Review Report 2016 Rupert Wearable

Review Report 2016
RUPERT Wearable
ABSTRACT
Repetitive training is the primary means for becoming self sufficient after a stroke ,
Traditional manually assisted training is usually labor-intensive and must be of shorter duration
to ensure an optimal therapeutic time due to the fatigue of the therapists. And it lacks
repeatability and not flexible for measuring patient performance and progress. There for
developed rehabilitation robots like Bi-Manu Track, Mirror image motion enabler etc, so that the
training duration can be easily increased and facilitated. Since human upper limb motion is used
in a majority of activities in everyday life , developing upper limb robots for rehabilitation and
daily motion assistance is relevant. Most of the upper limb rehabilitation robots are cumbersome
and anchored to a base or onto a wheelchair. This design forces the patients into a xed and
uncomfortable position . Its heavy weight, disproportionate size and prohibitive price make it
ineffectual. To overcome these problems, here introduces
an inexpensive wearable upper
extremity (UE) exoskeleton system to assist stroke patients through reach training and other
selected activities of daily living. It has
ve degrees-of-freedom ( 1. Shoulder flexion,2.
Humeral rotation, 3.Elbow flexion, 4. Fore arm pronation, 5.Wrist flexion) and is activated by
pneumatic muscles and controlled by adaptive sensory feedback control algorithms, for smooth
and safe guarded movements during the task-oriented training. Entire system is mounted on a
height adjustable holding frame. The pneumatic muscle is used as an actuator to generate a
pulling force on the joint. Padding are used in the system for comfort and adaptability to different
body size.
The unique features are , It is anchored on each users trunk and aligned at the shoulder of the
trained arm; Generates unidirectional assistive pulling force in each joint to encourage active
participation of the user during each movement;Provides gravity compensation only if the user
is too weak ,Can evaluate the effectiveness of therapy by performance analysis, Low cost and
portable.
The functional assessment and performance evaluation of the prototype can be done by
designing clinical and in home therapeutic program.
INTRODUCTION
DEPARTMENT OF ECE , COLLEGE OF ENGINEERING CHENGANNUR
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Here introduces a wearable, portable, low-cost, and easy-to-use upper extremity exoskeleton
robot- RUPERT, for clinical and in-home therapies of patients who have survived a stroke.
Repetitive training is the primary means for becoming self sufficient after a stroke , Traditional
manually assisted training is usually labor-intensive and must be of shorter duration to ensure an
optimal therapeutic time due to the fatigue of the therapists. And it lacks repeatability and not
flexible for measuring patient performance and progress. There for developed rehabilitation
robots like Bi-Manu Track, Mirror image motion enabler etc, so that the training duration can be
easily increased and facilitated. Since human upper limb motion is used in a majority of
activities in everyday life , developing upper limb robots for rehabilitation and daily motion
assistance is relevant.
Most of the upper limb rehabilitation robots are cumbersome and
anchored to a base or onto a wheelchair. This design forces the patients into a xed and
uncomfortable position . Its heavy weight, disproportionate size and prohibitive price make it
ineffectual. To overcome these problems, here introduces
an inexpensive wearable upper
extremity (UE) exoskeleton system to assist stroke patients through reach training and other
selected activities of daily living. It has
ve degrees-of-freedom ( 1. Shoulder flexion,2.
Humeral rotation, 3.Elbow flexion, 4. Fore arm pronation, 5.Wrist flexion) and is activated by
pneumatic muscles and controlled by adaptive sensory feedback control algorithms, for smooth
and safe guarded movements during the task-oriented training. Entire system is mounted on a
height adjustable holding frame. The pneumatic muscle is used as an actuator to generate a
pulling force on the joint. Padding are used in the system for comfort and adaptability to different
body size. The unique features are ,
1. It is anchored on each users trunk and aligned at the shoulder of the trained arm;
2. Generates unidirectional assistive pulling force in each joint to encourage active
participation of the user during each movement;
3. Provides gravity compensation only if the user is too weak
4. Can evaluate the effectiveness of therapy by performance analysis,
5. Low cost and portable
LITERATURE REVIEW
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There has been increasing interest in developing robotic and mechatronic devices for upper limb
therapy, including Massachusetts Institute of Technology-Manus , assisted rehabilitation and
measure-ment (ARM) guide , mirror image motion enabler, Bi-Manu-Track , ARM coordination
training 3-D, neuro-rehabilitation robot , GENTLE/system , rehabilitation robot , ARM in , and
so on . Following are few related researches in this area.
EXOSE FORCE Arm Master : It is a portable, back-mounted exoskeleton robot with ve
active degrees of freedom, This work builds upon advances in actuator/drive technology to
develop a lightweight but powerful exoskeleton that can be used for exercise therapy and
functional rehabilitation.
FREFLEX Exoskeleton: Floor-mounted, UE Robot,. Technology was developed by The
Human Sensory Feedback (HSF) Laboratory for US military and NASA applications. The
system gives force/moment feedback to the human operator; this sensory feedback enables more
efficient, safe, and realistic operations, even when the remote manipulator is distant from the
operator.
Neuro rehabilitation robot: Often robotic technologies attempt to leverage the principles
of neuro plasticity by improving quality of movement, and increasing the intensity and repetition
of the task. Over the last two decades, research into robot mediated therapy for
the rehabilitation of stroke patients has grown significantly as the potential for cheaper and more
effective therapy has been identified The nuro rehabilitation robot helps in process of functional
recovery following neurological injuries such as stroke, spinal cord injury, and traumatic brain
injury.
Fuzzy approximation: It helps in adaptive back stepping control of an exoskeleton for human
upper limbs to provide forearm movement assistance so that a human forearm can track any
continuous desired trajectory (or constant set point) in the presence of parametric/functional
uncertainties,unmodeleddynamics,actuatordynamics,and/ordisturbances
from
environments.
Given the desired trajectories of human forearm positions, in the developed control, adaptive
fuzzy approximators are used to estimate the dynamical uncertainties of the humanrobot
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system, and an iterative learning scheme is utilized to compensate for unknown time-varying
periodic disturbances
Gesture therapy : A low-cost vision-based system that allows stroke survivors to practice arm
movement exercises at home or at the clinic, with periodic interactions with a therapist. The
system integrates a virtual environment for facilitating repetitive movement training, with
computer vision algorithms that track the hand of a patient, using an inexpensive camera and a
personal computer. It includes a gripper with a pressure sensor to include hand and finger
rehabilitation; and it tracks the head of the patient to detect and avoid trunk compensation. It has
been evaluated in a controlled clinical trial at the National Institute for Neurology and
Neurosurgery in Mexico City.
THE RUPERT WEARABLE
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Most upper limb rehabilitation robots are cumbersome and anchored to a base or onto a
wheelchair. This design forces the patients into a xed and uncomfortable position.
Heavy weight, disproportionate size, and prohibitive price makes them less user friendly,
A wearable, portable, low-cost, and easy-to-use upper extremity exoskeleton robot, RUPERT, is
introduced here for clinical and in-home therapies of patients who have survived a stroke.
SYSTEM DESIGN
A. Mechanical Description
The design of the RUPERT robot has gone through six iterations over a ten-year
development cycle. The nal prototype robot has ve DoFs:
1. Shoulder exion/extension;
2. Humeral internal/external rotation;
3. Elbow exion/extension;
4. Forearm pronation/supination; and
5. Wrist exion/extension.
The depiction of a subject wearing the RUPERT robot is shown in Fig. 1., Fig. 2 shows the
mechanical design of the RUPERT robot. For each DoF, a pneumatic muscle is used as an
actuator to generate a pulling force on the joint.
Figure 1: Rupert assembly
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Figure 2: Mechanical structure

In order to enable the user to feel more comfortable while wearing the robotic arm, several
considerations are taken into account. First, all pneumatic muscles are housed in carbon ber
tubes for protection and aesthetic considerations. Second, paddings are used in the system for
comfort and adaptability to different body sizes. Finally, the system is designed to be adjustable
so it can t individuals with various arm types.
Trunk width and thickness, upper arm length and perimeter, and forearm length can all be
adjusted to align with the rotation joint for each DoF.
The robot is mounted on a height adjustable holding frame prior to securing it on the user. Fig.
3(a) shows a picture of the holding frame and the control box on the base. The control box also
acts as the counter weight for balancing the exoskeleton while it is resting on the frame. The
exoskeleton is being used on a subject participating in a motor task training in Fig. 3(d).
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Figure 3 : structure of the device
B. Controller Implementation
The control diagram of the current RUPERT robot is shown in Fig. 4. Its control algorithm has
the following characteristics: an outer loop controller for task specication, joint trajectory
planning, logics for determining when to enable on/off active assistance, and performance
evaluation; and an inner loop controller comprised several functional blocks such as an adaptive
proportional-integral-derivative control for each joint, iterative learning to adjust control
parameters for individual user, joint synergy coordination control, and built-in safety
mechanisms. The enable ag in the following block diagram plays the role of clerk, approving
the choice of activating optional iterative learning or joint synergy coordination control.
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Figure 4: Controller
The iterative learning controller uses the estimation of a subjects reachable workspace in order
to allow for maximum voluntary participation from the subject when a subject is practicing
reaching movements. The estimation is obtained on a trial-by-trial basis, iteratively, from the
subjects previous movements. The procedure can be briey described by
With
where Pj xf and Pj+1 xf are the jth and (j+1)th movement trial reference pressure signal
respectively, j x is the joint angle at the jth movement trial, x is the target angle, A() is the
assistance term, F() is the forgetting term, and Sj indicates the success or failure of the jth
movement trial.
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EVALUATION OF PERFORMANCE
A. Subject Recruitment:
Before conducting the therapeutic program, normal healthy
subjects were recruited to test the safety and operation of the robotic system, the
hardware t and comfort, and the control algorithm.
B.
Therapeutic Program Design: The therapeutic program was designed based on the
hierarchy functional skills (HIFUSs) principle. In other words, the training began with
simple and straightforward tasks and gradually advanced to more challenging motor tasks
in terms of required effort involving motor structures and increased movement
complexity. The progression was based on the measured success of completing the
trained task.
C. Structure of Therapeutic Session: The RUPERT sensed the movement trajectory and
the amount of forces exerted. The control algorithm was derived from these data
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including more intuitive or instructive outcomes and performance measures. The

structure of a therapy session is shown in Fig. 5. The therapy session started and ended
with a few repetitions (shown in green) of voluntary movement to predened targets.
These targets were xed by the therapist or the physician; the voluntary movement at the
start and end of the sessions was like a small assessment session. After the rst voluntary
movement, the block exercises began when the subject practiced the RUPERT-assisted
movement training of different tasks based on the HIFUS principle. Each session
consisted of N block of exercises, with each block containing M movement trials. There
was a small rest period between each trial (intertrial rest), and a longer one between each
block (interblock rest). At the end of each trial, block, and session, the data collected
from that corresponding epoch were analyzed and presented to the therapist and/or the
patient as knowledge of performance (KP) and knowledge of result (KR). The outcome
measures described in the next section were used in evaluating the performance of a
subject. However, these measures were not calculated for all trials, as some were
meaningful only for particular types of movement
Figure 5: Structure of a therapeutic section

D. Data Analysis
Measured robotic data from each subject is analyzed and summarized in Table 1. This table
shows the results of analysis on the changing trend over the complete four weeks of trainings for
each performance measure
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Figure 6: Table 1
FUNCTIONAL ASSESSMENT
Evaluated a 3-D, ve DoF wearable and portable UE exoskeleton robot for clinical and in-home
therapies that enables frequent training in functional reaching tasks after stroke. Compared to
other rehabilitation robots this robotic device is anchored on each users trunk and aligned at the
shoulder of the training arm, rather than on a base or onto a wheelchair as commonly found in
rehabilitation robots. This design makes the device portable for the user and can be used both in
a sitting or in a standing position. It also discourages most trunk and/or shoulder compensatory
movements commonly adapted by stroke survivors for reach training. This is very important
because experimental results suggest that hemi-paretic patients may not use all their potential
shoulder-elbow coordination if they can compensate it by using their trunk. If the trunk is
constrained, elbow joint rotation will be increased.The wearable attribute of RUPERT gives it an
advantage for training tasks in different settings, sitting, or standing, which is important from a
taskoriented training perspective. For example, a simple reaching task might involve the same set
of UE muscles in both a standing or a seated position although the postural control muscles will
be drastically different in either case. Thus, the availability of a wearable robot makes it possible
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to practice these tasks. These different settings mimic real-life activities. RUPERT unidirectional
actuation is its unique feature. Each DoF of RUPERT is actuated by a single pneumatic muscle
that is lightweight, powerful, and compliant, which results in unidirectional actuation in the
different DoFs. The active assistance is provided by pneumatic muscles and the assistive pulling
force is unidirectional in each joint to encourage active participation of the user during each
movement. This approach has two advantages: 1) simplifying the design by using less actuators
and 2) reducing the overall weight and cost. The pneumatic muscles can be built using offtheshelf parts, hence the cost of the actuator can be reduced. The nature of the exoskeleton robot
demands that the overall weight of the robot should be as low as possible. Pneumatic muscle
actuators are very light weight actuators, and this offers a superior power/force-to-weight (or
volume) ratio. All these will be helpful for us to achieve our primary goal of developing a
simple, light-weight, and low cost rehabilitation robot.
CONCLUSION
The application of robotic therapy at home may guide the rehabilitation of patients with
severe post-stroke impairment beyond what is currently feasible , Simplified design by using less
actuators and light weight & powerful pneumatic muscles. Reducing the overall weight and
cost , User
friendly ,patient can do therapy independent. The experimental results look
promising and the proposed robotic system exhibits a good prospect for a future commercialized
in-home therapy product.
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REFERENCE
[1.]
C. Carignan, M. Liszka, and S. Roderick, Design of an arm exoskeleton with

scapula motion for shoulder rehabilitation, in Proc. 12th Int. Conf. Adv. Robot. (ICAR),
Seattle, WA, USA, 2005, pp. 524531.
[2]
S. Balasubramanian and J. He, Adaptive control of a wearable exoskeleton for

upper-extremity neurorehabilitation, Appl. Bionics Biomech., vol. 9, no. 1, pp. 99115,
2012.
[3]
J. V. Basmajian et al., Stroke treatment: Comparison of integrated behavioural

physical therapy vs traditional physical therapy programs, Arch. Phys. Med. Rehabil.,
vol. 68, no. 5, pp. 272276
[4]
Z. Li, C.-Y. Su, G. Li, and H. Su, Fuzzy approximation-based adaptive

backstepping control of an exoskeleton for human upper limbs, IEEE Trans. Fuzzy
Syst., vol. 23, no. 3, pp. 555566, Jun. 2015.
[5]
L. E. Sucar, R. Leder, J. Hernndez, I. Snchez, and G. Azcarate, Clinical

evaluation of a low-cost alternative for stroke rehabilitation, in Proc. IEEE 11th Int.
Conf. Rehabil. Robot., Kyoto, Japan, Jun. 2009, pp. 863866.
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an inexpensive wearable upper

ve degrees-of-freedom ( 1. Shoulder flexion,2.