Cerebral palsy is an occurrence in which the nerves and muscles if the body may function properly, but there is damage to the brain that causes it to transmit incorrect electri-cal impulses to the muscles including both too many and too few signals. Without the correct cohesive electrical impulses to balance the opposing muscles of a joint, normal everyday tasks that most of us take for granted become very difficult to learn and perform. As exoskeletons become more advanced and practical, their applications have a lot of room for growth. Cerebral Palsy is one portion of the medical field that can benefit from the development of exoskeletons. As demonstrated with modern rehabilitation techniques, the application of an exoskeleton has the possibility of making the learning process and performance of many tasks easier and faster for both the patient as well as the doctor working with them. However, in order to appropriately apply the technology to the need, many changes in both the controls and the actual physical design of current devices need to be addressed. An exoskeleton for the purpose of helping cerebral palsy patients learn to walk is not limited to one specific form depending on the complexity of the tasks it is desired to assist with. However, there are a couple needs of this type of exoskeleton that are absolutely necessary. The size of the exoskeleton must be designed around the size of a child and not an adult. If the individual is learning to walk from the very beginning, the controls of the device will need to initially be able to take complete control over the individual’s limbs to exercise the motions of walking. With the nature of an exoskeleton controlling the limbs of a person instead of simply assisting with current movements, the physical attachments of the exoskeleton must be improved from current designs in order to make movements of the exoskeleton and the body more parallel. Other features such as different muscle sensing techniques may also improve performance, but are not required. An exoskeleton that can help cerebral palsy patients learn to walk can also be applied to many other rehabilitation needs.

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Background: It has been shown that intense training can significantly improve post-stroke upperlimb functionality. However, opportunities for stroke survivors to practice rehabilitation exercises can be limited because of the finite availability of therapists and equipment. This paper presents a haptic-enabled exercise platform intended to assist therapists and mo-derate-level stroke survivors perform upper-limb reaching motion therapy. This work extends on existing knowledge by presenting: 1) an anthropometrically-inspired design that maximizes elbow and shoulder range of motions during exercise; 2) an unobtrusive upper body postural sensing system; and 3) a vibratory elbow stimulation device to encourage muscle movement. Methods: A multi-disciplinary team of professionals were involved in identifying the rehabilitation needs of stroke survivors incorporating these into a proto-type device. The prototype system consisted of an exercise device, postural sensors, and a elbow stimula- tion to encourage the reaching movement. Eight experienced physical and occupational therapists partici-pated in a pilot study exploring the usability of the prototype. Each therapist attended two sessions of one hour each to test and evaluate the proposed system. Feedback about the device was obtained through an administered questionnaire and combined with quantitative data. Results: Seven of the nine questions regar-ding the haptic exercise device scored higher than 3.0 (somewhat good) out of 4.0 (good). The postural sensors detected 93 of 96 (97%) therapistsimulated abnormal postures and correctly ignored 90 of 96 (94%) of normal postures. The elbow stimulation device had a score lower than 2.5 (neutral) for all as-pects that were surveyed, however the therapists felt the rehabilitation system was sufficient for use without the elbow stimulation device. Conclusion: All eight therapists felt the exercise platform could be a good tool to use in upperlimb rehabilitation as the prototype was considered to be generally well de-signed and capable of delivering reaching task therapy. The next stage of this project is to proceed to clinical trials with stroke patients.

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