Search Results (288)

Lower-limb exoskeleton robots play a pivotal role in rehabilitation medicine and assistive augmentation, where precise dynamic modelling and trajectory tracking control are fundamental to effective assistance. Existing models predominantly focus on hip and knee rotational degrees of freedom, with insufficient attention to ankle dynamics and pelvic translation. To address these limitations, this paper establishes a sagittal-plane dynamic model comprising nine generalised coordinates, treating the human lower limb and exoskeleton as an integrated coupled system. A seven-segment kinematic model encompassing the trunk, bilateral thighs, shanks, and feet is constructed via a modified Denavit–Hartenberg parameter method, and dynamic equations are derived using Lagrangian formulation. Three control strategies—PD control, PD with gravity compensation, and the computed torque method—are designed and evaluated through simulations using gait data from five subjects (two self-collected, three from a public dataset) acquired via Vicon motion capture. Results demonstrate that the computed torque method achieves a joint angle tracking root mean square error (RMSE) of 0.59°, representing an 86.3% improvement over conventional PD control, while maintaining a low control torque RMS of 4.44 N·m. The controller exhibits stable tracking performance across walking speeds of 0.4–1.45 m/s, validating the effectiveness of the proposed model and control strategies. Full article

Lower-limb rehabilitation exoskeletons must balance biomechanical compatibility, structural safety, and low mass to enable practical, repeatable gait assistance. This paper proposes a planar pantograph-derived exoskeleton leg driven by a Chebyshev Lambda linkage and develops an integrated workflow from mechanism synthesis to manufacturable optimization and experimental verification. A mannequin-coupled multibody model was built in MSC ADAMS to evaluate joint kinematics, end-point (foot) trajectories, and joint reaction forces under multiple scenarios (fixed-frame, ramp, stair ascent, and inclined-plane walking). The extracted joint loads were transferred to a parametric finite element model in ANSYS Workbench 2019, where response surface surrogates and a multi-objective genetic algorithm (MOGA) were used to minimize mass under stiffness and strength constraints. For the optimized load-bearing link, the selected minimum-mass design reached a component mass of 0.542 kg while respecting the imposed structural limits, i.e., a maximum total deformation below 0.2 mm and a maximum equivalent (von Mises) stress below 50 MPa (e.g., ~0.188 mm deformation and ~39 MPa stress in the optimal candidate). A rapid prototype was manufactured by 3D printing and experimentally evaluated using CONTEMPLAS high-speed video tracking, providing measured X_M(t) and Y_M(t) trajectories and joint-angle histories for quantitative comparison with simulations via RMSE metrics. Full article

Background: Freezing of gait (FoG) is a common symptom of Parkinson’s disease, especially in its later stages of progression. Characterized by involuntary stopping during normal gait patterns, FoG greatly increases fall risk, reducing quality of life. Given the complex presentation and etiology of FoG, current treatments have proven ineffective in managing episodes. In recent years, machine learning algorithms have been leveraged to derive actionable clinical insights from biomedical datasets. As a manifestation of neuromechanical dysfunction, impending FoG episodes may be characterized through data collected by wearable devices and sensors. Objective: This scoping review evaluates the current landscape of machine and deep learning-derived biomarkers to enhance the personalized management of FoG. Methods: This scoping review was conducted using established methodological frameworks for scoping reviews and is reported in accordance using the PRISMA-ScR checklist. Three databases were queried, with screening yielding 60 studies. Results: Thirty-nine papers reported on deep learning techniques, with the most common architectures being convolutional neural networks and long short-term memory models. Conclusions: Inertial measurement units, which can be worn on various locations, may be a promising modality for practical implementation. To generate closed-loop FoG therapies, algorithms can be integrated into real-time systems like robotic exoskeletons or adaptive deep brain stimulation. Future work in generating datasets from ambulatory devices, as well as distributed computing strategies, may lead to real-time FoG management. Full article

Forestry, nursery, and planting tasks involve repetitive trunk flexion, squatting, and kneeling, as well as manual handling, increasing musculoskeletal load, and the need for mobility-related safety measures. Passive exoskeletons could mitigate postural exposure and reduce the overall body workload. We conducted a preliminary study (n = 14) to test the feasibility of a protocol and estimated model- and task-specific trends during standardized simulated nursery activities in a laboratory setting. Participants simulated planting and seeding tasks (loads of 0.5–2 kg) and material handling and preparation tasks (loads of 5–15 kg) without an exoskeleton (No-EXO) and with three passive models (EXO 1–EXO 3). EXO 3 was excluded from the planting tasks for feasibility reasons. Whole-body kinematics were recorded using an IMU-based motion capture system and converted into time-based ergonomic exposure outcomes (OWAS and RULA). Physiological load was monitored via heart-rate (HR) measurements. Compared to the No-EXO condition, exoskeleton use shifted posture exposure towards lower-risk categories. The largest improvements were observed with EXO 2 and EXO 3 during material handling (OWAS: −18%/−20%; RULA action-level reduction: −25%/−39%) and with EXO 2 during planting/seeding (OWAS: −15%; RULA: −26%). HR_max did not increase across tasks or conditions and HR tended not to rise with higher workload when exoskeletons were used. Overall, the results suggest positive ergonomic and workload trends related to the model and tasks. Field validation on uneven terrain with full personal protective equipment and harness integration is needed to confirm usability and support and to define implementation requirements (fit, compatibility with PPE, and safe-use conditions). Full article

Background and Objectives: This study was conducted to investigate the effects of robot-assisted gait rehabilitation approaches using commonly used end-effector, fixed exoskeleton, and wearable exoskeleton on gait and balance abilities in patients with early post-stroke (≤3 months). Materials and Methods: Sixty patients admitted to a rehabilitation center with confirmed stroke by a medicine specialist were assigned to three groups such as the end-effector group (EG 1), the fixed exoskeleton group (EG 2), and the wearable exoskeleton group (EG 3). The primary endpoint was pre-specified as the change in timed up-and-go gait test (TUG) from baseline to week 6, and all other outcomes were treated as secondary. The functional gait category (FAC), 10-m walk test (10MWT), six-minute walk test (6MWT), timed up-and-go gait test (TUG), dynamic gait index (DGI), and Berg Balance Scale (BBS) were measured at four time points (baseline, 2 weeks, 4 weeks, and 6 weeks). Results: A significant main effect of time was observed for all outcome variables, but neither the main effect of group nor the interaction between group and time was significant for any outcome variable. Within-group analyses revealed that FAC, 6MWT, DGI, and BBS increased over time in all groups, whereas 10MWT and TUG decreased. Conclusions: All three robot-assisted gait rehabilitation approaches in patients with early post-stroke were associated with significant improvements in gait and balance abilities over 6 weeks. However, statistically significant differential trajectories were not detected across robot types in this sample. Full article

Ensuring user safety while enabling independent mobility is crucial to autonomous healthcare and rehabilitation robots, such as active lower-limb orthoses and exoskeletons. A key requirement for these devices is to provide full assistance without supervision; however, existing designs do not simultaneously satisfy autonomous operation and inherent safety. To address this gap, a novel safety principle, Safety by Design, and a corresponding system architecture for a fully assistive active knee orthosis are introduced. The proposed architecture is based on a comprehensive risk analysis for the use of active orthoses and exoskeletons and integrates redundancies for all safety-critical components while minimizing additional weight. This redundancy enables the orthosis to remain operational at reduced power in the event of component failure, improving both user safety and system reliability. The design supports safe, unsupervised operation by ambulatory users, enhancing independent patient mobility and the performance of the gait activities of level walking, stair climbing and sitting down/standing up. The proposed architecture is scalable and adaptable to a wide range of robotic devices. By improving robustness, efficiency, and safety, this work contributes to the advancement of autonomous biomedical robotic systems and wearable assistive devices. Full article

Surface electromyography (EMG) can drive assistive training systems in neurorehabilitation. This systematic review and meta-analysis evaluated whether EMG-driven device-assisted rehabilitation improves upper-limb (UL) and lower-limb (LL) outcomes versus conventional therapy (CT). The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in PROSPERO (CRD420251029642). We searched databases for randomized controlled trials in adults with neurological disorders; three reviewers screened records, extracted data, and assessed risk of bias using the Revised Cochrane risk-of-bias tool (RoB 2). Seven trials (n = 160) were included, all in post-stroke populations (UL: 3; LL: 4). UL trials showed mixed findings, and pooled effects were imprecise and not statistically significant for activities of daily living (ADL) (standardized mean difference, SMD −0.55; p = 0.09; I² = 0%). LL pooled estimates showed no significant differences in motor function (Fugl-Meyer Assessment, lower extremity, FMA-LE) (mean difference, MD −1.69; p = 0.40), walking independence (Functional Ambulation Categories, FAC) (MD −0.24; p = 0.61), balance (SMD 0.12; p = 0.61), mobility (Timed Up and Go, TUG) (MD −3.24; p = 0.71), or endurance (SMD −0.19; p = 0.43). Current evidence does not demonstrate clinical superiority over CT. EMG-driven systems may be used as an adjunct, but larger trials with standardized protocols, implementation outcomes, and neurological pathologies beyond stroke are needed. Full article

Most pediatric exoskeletons for cerebral palsy (CP) focus on lower-limb assistance and neglect trunk control, limiting rehabilitation outcomes. This study presents a self-aligning trunk–limb exoskeleton that integrates trunk stabilization with active lower-limb support. The design includes a hip–waist rapid adjustment mechanism, a bioinspired gear-rolling knee joint, modular thigh–shank structures, a trunk support module, and a body-weight support device. To enable transparent and coordinated assistance under pathological gait conditions, a continuous gait progress-based multi-joint control framework is developed. Joint motion is described as continuous gait progress over the full gait cycle (0–100%), and joint-specific progress estimates are fused into a unified system-level reference using observability-weighted circular statistics. Inter-joint coordination is achieved through phase-consistency-based temporal modulation implemented, enabling smooth synchronization while preserving joint-level autonomy and motion continuity. Technical evaluation—comprising kinematic misalignment analysis, simulation validation, and gait trials—demonstrated a 66.8% reduction in hip misalignment and an 87.4% reduction in knee misalignment. Gait parameters under exoskeleton-assisted walking closely matched baseline walking, confirming natural kinematic preservation without interference. These results indicate that the proposed trunk–limb exoskeleton improves human–robot synergy, enhances postural stability, and provides a promising solution for pediatric gait rehabilitation in CP. Full article

With an aging population and the high incidence of neurological diseases, rehabilitative lower limb exoskeleton robots, as a wearable assistance device, present important application prospects in gait training and human function recovery. As the core of human–computer interaction, control strategy directly determines the exoskeleton’s ability to perceive and respond to human movement intentions. This paper focuses on the control strategies of rehabilitative lower limb exoskeleton robots. Based on the typical hierarchical control architecture of “perception–decision–execution,” it systematically reviews recent research progress centered around four typical control tasks: trajectory reproduction, motion following, Assist-As-Needed (AAN), and motion intention prediction. It emphasizes analyzing the core mechanisms, applicable scenarios, and technical characteristics of different control strategies. Furthermore, from the perspectives of drive system and control coupling, multi-source perception, and the universality and individual adaptability of control algorithms, it summarizes the key challenges and common technical constraints currently faced by control strategies. This article innovatively separates the end-effector control strategy from the hardware implementation to provide support for a universal control framework for exoskeletons. Full article

This paper presents the design, development, and evaluation of a proof-of-concept arm swing facilitator device (ASFD) to promote proper arm swing during gait training. Although coordinated arm swing plays a critical role in human locomotion and neurorehabilitation, few wearable systems have been developed to integrate it into gait training. The ASFD was designed to test the feasibility of generating torque at the shoulder joint to initiate arm flexion–extension motion while allowing other shoulder degrees of freedom to move freely. The device induced cyclic arm motion at 1 Hz, producing sufficient torque while maintaining ergonomic criteria, such as a large workspace and back-mounted actuation to minimize arm load. The system incorporated a double-parallelogram mechanism to expand the workspace and a two-stage pulley–belt transmission to amplify torque. Testing showed that the ASFD produced up to 15 N·m and 11 N·m torques in static and dynamic load tests, respectively. Kinematic and experimental analyses confirmed sufficient motion freedom, except for some constraints in rotation. Human subject experiment demonstrated that the ASFD successfully induced arm swing within the 0.8–1.2 Hz frequency range and torques below 11 N·m. The ASFD met its design objectives, establishing a foundation for future development aimed at gait rehabilitation applications. Full article

Human gait exhibits stable contralateral coupling, making healthy-side motion a viable predictor for affected-limb kinematics. Leveraging this property, this study develops FusionTCN–Attention, a causality-preserving temporal model designed to forecast contralateral hip and knee trajectories from unilateral IMU measurements. The model integrates dilated temporal convolutions with a lightweight attention mechanism to enhance feature representation while maintaining strict real-time causality. Evaluated on twenty-one subjects, the method achieves hip and knee RMSEs of 5.71° and 7.43°, correlation coefficients over 0.9, and a deterministic phase lag of 14.56 ms, consistently outperforming conventional sequence models including Seq2Seq and causal Transformers. These results demonstrate that unilateral IMU sensing supports low-latency, stable prediction, thereby establishing a control-oriented methodological basis for unilateral prediction as a necessary engineering prerequisite for future hemiparetic exoskeleton applications. Full article

Lower-limb exoskeletons have become an effective tool for gait rehabilitation by enabling precise and repetitive joint movements for individuals with motor impairments. Nevertheless, the nonlinear and uncertain nature of human–robot interaction dynamics requires effective control strategies that are both robust and smooth. Conventional sliding mode control (SMC) provides robustness against disturbances but, in effect, is prone to chattering, which can adversely cause mechanical vibrations and reduce user comfort. This paper proposes a novel hybrid sliding mode control integrated with integral resonant control (SMC + IRC), strategy addressing a gap in 3-DOF exoskeleton control where structural resonance and chattering mitigation are simultaneously required while maintaining robustness and trajectory accuracy. The IRC component in this work uses a resonant damping mechanism to filter high-frequency switching elements in the SMC signal, resulting in smoother actuator torques without compromising system stability, robustness or responsiveness. The proposed control framework here is implemented on a lower-limb exoskeleton with hip, knee, and ankle joints and compared to classical SMC and Super-Twisting SMC (STSMC) methods. Upon simulation, results showed that the SMC + IRC approach significantly reduces chattering as well as produces smoother torque profiles while maintaining high tracking precision. Quantitative analyses using RMSE and chattering index metrics prove the superior performance of the proposed controller over the previous ones, establishing it as a practical and effective solution for safe and comfortable rehabilitation motion in real-time exoskeleton systems. Full article

Intelligent lower-limb exoskeleton rehabilitation robots are increasingly superseding traditional rehabilitation equipment, making them a focus of research in this field. However, existing systems remain challenged by dynamic instability resulting from various disturbances during actual walking. To address this limitation, this study proposes a novel dynamic stability criterion. Through an analysis of the principles and limitations of the traditional zero-moment point (ZMP) stability criterion, particularly during the late single-leg support phase, a new stability criterion is introduced, which is founded on the swing projection polygon during single-leg support. This approach elucidates the variation patterns of the stability polygon during a single-step motion and facilitates a qualitative analysis of the stability characteristics of the human–robot system in multiple postures. To further enhance the stability and smoothness of gait trajectories in lower-limb exoskeleton rehabilitation robots, the shortcomings of conventional gait planning approaches, namely their non-intuitive nature and discontinuity, are addressed. A recurrent gait planning method leveraging Long Short-Term Memory (LSTM) neural networks is proposed. The integration of the periodic motion characteristics of human gait serves to validate the feasibility and correctness of the proposed method. Finally, based on the recurrent gait planning method, the dynamic stability of walking postures is verified through theoretical analysis and experimental comparisons, accompanied by an in-depth analysis of key factors influencing dynamic stability. Full article

Background: Recovery following incomplete spinal cord injury (iSCI) remains challenging, with conventional rehabilitation often emphasizing compensation over functional restoration. As most new spinal cord injury cases preserve some motor or sensory pathways, there is increasing interest in therapies that harness neuroplasticity. Robotic exoskeletons provide a promising means to deliver task-specific, repetitive gait training that may promote adaptive neural reorganization. This feasibility study investigates the feasibility, safety, and short-term effects of exoskeleton-assisted walking in individuals with degenerative iSCI. Methods: Two cooperative male patients (patients A and B) with degenerative iSCI (AIS C, neurological level L1) participated in a four-week intervention consisting of one hour of neuromotor physiotherapy followed by one hour of exoskeleton-assisted gait training, three times per week. Functional performance was assessed using the 10-Meter Walk Test, while gait quality was examined through spatiotemporal gait analysis. Vendor-generated surface electromyography (sEMG) plots were available only for qualitative description. Results: Patient A demonstrated a clinically meaningful increase in walking speed (+0.15 m/s). Spatiotemporal parameters showed mixed and non-uniform changes, including longer cycle, stance, and swing times, which reflect a slower stepping pattern rather than improved efficiency or coordination. Patient B showed a stable walking speed (+0.03 m/s) and persistent gait asymmetries. Qualitative sEMG plots are presented descriptively but cannot support interpretations of muscle recruitment patterns or neuromuscular changes. Conclusions: In this exploratory study, exoskeleton-assisted gait training was feasible and well tolerated when combined with conventional physiotherapy. However, observed changes were heterogeneous and do not allow causal or mechanistic interpretation related to neuromuscular control, muscle recruitment, or device-specific effects. These findings highlight substantial inter-individual variability and underscore the need for larger controlled studies to identify predictors of response and optimize rehabilitation protocols. Full article

Background: Robotic assistive devices are increasingly used in post-stroke gait rehabilitation, yet quantitative evaluations of synchronization between human and robotic joint motion remain limited. This study examined gait kinematics in post-stroke hemiplegic patients using two exoskeleton-type devices—HAL^® (Cyberdine Inc., Tsukuba, Japan) and curara^® (AssistMotion Inc., Ueda, Japan)—based on synchronized IMU measurements. Methods: Two post-stroke patients performed treadmill walking under non-assisted and assisted conditions with HAL^® and curara^®. Only the paretic knee joint was analyzed to focus on the primary control joint during gait. Inertial measurement units (IMUs) simultaneously recorded human and robotic joint angles. Synchronization was assessed using Bland–Altman (BA) analysis, root mean square error (RMSE), and mean synchronization jerk (MSJ). The study was designed as an exploratory methodological case study to verify the feasibility of synchronized IMU-based human–robot joint measurement. Results: Both assistive devices improved paretic knee motion during gait. RMSE decreased from 7.8° to 4.6° in patient A and from 8.1° to 5.0° in patient B. MSJ was lower during curara-assisted gait than HAL-assisted gait, indicating smoother temporal coordination. BA plots revealed reduced bias and narrower limits of agreement in assisted conditions, particularly for curara^®. Differences between HAL^® and curara^® reflected their distinct control strategies—voluntary EMG-based assist vs. cooperative gait-synchronization—rather than superiority of one device. Conclusions: Both devices enhanced synchronization and smoothness of paretic knee motion. curara^® demonstrated particularly smooth torque control and consistent alignment with human movement. IMU-based analysis proved effective for quantifying human–robot synchronization and offers a practical framework for optimizing robotic gait rehabilitation. The novelty of this study lies in the direct IMU-based comparison of human and robotic knee joint motion under two contrasting assistive control strategies. Full article