This article presents the state of the art in passive devices for enhancing limb movement in people with neuromuscular disabilities. Both upper- and lower-limb projects and devices are described. Special emphasis is placed on a passive functional upper-limb orthosis called the Wilmington Robotic Exoskeleton (WREX). The development and testing of the WREX with children with limited arm strength are described. The exoskeleton has two links and 4 degrees of freedom. It uses linear elastic elements that balance the effects of gravity in three dimensions. The experiences of five children with arthrogryposis who used the WREX are described.

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Экзоскелет человеческой руки ЕSА был разработан для обеспечения телеманипуляций с силовой обратной связью в открытом космосе при помощи вспомогательных роботизированных рук.

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A wearable action-assist device which assists or executes an action of a wearer by substituting for the wearer is provided with an action-assist tool 2 having an actuator 201 which gives power to the wearer 1, a biosignal sensor 221 which detects a wearer’s biosignal, a biosignal processing unit 3 which acquires from a biosignal “a” detected by the biosignal sensor a nerve transfer signal “b” for operating a wearer’s muscular line skeletal system, and a myoelectricity signal “c” accompanied with a wearer’s muscular line activity, an optional control unit 4 which generates a command signal “d” for causing the actuator 201 to generate power according to the wearer’s intention using the nerve transfer signal “b” and the myoelectricity signal “c” acquired by the biosignal processing unit 3, and a driving current generating unit 5 which generates a current according to the nerve transfer signal b and a current according to the myoelectricity signal “c”, respectively, based on the command signal “d” generated by the optional control unit 4, and supplies the currents to the actuator 201.

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Many patients with spinal injures are confined to wheelchairs, leading to a sedentary lifestyle with secondary pathologies and increased dependence on a carer. Increasing evidence has shown that locomotor training reduces the incidence of these secondary pathologies, but the physical effort involved in this training is such that there is poor compliance. This paper reports on the design and control of a new “human friendly” orthosis (exoskeleton), powered by high power pneumatic Muscle Actuators (pMAs). The combination of a highly compliant actuation system, with an intelligent embedded control mechanism which senses hip, knee, and ankle positions, velocity, acceleration and force, produces powerful yet inherently safe operation for paraplegic patients. This paper analyzes the motion of ankle, knee, and hip joints under zero loading, and loads which simulate human limb mass, showing that the use of “soft” actuators can provide a smooth user friendly motion. The application of this technology will greatly improve the rehabilitative protocols for paraplegic patients.

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An important goal in rehabilitation engineering is to develop technology that allows individuals with severe motor impairment to practice arm movement without continuous supervision from a rehabilitation therapist. This paper describes the development of such a system, called Therapy WREX or («T-WREX»). The system consists of an orthosis that assists in arm movement across a large workspace, a grip sensor that detects hand grip pressure, and software that simulates functional activities. The arm orthosis is an instrumented, adult-sized version of the Wilmington Robotic Exoskeleton (WREX), which is a five degrees-of-freedom mechanism that passively counterbalances the weight of the arm using elastic bands. After providing a detailed design description of T-WREX, this paper describes two pilot studies of the system’s capabilities. The first study demonstrated that individuals with chronic stroke whose arm function is compromised in a normal gravity environment can perform reaching and drawing movements while using T-WREX. The second study demonstrated that exercising the affected arm of five people with chronic stroke with T-WREX over an eight week period improved unassisted movement ability (mean change in Fugl-Meyer score was 5 points plusmn2 SD; mean change in range of motion of reaching was 10%, p<0.001). These results demonstrate the feasibility of automating upper-extremity rehabilitation therapy for people with severe stroke using passive gravity assistance, a grip sensor, and simple virtual reality software.

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