop an assessment and training procedure that will result in improving handwriting taking advantage of the force feedback provided by the haptic device. We also incorporate inertia and viscosity effects to decrease the tremor in the hand as well as to stimulate the muscles involved in the task of holding a pencil (known as facilitation technique in the Occupational Therapy field). A set of assessment tests, commonly used by occupational therapists, were chosen to implement various functions using force, inertia and viscosity effects. The test bed used for these tasks consisted of a six-degree-of-freedom force-reflecting haptic interface device, PHANToM with the GHOST SDK Software.

Keywords: Plasticity in Sensory-Motor Control & Learning, Posture Control in Sensory-Motor Control & Learning, Kinematics in Sensory-Motor Control & Learning
Abstract: Whether attempting to pour water into a hand-held glass, or simply trying to hold a young child’s hand, many activities of daily living require interaction with unpredictable or uncertain mechanical environments. Here we describe a systems identification study that used a planar manipulandum to characterize how hemiparetic stroke survivors adapt reaching movements to novel mechanical environments. By analyzing trial-by-trial variations in hand path kinematics, we found that stroke survivors are less likely than neurologically-intact subjects to adjust motor commands for upcoming movements based on hand trajectory errors experienced on previous trials. This ability is most significantly compromised in subjects with Fugl-Meyer scores < 20. The ability to terminate movement accurately at the desired target was significantly compromised on the impaired side for most stroke survivors. This measure of performance contrasts with the trajectory updating measure in that it did not depend on impairment level. These data suggest that stroke survivors vary in their ability to effectively adapt motor commands based on recent sensorimotor experience. The findings also provide indirect support for the hypothesis that final posture regulation and feed-forward trajectory control are complimentary processes that may be differentially compromised following stroke.

Keywords: Kinematics in Sensory-Motor Control & Learning, Posture Control in Sensory-Motor Control & Learning
Abstract: The strategy the central nervous system utilizes to produce movements in the face of multiple degrees of freedom available has been a subject of study for the past few years. Of the possible mechanisms, the muscle synergies - stereotypical coordinated patterns of muscle activity elicited by dedicated networks have been suggested to be the building blocks. Based on this hypothesis, several algorithms have been proposed to discern these synergies from the recorded electromyographic signals (EMG). In the proposed model, the synergies are treated as filters (IRFs) that take as input any arbitrary non-negative signal. That is, the EMG is seen as a convolution mixture of synergies and corresponding inputs.

Keywords: Kinematics in Sensory-Motor Control & Learning, Training Programs in Therapeutic Robotics, Training Evaluation in Clinical Experience
Abstract: Mechanical guidance is a common technique to teach patients desired movement patterns during motor rehabilitation, but little is known about the motor learning processes involved with this technique. In this study we examined how well unimpaired subjects could learn to trace a novel path after they practiced it with mechanical guidance from a robot. The form of haptic guidance used was a virtual channel that constrained the hand to follow the desired path (a snake-like curve). Subjects substantially improved their ability to trace the path following practice with haptic guidance, relative to their performance following an initial visual demonstration. They slowly improved their performance with more haptic training. However, when asked to reproduce the path repeatedly, their performance degraded over the course of a few trials. The tracing errors were not random, but instead were consistent with a systematic evolution toward another path, as if being drawn to an “attractor path”. These results suggest that haptic demonstration can improve short-term performance of a novel desired trajectory. However, in the short term, the motor system is inclined to repeat its mistakes following just a few movements without guidance.

Keywords: Kinematics in Sensory-Motor Control & Learning, Locomotion in Sensory-Motor Control & Learning, Lower-limb in Robotic Prosthetics/Orthotics
Abstract: An ankle-foot orthosis (AFO) is commonly used to help subjects with weakness of ankle dorsiflexor muscles due to peripheral or central nervous system disorders. Both these disorders are due to the weakness of the tibialis anterior muscle which results in lack of dorsiflexion assist moment. The deformity and muscle weakness of one joint in the lower extremity influences the stability of the adjacent joints, thereby requiring compensatory adaptations. We present an innovative ankle-foot orthosis (AFO) that was designed to allow two degree-of-freedom motion while serving to maintain proper foot position for subjects. The prototype AFO would introduce greater functionality over currently marketed devices by means of its inversion-eversion degree-of-freedom in addition to flexion/extension. The flexion/extension is controlled with the help of an actuator and inversion/eversion with a spring and a damper.

Keywords: Plasticity in Sensory-Motor Control & Learning, Kinematics in Sensory-Motor Control & Learning
Abstract: Abstract— We are investigating whether repetitive training, such as that used during rehabilitation interventions, can induce short term plasticity in the motor pathways controlling the proximal muscles of the human upper-limb. A ballistic, planar whole limb extension training routine has been employed in this study. This study uses transcranial magnetic stimulation (TMS) to quantify user-dependent plasticity in proximal and distal muscles throughout the upper-limb. Previous studies have shown consistent training induced plasticity in distal upper-limb muscles and proximal muscles with altered somatosensory input. This study demonstrates that whole limb motions can generate short term plastic effects in proximal upper-limb muscles, though results have not been consistent.

Keywords—TMS, plasticity, motor learning

Keywords: Kinematics in Sensory-Motor Control & Learning, Multifunction Control in Prosthetics/Orthotics, Upper-limb in Prosthetics/Orthotics
Abstract: We seek to quantify the electromyographic similarities and differences between six major grasping patterns of the human hand: cylindrical, hook, palmar, lateral, spherical, and tip. Fuzzy c-means clustering (FCM) is a data reduction technique that allows continuous membership, on a [0,1] interval, of data points in the representative clusters. We found no grasp to be completely distinct from any other grasp, and found significant overlap of characteristics between several grasps. This overlap is quantified and discussed.

Keywords: Upper Extremity in Therapeutic Robotics, Neuro-Rehabilitation in Therapeutic Robotics, Training Evaluation in Clinical Experience
Abstract: New training methods and exercises for upper limbs rehabilitation can be developed using robotics and virtual reality technologies. The technologies can make quantitative evaluations and enhance the qualitative effect of trainings. We have developed a 3D exercise machine for upper limbs (EMUL) with special actuators using electrorheological (ER) fluid. The ER actuator is composed of an ER clutch and its driven mechanism consisting of a motor and a reduction-gear-unit, and we can ensure safety of patients mechanically by using them. This paper deals with the development of EMUL. We also present the development of software for motion exercise trainings and some results of clinical evaluation.

Keywords: Upper Extremity in Therapeutic Robotics
Abstract: Task-oriented repetitive movement can improve movement performance in patients with neurological or orthopaedic lesions. The application of robotics can serve to assist, enhance, evaluate, and document neurological and orthopaedic rehabilitation of movements. ARMin is a new robot for arm therapy applicable to the training of activities of daily living in clinics. ARMin has a semi-exoskeleton structure with six degrees of freedom, and is equipped with position and force sensors. The mechanical structure, the actuators and the sensors of the robot are optimized for patient-cooperative control strategies based on impedance and admittance architecture. This paper describes the new robot, the mechanical structure, the control circuit, the sensors and actuators and some safety aspects.

Keywords: Manipulation in Assistive Robotics, Kinematics in Sensory-Motor Control & Learning, Upper Extremity in Therapeutic Robotics
Abstract: Stroke is a common condition resulting in 30,000 people per annum left with significant disability. In patients with severe arm paresis after stroke, functional recovery in the affected arm is poor. Inadequate intensity of treatment is cited as one factor accounting for the lack arm recovery found in some studies. Given that physical therapy resource is limited, strategies to enhance the physiotherapists' efforts are needed. One approach is to use robotic techniques to augment movement therapy. Kinematic analysis of upper limb movement during a patient’s physiotherapy session was used to determine the appropriate therapeutic workspace. An existing single robot arm is adapted to optimize its operating area to allow full movement in this desired workspace. The kinemetic data is also used to look at the constraints involved in attaching two robot arms to the user’s forearm and upper arm. An optimized design and configuration of the dual robot arms is proposed that allows appropriate control of the patient’s arm throughout the desired workspace.

Keywords: Novel Techniques in Therapeutic Robotics, Functional Outcomes in Clinical Experience, Upper Extremity in Therapeutic Robotics
Abstract: Objective tracking tests for evaluating the functional studies of the upper limbs (UL) in patients with neuromuscular disorders (NMD) and neurological disorders (ND) are presented. The experimental measurement setup and the methodology for the assessment of upper limb functional state uses the Phantom 1.5. The measurement setup consists of a powerful virtual reality simulator, capable of providing quality haptic, visual and audio feedback in two different tracking tasks/exercises. The Phantom 1.5 haptic interface serves as a kinematic measuring device and as a force feedback generator, providing disturbance forces to the patient. The method has been applied to 75 patients with various forms of NMD and ND as well as to 19 healthy subjects. Some typical characteristics of the upper limb movement, affected by neuro-muscular disorders are shown in a quantitative manner. Data mining was used to demonstrate good content validity of the proposed tests.

Keywords: Upper Extremity in Therapeutic Robotics, Neuro-Rehabilitation in Therapeutic Robotics, Measures in Evaluation in Clinical Experience
Abstract: Learned non-use (LNU) may be a measure of carry-over and a potential measure for determining the efficacy of robot-based training for stroke rehabilitation. Identifying sensitive and reliable measures for detecting LNU would help evaluate whether robot training consistently reduced both motor impairment and functional disability after stroke-induced hemiplegia. We report on investigations into the relationship between LNU and four kinematic metrics commonly used to characterize impaired arm movements in Cartesian space during functional reaching. Results indicate that movement time, peak velocity, total displacement and movement smoothness accounted for less that 17% of the variability in LNU scores. A metric, derived from changes in impaired arm kinematic scores between unilateral and bilateral functional reaches, did not improve the prediction of LNU. Objectively quantifying LNU may require kinetic and kinematic metrics that measure proximal and distal sensory and motor impairment.

Keywords: Novel Techniques in Therapeutic Robotics, Locomotion & Posture in Therapeutic Robotics, Neuro-Rehabilitation in Therapeutic Robotics
Abstract: Perturbations are an important measure to improve gait training and to investigate the the learning success of stroke patients during rehabilitation. This paper describes the development and implementation of algorithms for the synthesis of perturbations during gait training on a robotic walking simulator. The perturbation algorithm performs an automatic on-line adaptation of the robot motion override. Hence, it is independent from the type of motion interpolation which the robot motion is based on. Perturbations we have implemented so far include stumbling, i.e. hitting an obstacle during swing phase, and slipping, i.e. sliding on an obstacle during stance phase. An additional catch-up control algorithm ensures that both eet will regain synchronous motion again after the event. The algorithms have been implemented in the control software of the HapticWalker, a programmable footplate based human walking simulator for gait rehabilitation, which we have developed. So far a number of healthy subjects have successfully tested the algorithms on the simulator. Clinical trials will follow.

Keywords: Upper Extremity in Therapeutic Robotics, Training Programs in Therapeutic Robotics
Abstract: A pneumatically controlled glove has been developed at the Rehabilitation Institute of Chicago in order to study its use on improving hand functions for individuals with hand impairment following stroke. The methods of the control system and glove design are presented in this article. Preliminary data has been collected on neurologically healthy subjects to demonstrate the training regime, and also to show the ability of the glove to assist in extending the fingers for grasping objects. Data from a stroke survivor who completed training is also shown.

Keywords: Upper Extremity in Therapeutic Robotics, Training Programs in Therapeutic Robotics, Automated Therapy in Therapeutic Robotics
Abstract: This paper reports on a field test of our simple force-sensor-based rehabilitation device that can be handled at homes or neighboring medical institutions. We propose a tri-axial load cell controller system for quantitatively evaluating the visually guided motor control characteristic of a weak palsy arm. The result is recorded in the database while evaluation is presented for each trial. The system is tested at an orthopedic clinic with outpatients: cervical spinal cord injured patient and two other cases. Their mid-term testing results are discussed.

Keywords: Upper Extremity in Therapeutic Robotics, Neuro-Rehabilitation in Therapeutic Robotics, Novel Techniques in Therapeutic Robotics
Abstract: Robotic devices, especially those that are motivating, have shown a great deal of potential for use in upper-extremity stroke rehabilitation. The TheraJoy project aims at designing a cost efficient device for use in home therapy. This has involved altering a commercial force-reflecting joystick by lengthening the joystick shaft to encompass a larger range of horizontal motion, adding a vertical linkage system to add vertical arm movements, and adding springs to support the application of light passive and actuated forces. This system has been used in conjunction with specially designed software to study both assessment and therapeutic tasks. As the endpoint for each linkage moves in an arc that is nearly a plane, there is a need to generate expectations for tracking patterns for each manipulator. This study evaluates movements in able-bodied subjects for strategic tracking tasks. A key observation is that the non-dominant hand displays both longer reaction and movement times and also greater and more consistent deviations from straight-line paths over certain ranges and directions.

Keywords: Neuro-Rehabilitation in Therapeutic Robotics, Training Programs in Therapeutic Robotics, Upper Extremity in Therapeutic Robotics
Abstract: In order to estimate the effect of neural rehabilitation robot for improving the upper extremity motor function, 23 hemiplegia patients who are BrunnstromIII at least receive clinical rehabilitation training by the upper extremity compound movements rehabilitation training robot. The assistance models of the neural rehabilitation robot and the programming of the clinical rehabilitation training are studied in this dissertation. The clinical assessment results make clear that after a period of rehabilitation treatment, the function of most patients, which could be assessed by Fugl-Meyer method, improved to a certain extent, and the rehabilitation effect is better than the traditional rehabilitation training. The outcome indicates that, the upper extremity compound movements rehabilitation training robot has a significant application prospect in clinical rehabilitation.

Keywords: Upper Extremity in Therapeutic Robotics, Neuro-Rehabilitation in Therapeutic Robotics, Automated Therapy in Therapeutic Robotics
Abstract: Intensive repetitive therapy shows promise to improve motor function and quality of life for stroke patients. Intense therapies provided by individualized interaction between the patient and rehabilitation specialist to overcome upper extremity impairment are beneficial, however, they are expensive and difficult to evaluate quantitatively and objectively. The development of a pneumatic muscle (PM) driven therapeutic device, the RUPERT™, has the potential of providing a low cost and safe take-home method of supplementing therapy in addition to in the clinic treatment. The device can also provide real-time, objective assessment of functional improvement from the therapy.

Keywords: Lower-limb in Robotic Prosthetics/Orthotics, Manipulation in Assistive Robotics, Modeling in Biorobotics/Biomimetics
Abstract: One of the key areas of support for individuals with lower limb disabilities, whether resulting from trauma or disease, is that of providing, and enhancing, mobility, something which is currently achieved largely through the use of wheelchairs. However, there is a case to be made for some of these individuals to attempt to restore, either in whole or in part, a degree of the Walking Function.. The potential for using an exoskeleton to support mobility has been considered for some time and early projects include those at the Mihailo Pupin Institute, the University of Winsconsin and the Tokushima Hospital. More recently, work such as that at the University of Tsukuba, the Kanagawa Institute of Technology and Berkeley have attempted to provide powered augmentation of the walking function.

However, none of these systems met the requirements of an effective support for the walking function in a simple, lightweight system which could provide limited support for mobility in constrained environments such as a supermarket or a museum. The project described in the paper therefore took as its premise a requirement for a system to support the walking function for a limited period of time in such environments while retaining the wheelchair as the primary means of achieving mobility.

The paper begins by considering the procedures associated with the analysis, design and implementation of a model for a lightweight design of an exoskeleton and shows how the integration of motion analysis with modelling supported the development of the system concepts. It then proceeds to consider the implementation of the identified control and operational strategies in model form and how the evolved concepts are deployed in support of an implementation of system to support the rehabilitation of the lower limbs.

Keywords: Novel Actuators in Prosthetics/Orthotics, Upper Extremity in Therapeutic Robotics, Mobility and Navigation in Assistive Robotics
Abstract: A cable-driven, rotary Series Elastic Actuator named MARIONET (Moment arm Adjustment for Remote Induction Of Net Effective Torque) is introduced as a novel means to deliver torque to a joint. Its advantages include remote actuation, independent control of compliance and equilibrium, and in future versions, the ability to span multiple joints. This cable-driven, compliant mechanism should prove very useful in a variety of human-robot interactions. Here we present a single joint device evaluated in terms of its position and torque step responses, its ability to follow a minimum jerk trajectory, and its ability to create torque fields. Results show that this device behaves as planned with several important limitations. We conclude with potential applications of this type of mechanism.

Keywords: Novel Controls in Prosthetics/Orthotics, Upper-limb in Prosthetics/Orthotics
Abstract: This paper presents an experimental investigation on a novel interface for high level control of hand prostheses, based on selected foot movements. A prototype has been developed that integrates four sensitive areas, battery, and electronics for data acquisition and wireless transmission into a wearable insole. The prototype foot interface has been experimentally validated in the control of a robotic hand prosthesis. Comparative experimental trials were conducted with 10 able-bodied subjects, with both the foot interface and an electromyographic(EMG)-based control. The results confirmed the effectiveness of the foot interface in the control of the hand prosthesis and showed a significant decrease in required adaptation and learning from the user’s side.

Keywords: Lower-limb in Robotic Prosthetics/Orthotics, Mechanical systems in Hardware/Control, Manipulation in Assistive Robotics
Abstract: An adjustable Robotic Tendon is a spring based linear actuator in which the properties of a spring are crucial to its successful use in a gait assistance device. Like its human analog, the adjustable Robotic Tendon uses its inherent elastic nature to both reduce peak power and energy requirements for its motor. In the ideal example, peak power required of the motor for ankle gait is reduced from 250W to just 81W. In addition, ideal energy requirements are reduced from nearly 36 Joules to just 25 Joules per step. Using this approach, an initial prototype is expected to provide 100% of the power and energy neccessary for ankle gait in a compact 0.84kg package. This weight is 8 times less than that predicted for an equivalent direct drive approach.

Keywords: Upper-limb in Prosthetics/Orthotics, Novel Actuators in Prosthetics/Orthotics, Novel Controls in Prosthetics/Orthotics
Abstract: Neuromuscular disorders affect millions of people worldwide. Upper limb tremor is a common symptom, and due to its complex aetiology it is difficult to compensate for except, in particular cases by surgical intervention or drug therapy. Wearable devices that mechanically compensate for limb tremor could benefit a considerable number of patients, but the technology to assist suffers in this way is under-developed. In this paper we propose an innovative orthosis that can dynamically suppress pathological tremor, by applying viscous damping to the affected limb in a controlled manner. The orthosis design utilises a new actuator design based on Magneto-Rheological Fluids that efficiently deliver damping action in response to the instantaneous tremor frequency and amplitude.

Keywords: Locomotion in Sensory-Motor Control & Learning, Plasticity in Sensory-Motor Control & Learning, Kinematics in Sensory-Motor Control & Learning
Abstract: Abstract—In this study healthy human subjects (n=10) manually controlled a rotary handle to track a sinusoidally moving target as displayed on a computer screen. During movement, either the apparent handle inertia or tracking frequency changed to a higher or lower value. We analyzed the initial performance recovery following task perturbation using a linear fit of the velocity tracking error trends. For both types of task perturbations, we found significant increases in the intercept of the line fit (paired t-tests, two-tailed: p<.05) compared to trials with no change. We also found that adaptation rates indicated by the slope of the line fit of the tracking velocity error were larger for frequency changes than for apparent changes of the inertia for parameter increases (p=0.029, paired t-tests, one-tailed) and parameter decreases (p=0.055, paired ttests, one-tailed). Our results provide evidence that humans use low impedance control that is task-specific to object parameters such as inertia. In addition, the results provide evidence that the adaptation to motion parameter changes and object parameter changes are different control processes.

Keywords: Devices in Evaluation in Clinical Experience, Upper Extremity in Therapeutic Robotics, Interfaces in Hardware/Control Developments
Abstract: An investigation into the use of standardized, unmodified, industrial robots for motion therapy of hemiparectic extremities was initiated in 2000. A system called REHAROB, designed and built over a two year period, was completed for this clinical trial in 2003. The results confirmed that therapy using this system was safe and thus performed as intended. In 2004, following this trial, the programming interface and the interface device between the patient and the robots were improved. A controlled clinical study is currently under way to assess the clinical efficiency of the REHAROB movement therapy. This paper describes the results of the first clinical trial with the REHAROB Therapeutic System, and also reports why and how the system was improved for the second clinical trial.

Keywords: Devices in Evaluation in Clinical Experience, Novel Techniques in Therapeutic Robotics, Training Evaluation in Clinical Experience
Abstract: Realistic simulation of grasping requires accurate modeling of forces and torques on the virtual object produced by fingers in contact. We present isometric 3By6 Finger Device for multi-fingered grasping in virtual environment (VE). The finger device was designed to measure forces of three fingers. Mathematical model of grasping adopted from the analysis of multi-fingered robot hands was used. The dynamics of the virtual object corresponds to the forces and torques applied by the three fingers. The multi-fingered grasping is demonstrated in four tasks aimed at the rehabilitation of the upper extremities of stroke patients. The tasks include opening of a safe, filling and pouring water from a glass, training of muscle strength with an elastic torus and force-tracking task.

Keywords: Devices in Evaluation in Clinical Experience, Functional Outcomes in Clinical Experience
Abstract: The purpose was to develop an extension finger-force measurement device, and investigate the intra-individual repeatability. The design of the measuring device allows single finger force and whole hand measurements, and the repeatability error on extension finger forces was measured, both on the whole hand, as well as on individual fingers. The tests showed that a repeatability error of less then 15 % can be achieved for single finger measurements and less then 21 % for whole hand measurements.

Keywords: Control in Hardware/Control Developments, Mobility and Navigation in Assistive Robotics
Abstract: This paper propose an online approach to adapt user's controlling characteristic for robotic walker control. This approach is based on relocating the center of rotation (COR) of the robotic walker and it will be implemented online in training. This study aims to aid users that have difficulties in controlling their walking support system.

To adapt user's controlling characteristics, a user will be asked to follow some training path and the error between the training and actual path will be used to change the COR of the system. This training process will be done until the user can successfully follow the training path. Several training paths will be considered and the relationship between user's intention in the form of applied force/torque and the new COR will be taken. This relationship will be used in the actual control implementation of a variable COR. Experimentation and evaluation will be presented to show the validity of the proposed approach.

Keywords: Mechanical systems in Hardware/Control, Control in Hardware/Control Developments
Abstract: Cobots are a class of robots that use continuously variable transmissions to develop high fidelity programmable constraint surfaces. Cobots consume very little electrical power even when providing high output forces, and their transmissions are highly efficient across a broad range of transmission ratios. Cobotic transmissions also have the ability to act either as a brake or to become entirely free. The design and performance of the Cobotic Hand Controller, a recently developed six-degree-of-freedom haptic display, is reviewed. This device illustrates the high dynamic range and low power consumption achievable by cobots. A thorough comparison of the power efficiency of a cobotic system versus a conventional electro-mechanical system is provided.

Keywords: Interfaces in Hardware/Control Developments, Upper-limb in Prosthetics/Orthotics, Neuro-Rehabilitation in Therapeutic Robotics
Abstract: Flexed elbow is a stereotypical pattern of arm deformity commonly seen in stroke survivors. In this study, a low-cost and portable tele-rehabilitation system suitable for home-based therapy is developed. A slave device with a slave controller is designed to stretch and mobilize the impaired elbow joints accurately and safely. A master device with a master controller is designed to control/monitor the procedure of treatment and assess the outcome of treatment remotely and accurately. Compared with the traditional hospital-based therapy, the tele-rehabilitation system is more cost-efficient and convenient for both the stroke survivors and the clinicians.

Keywords: Mechanical systems in Hardware/Control, Upper Extremity in Therapeutic Robotics, Devices in Evaluation in Clinical Experience
Abstract: The ACtive REhabilition (ACRE) system provides motivation-based therapy at home to people who suffer from (temporary) loss of muscle control in the upper limbs. In a first prototype the movement of the patient's arm (i.e. the therapy) is supported by a passive gravity compensating mechanism. The patient interacts with a therapy-game while the patient's movements are measured. Data analysis on the movement can help in researching the benefits of different types of exercises. The prototype showed promising results during the first user trials. However, during these trials the system put rather high constraints on the users with respect to the minimal force and reach needed to execute certain tasks. By developing a new, motorized gravity compensation mechanism, these constraints can be lowered and the group of patients that can benefit from this system can be enlarged. Intensive evaluations of the system are planned, starting from June 2005 until the end of the year.

Keywords: Sensors in Hardware/Control Developments, Mechanical systems in Hardware/Control, Devices in Evaluation in Clinical Experience
Abstract: In this paper the innovative ALLADIN platform for whole-body isometric force measurements to be used in neuro-rehabilitation for assessing post-stroke functional recovery is presented. A mechatronic approach was used in the design and development of this platform, which consists of an ergonomic mechanical structure embedding eight force/torque sensors that sample data about the performance of simulated activities of daily living in stroke patients. The overall ALLADIN system also includes a dedicated database, where all measures and other clinical scores are stored, and a PDA-based natural language system interface for the therapist. This paper only focuses on the mechatronic platform of the ALLADIN system. The proposed platform, which is currently being validated in three different clinical centers in Europe, aims at offering a brand new method for decision support in neuro-rehabilitation. It calculates and predicts the functional recovery of stroke patients and makes clinical assessments and quantitative measurements easily exchangeable among clinical stroke rehabilitation units.

Keywords: Control in Hardware/Control Developments, Sensors in Hardware/Control Developments
Abstract: Stability of a haptic interface is essential for safe and quality haptic interaction. This paper addresses the contact instability of admittance control haptic interface in free space. Experiments with special dedicated system for measuring grasp force have been performed to explore conditions of contact instability. Baseline experimental results are here compared to simulations from a model of haptic interaction. The model serves also as a basis for stability and performance improvements with a special compensator filter for force filtering. Experimental and simulation results both confirm stability improvements.

Keywords: Mechanical systems in Hardware/Control, Control in Hardware/Control Developments, Devices in Evaluation in Clinical Experience
Abstract: Air mattress is now used widely to prevent the pressure ulcer by reducing the localized pressure peaks. In this paper an air-cell mattress and its pressure control method based on an approximate anthropometric model are presented. The air-cell mattress has eighteen cylindrical air cells made of porous material allowing air leakage to contribute in reducing the development of pressure ulcer by lowering the pressure peak, temperature and humidity. To determine an optimal air-cell pressure appropriate for each user, we divide the parts of the body into four sections such as head, trunk, hip, and leg. Then, the pressure of each section is independently calculated from the weight of each part based on the individual body height and weight and the approximate anthropometric model. Air supply system for the air-cell mattress is implemented by using four electronic solenoid valves and an air compressor, and it is driven by a real-time micro-controller. The experimental results for seven subjects shows that the proposed air-cell mattress is effective for the prevention of the pressure ulcer.

Keywords: Smart Home in Assistive Robotics, Mobility and Navigation in Assistive Robotics, Manipulation in Assistive Robotics
Abstract: This paper describes the development of generic human machine interface (HMI) to control the manus assistive robot. The personalization of the HMI, according to each end user, is crucial for the usability of any assistive technology. The control of complex devices, such as robot having many degrees of freedom (DOF), with a limited number of DOF at the level of the user, implies a strong design of the HMI to facilitate the interaction. Our research activities focus mainly at this level, which means not only providing several functionalities of the controlled system, but also on the presentation of those functionalities to the user. The challenge is to hide the complexity of any controlled system to the user, and particularly, when these users are having severe disabilities. Preliminary results are also presented. This work is funded by a European program, through the AMOR project, and by national support, through the Smart Home project. A demonstration of the running prototype will be provided during the conference.

Keywords: Mobility and Navigation in Assistive Robotics, Safety in Assistive Robotics
Abstract: The residents in long term care facilities with cognitive impairment and mobility disability need an anti-collision system on their powered wheelchairs to prevent them from causing other seniors to fall. Because of the severe consequence of falling, the detection method of the anti-collision system must be very reliable. However, many object detection techniques tend to miss targets that are unfavourably oriented or have certain surface properties. This research evaluated an uncommon method: Laser Line Object Detection (LLOD). The LLOD system projects an invisible infrared laser line onto the ground, and reads the resulting image via a camera. By analyzing the laser line in the image, the system can identify whether objects are in the target area. A pilot LLOD system was designed and installed on a powered wheelchair. The results of the evaluation experiments showed that the LLOD system can detect almost all obstacles with different orientations and materials, and produced a high detection rate on favourable flooring surfaces.

Keywords: Mobility and Navigation in Assistive Robotics, Safety in Assistive Robotics, Mechanical systems in Hardware/Control
Abstract: This work introduces a new indoor navigation method for an omnidirectional passive walking aid system, called Omni RT Walker-II. Omni RT Walker-II is the second version of a newly manufactured walking aid system with an omnidirectional platform which is controlled through merely control of MR rotary brakes and excludes actuators, aiming at higher safety and better functionality and maneuverability of the system. The proposed navigation method is unique in that it uses both environment information and human characteristics in order to provide its user with further freedom in handling the walker, and avoids abrupt movements of the system. The new method can assist the users with gait disorder and avoid turning over or falling while navigating the user to a destination. Experimental results are presented to evaluate the accuracy and quality of navigation.

Keywords: Manipulation in Assistive Robotics, Smart Home in Assistive Robotics
Abstract: In this paper the mechanism, design, and control system of a new humanoid-type hand with human-like manipulation abilities is discussed. The hand is designed for the humanoid robot which has to work autonomously or interactively in cooperation with humans. The ideal end effector for such a humanoid would be able to use the tools and objects that a person uses when working in the same environment. Therefore, a new hand is designed for anatomical consistency with the human hand. This includes the number of fingers and the placement and motion of the thumb, the proportions of the link lengths, and the shape of the palm. The hand can perform most of human grasping types. In this paper, particular attention is dedicated to measurement analysis, technical characteristics, and functionality of the hand prototype. Furthermore, first experience gained from using hand prototypes on a humanoid robot is outlined.

Keywords: Mobility and Navigation in Assistive Robotics
Abstract: Robotic systems that assist users by crossing a street safely and automatically would benefit people with vision and/or mobility impairments. This paper describes progress toward a street-crossing system for an assistive robotic system. The system detects and tracks vehicles in real time. It reasons about extracted motion regions in order to decide when it is safe to cross.

Keywords: Manipulation in Assistive Robotics, Mechanical systems in Hardware/Control, Devices in Evaluation in Clinical Experience
Abstract: From a developmental and educational perspective, play is a 'natural' way in which children learn in an enjoyable manner. This paper aims to describe one possible contribution of selected robotics technology and automation for making toys available to children with severe physical disabilities. This work is mainly based on a qualitative study which is aimed to analyse how children with physical disabilities play in comparison with normal children. One particular result of this study is a dedicated robot system which supports children with the above mentioned disabilities for interaction with standard toys being realized by ARC Seibersdorf research GmbH. Besides of a description of the robot system the paper gives first results from user trials and outlines future development.

Keywords: Mobility and Navigation in Assistive Robotics, Safety in Assistive Robotics, Manipulation in Assistive Robotics
Abstract: We develop a work assistant mobile robot to help the handicapped. Mission statements for developing an assistant robot are derived based on survey to assist effectively the handicapped as many as possible in a real employment situation. According to the mission statements, work assistant mobile robot system type I and type II are developed, and the robots are performed user-trials by the disabled who is working in a manufacturing labor.

Keywords: Manipulation in Assistive Robotics, Functional Outcomes in Clinical Experience
Abstract: Besides the social and personal benefits of a rehabilitation robot, the direct cost-savings and other (indirect) economic benefits, or effectiveness, are of major importance to party who pays for (or reimburses) the rehabilitation robot. This paper gives an overview of these cost-savings and, on a larger scale, economic benefits of the Assistive Robotic Manipulator (ARM) rehabilitation robot.

Keywords: Neural Coding in Brain-Machine Interfaces, Probe Technologies in Brain-Machine Interfaces
Abstract: Extracellular recordings of motor cortex (MI) neurons, using a chronically implanted multi-electrode array, promise to yield a high dimensional input signal to external devices such as a computer, exoskeleton or prosthetic arm. For the multi-electrode array to be used as a sensor for a neuromotor prosthesis (NMP), it is important that it continually record movement-related signals over long time periods. Recent studies have demonstrated that it is possible to continually record for up to 1.5 years from a sufficient number of MI neurons in monkeys to enable neural decoding of arm movement. Cyberkinetics Neurotechnology Systems Inc. has initiated an investigational device exemption (IDE) study investigating the safety and efficacy of the BrainGate™ Neural Interface System, a medical device that combines this sensor with data acquisition and processing devices to decode movement intent. This device is currently being investigated as a means for a quadriplegic person to operate a range of assistive technologies. Preliminary results from this case study provide evidence that (1) MI neurons remain active more than 3 years after spinal cord injury, (2) units can be recorded 6 months after surgery. This technology may benefit quadriplegic people by providing a new output pathway from the cortex, to control their muscles.

Keywords: Locomotion & Posture in Therapeutic Robotics, Plasticity in Sensory-Motor Control & Learning, Mechanical systems in Hardware/Control
Abstract: Task-specific practice can be beneficial for motor rehabilitation after neurological injury. Unfortunately, high labor demands have limited its clinical acceptance, especially for gait rehabilitation. A number of research teams around the world are testing large robotic devices for assisting treadmill stepping as a means for reducing therapist labor. We propose that powered lower limb orthoses may also have a role in assisting gait rehabilitation. Powered orthoses could assist task specific practice of gait with the long-term goal of improving patients’ inherent locomotor capabilities. We present data showing that: (1) pneumatically powered lower limb orthoses can provide substantial mechanical assistance to human walking, (2) powered orthoses can lead to motor adaptation of gait in healthy subjects, and (3) powered lower limb orthoses may have positive benefits during gait rehabilitation.

Keywords: Devices in Evaluation in Clinical Experience, Measures in Evaluation in Clinical Experience, Training Evaluation in Clinical Experience
Abstract: Abstract- The ability to monitor and quantify force exertions made by individuals during fMRI scans of the brain would provide researchers and clinicians a standardized, well-controlled behavioral task that could improve the repeatability and accuracy of imaging studies. In this work, we present a MRI compatible wrist module that is capable of measuring isometric forces generated at the hand and joint moments along wrist flexion-extension and wrist ulna-radial deviation axes. Joint moments measured by the system can be visually displayed to the individual and used during target matching tasks. In a small set of pilot tests, it was found that the noise on the force and moment signals were not affected by the magnetic fields nor were the fMRI images influenced by the presence of the device. In future studies, we plan to use the wrist module to investigate cortical reorganization in stroke patients following prolonged neurorehabilitation.

Keywords: Devices in Evaluation in Clinical Experience, Functional Outcomes in Clinical Experience, Locomotion & Posture in Therapeutic Robotics
Abstract: The main aim of this work was to identify an experimental method for the quantitative assessment of the motor performance of elderly people, during motor tasks requiring also different cognitive efforts. Specifically, a dual task approach was used to investigate age-related deficits in the ability to walk or climb stairs, and to concurrently perform various categories of cognitive tasks. A wearable biomechatronic system was used to measure the kinematics of the lower limb, during the task execution. Parameters derived from gait analysis were used for the quantitative assessment of examined subjects motor performances. Preliminary results showed that the proposed method can provide accurate and reliable measurements, which could be useful to deep inside the comprehension of the age-related deficits of lower limb motor control strategies.

Keywords: Devices in Evaluation in Clinical Experience, Training Evaluation in Clinical Experience, Training Programs in Therapeutic Robotics
Abstract: In 1991, a novel robot named MIT-MANUS was introduced as a test bed to study the potential of using robots to assist in and quantify the neuro-rehabilitation of motor function. It introduced a new type of therapy, offering a highly backdrivable mechanism with a soft and stable feel for the user. MIT-MANUS proved an excellent fit for the rehabilitation of shoulder and elbow of stroke patients with results in clinical trials showing a reduction of impairment in these joints. Notably, we found a greater reduction in motor impairment in the exercised muscle groups. This suggests a need for additional robots to rehabilitate other targeted joints and different muscle groups. The intent of this paper is to present data that supports the use of multiple robots to deliver focused therapy to different limb segments and joints.

Keywords: Functional Outcomes in Clinical Experience
Abstract: In 1991, a novel robot named MIT-MANUS was introduced as a test bed to study the potential of using robots to assist in and quantify the neuro-rehabilitation of motor function. It introduced a new type of therapy, offering a highly back-drivable mechanism with a soft and stable feel for the user. MIT-MANUS proved an excellent fit for rehabilitation of the paretic shoulder and elbow in patients with stroke, with clinical trials showing a reduction of impairment at these joints. However, the desired outcome of rehabilitation services is reduced impairment in movement capacities, as well as improved functional abilities and participation in daily life tasks. While we have seen reductions in motor impairment, no specific attempts were made during these studies to help the person link the movements practiced during robotic therapy to motor actions during daily tasks. In this paper we are presenting our first attempt to link movements practiced in robotic therapy with distal training during functional tasks.

Keywords: Functional Outcomes in Clinical Experience, Novel Techniques in Therapeutic Robotics, Automated Therapy in Therapeutic Robotics
Abstract: Patients with severe neurological, orthopedic or cardio-pulmonary disorders including spinal cord injury (SCI) and traumatic brain injury (TBI) are often forced to lie in bed for a comparable long time. This may cause many complications, one of the most prominent problems being the instability of the cardio-pulmonary system due to venous pooling in the lower extremity when transferred from the horizontal to the upright position. Any kind of mobilization of these patients would help to prevent these effects from happening. The most commonly used method for mobilization therapy of these patients is to passively move the lower extremities. To date commercially available continuous passive motion devices are inadequate to achieve the expected results. Therefore a novel device for an automated stepping training (“Erigo”) was developed with the possibility of simultaneous verticalization of the patients. The first clinical application of this robotic device in high (cervical) complete spinal cord injured patients and a case study of a traumatic brain injured patient will be presented.

Keywords: Neuro-Rehabilitation in Therapeutic Robotics, Training Programs in Therapeutic Robotics, Locomotion & Posture in Therapeutic Robotics
Abstract: This paper presents work towards quantifying the manual assistance provided by therapists during locomotor training for people with spinal cord injury. The final goal is to translate human trainers' skill into gait-training robot algorithms. Locomotor training is a rehabilitation technique in which three therapists assist the legs and hip of the patient to walk on a treadmill while part of the patient's body weight is supported by an overhead harness. We have developed a sensorized orthosis that measures shank kinematics and therapist forces during locomotor training. The orthosis is attached to one of the legs, so that one of the therapists assists through the orthotic interface. This interface is similar to how a locomotor-training robot is attached to the patient's shank. However, the force and intelligence behind the orthosis is not robotic, but human. Our intention is to quantify and analyze the human therapists' intelligence and expertise to help design better gait-training robot control algorithms. In this paper we present some preliminary results from the first locomotor training sessions with spinal cord injured patients using this sensor system. A key initial finding is that even skilled trainers assist with substantial differences in terms of both forces and motions. With the same patient, same stepping speed and same body weight support, the differences in peak forces applied to the knee between trainers were up to 100% in some sessions.

Keywords: Manipulation in Assistive Robotics, Workstation in Assistive Robotics
Abstract: Users of the MANUS robot arm experience a high cognitive and physical load when performing activities of daily living with the arm. These high loads originate from user interface problems and limitations. To reduce these high loads the user interface of the MANUS needs to be improved. Because large differences exist between the residual capabilities of MANUS users, different user interfaces need to be developed. As a design aid, a framework with user interface improvements and new features was developed. With this framework several new user interfaces can be designed. Most interface features in the framework can be adjusted to the residual body functions of the users and thereby reduce the high loads that users experience.

Keywords: Mobility and Navigation in Assistive Robotics, Locomotion & Posture in Therapeutic Robotics, Devices in Evaluation in Clinical Experience
Abstract: The KineAssist is a robotic device for gait and balance training. A user-needs analysis led us to focus on increasing the level of challenge to a patient's ability to maintain balance during gait training, and also on maintaining direct involvement of a physical therapist (rather than attempting robotic replacement.) The KineAssist provides partial body weight support and postural torques on the torso; allows many axes of motion of the trunk as well as of the pelvis; leaves the patient's legs accessible to a physical therapist during walking; servo-follows a patient's walking motions overground in forward, rotation, and sidestepping directions; and catches a patient who begins to fall. Design and development of the KineAssist proceeded more rapidly in the context of a small company than would have been possible in most research contexts. A prototype KineAssist has been constructed, and has received FDA approval and IRB clearance for initial human studies. We describe the KineAssist's motivation, design, and use.

Keywords: Manipulation in Assistive Robotics, Kinematics in Sensory-Motor Control & Learning
Abstract: The Manus manipulator is a wheelchair mounted assistive device for severely motor disabled persons. It is a six degrees of freedom rehabilitation robot (excluding external lift and gripper) of which the control can be improved through the introduction of sensors, especially for users with very limited rest functionality. The approach presented in this paper combines sensor based control with direct user control resulting in a collaborative controller and deals with human interface extensions and improvements.

Keywords: Safety in Assistive Robotics, Novel Techniques in Therapeutic Robotics
Abstract: This paper presents a system-level approach to the design of a safety-critical robotic system that is sufficiently safe to satisfy human-subject safety criteria. This system design approach utilizes preliminary hazard analysis, and fault tree analysis, and was successfully applied to a dexterous space robot designed to fly on NASA’s space shuttle. An application of this approach to a shoulder rehabilitation exoskeleton will be presented and shown to improve the safety of the overall system.

Keywords: Manipulation in Assistive Robotics, Functional Outcomes in Clinical Experience, Devices in Evaluation in Clinical Experience
Abstract: New user interface features and a new user interface for the MANUS robot arm, were designed in order to reduce the high cognitive and physical load that users experience when controlling the MANUS. These interface features, and the new interface, were evaluated for their performance. The following results were obtained. A new method of switching between control modes proved to be a significant improvement. However, the introduction of a new control mode, called pilot control mode, increased the cognitive and physical load of the MANUS users. The users were content with the new interface and with the extra functionalities that were added in this interface, such as the collaborative controller, with which some degrees of freedom of the MANUS can be controlled automatically, and with an alternative centre of rotation of the gripper that allows for new movements of the gripper.

Keywords: Manipulation in Assistive Robotics, Mobility and Navigation in Assistive Robotics
Abstract: We are studying the use of programmable constraint machines for rehabilitation and as assistive devices in materials handling. In this paper we describe initial experiments in human interaction with a two-joint passive programmable constraint device, or cobot. The user grasps the manipulandum at a handle, and the manipulandum implements a smooth, hard, low friction constraint curve. Initial experiments in reaching tasks subject to such a constraint show that subjects apply significant forces against the constraint, in a manner dependent on the movement speed and constraint shape. These forces can be broken into passive forces (due simply to the dynamics of the human arm) and forces actively generated by the muscles. Some motor adaptation is also evident.