Therapist-in-the-Loop robotics-assisted mirror rehabilitation therapy: An Assist-as-Needed framework

Abstract

Abstract-This paper presents a Therapist-in-the-Loop (TIL) framework for robotics-assisted mirror rehabilitation therapy integrated with adaptive Assist-as-Needed (ANN) training, to be adjusted based on the impairment and disability level of the patient's affected limb. Closed-loop system stability has been investigated using a combination of the Circle Criterion and the Small-Gain Theorem to account both for time-delay and the time-varying adaptive ANN training. Experiments to investigate the performance of the proposed framework are reported.

Hand-Exoskeleton Assisted Progressive Neurorehabilitation Using Impedance Adaptation Based Challenge Level Adjustment Method

“…The musclular model free approach of providing assistance to the patients also simplifies the exoskeleton control and the therapeutic process. First of all, it is difficult to construct the patient specific model of human motor system [53], or predefine trajectory for each individual, which sometimes needs the involvement of a human therapist [54]. Therefore, a similar approach of not forcing the patients to follow a predefined joint angle trajectory is chosen, like some other studies [1], [23], [24].…”

Review of Advanced Medical Telerobots

“…An example for medical application is tele-mirror-rehabilitation when a human therapist holding the first robot works with a remote patient holding the second robot with her/his left hand and the third robot with her/his right hand (in a mirrored fashion) to provide kinesthetic mirror rehabilitation exercises [247,253,254]. As another example, the same structure can be used for an expert-in-the-loop (EIL) surgical training mechanism to train a novice surgeon on how to conduct tasks such as telesurgery [206,208].…”

“…Multi-leader-single-follower (ML/SF) system grants the ability for multiple operators to command one single follower robot through manipulation of their associated leader robot and fusion of their motion command to control the follower robot [218,[230][231][232][255][256][257]. Applications of these systems can be seen in various forms such as EIL multi-robot rehabilitation [4,247,253,254,[258][259][260][261][262][263][264][265][266][267], collaborative surgery [163,206,237,268] and surgical training [4,163,206,208,258,[260][261][262][263][264][265][266][267][268]. More specifically, using this topology, multiple surgeons can share the control of a single follower robotic system (details of medical autonomy are given in Section 3.2 of this paper).…”

“…Yet another example of such a scenario is therapistin-the-loop (TIL) mirror robotic rehabilitation for post-stroke patients, using which the therapist's trajectories (first leader robot) is modulated by the user's hand on the less affected side in a mirrored fashion (second leader robot) to rehabilitate the hand on the affected side (the follower robot). This architecture not only allows for higher safety and reliability of the therapy but can potentially allow for stimulating neural recovery through the medium of mirror rehabilitation [247,253,254].…”

“…More details on this can be found in Section 3.2 where we compare various autonomy levels. The wide literature related to DUST architectures can be categorized into two main branches of research: (1) control [150,207,[269][270][271][272][273][274]277,[306][307][308][309], and (2) Functionality [4,247,253,254,[258][259][260][261][262][263][264][265][266][267].…”