Background: It is the purpose of this article to iden-tify and review criteria that rehabilitation technology should meet in order to offer arm-hand training to stroke patients, based on recent principles of motor learning. Methods: A literature search was conducted in PubMed, MEDLINE, CINAHL, and EMBASE (1997–2007). Results: One hundred and eighty seven scientific pa-pers/book references were identified as being relevant. Rehabilitation approaches for upper limb training after stroke show to have shifted in the last decade from being analytical towards being focussed on envi-ronmentally contextual skill training (task-oriented training). Training programmes for enhancing motor skills use patient and goal-tailored exercise schedules and individual feedback on exercise performance. Therapist criteria for upper limb rehabilitation technology are suggested which are used to evaluate the strengths and weaknesses of a number of current technological systems. Conclusion: This review shows that technology for supporting upper limb training after stroke needs to align with the evolution in rehabi-litation training approaches of the last decade. A major challenge for related technological developments is to provide engaging patient-tailored task oriented arm-hand training in natural environments with pa-tient-tailored feedback to support (re) learning of motor skills.

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We present an overview of the work devoted to exoskeletons which has been performed for the last seven years at TU Berlin. Three different types of exoskeleton devices have been developed: hand and finger exoskeletons for rehabilitation, a leg exoskeleton for motion support, and an arm exoskeleton for multimodal human-computer interaction. The research has been focused on different types of control strategies and algorithms as well as on the implementation of applications. The main part of this work is devoted to using electrical muscle signals for the control systems. We present the concepts for design and application, review the main algorithms and show experimental results and first experience with applications.

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The design of a wearable robotic exoskeleton needs to consider the interaction, either physical or cognitive, between the human user and the robotic device. This paper presents a method to analyse the interaction between the human user and a unilateral, wearable lower-limb exoskeleton. The lower-limb exoskeleton function was to compénsate for muscle weakness around the kneejoint. It isshown that the cognitive interaction is bidirectional; on theone hand, the robot gathered information from the sensors in order to detect human actions, such as the gait phases, but the subjects also modified their gait patterns to obtain the desired responses from the exoskeleton. The results of the two-phase evaluation of learning with healthy subjects and experiments with a patient case are presented, regarding the analysis of the interaction, assessed in terms of kinematics, kinetics and/or muscle recruitment. Human-driven response of the exoskeleton after training revealed the improvements in the use of the device, while particular modifications of motion patterns were observed in healthy subjects. Also, endurance (mechanical) tests provided criteria to perform experiments with one post-polio patient. The results with the post-polio patient demónstrate the feasibility of providing gait compensation by means of the presented wearable exoskeleton, designed with a testing procedure that involves the human users to assess the human-robot interaction.

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In recent years, the rate of aged people is continuously increasing in Japan: in ten years, around 30% of the Japanese population will be aged more than 65 years old. These people often need some help from caretakers, and this causes a problem for the caretakers: it takes a very big burden for caretakers, for example, to lift people from their bed, when they need to go to toilets. So, a system to help caretakers would be needed: This is a master-slave unit exoskeleton, which helps the caretaker while loading the patient. It is moved by a Hydraulic Bilateral Servo system, whose master cylinders are moved by servo-motors. Presently, the conceptions of the body and hardware are finished. We are developing the servo-loop system and the driving software for the system, and more specially the pulse generation software for the motor of the master part of the exoskeleton. We will be able to discuss about the driving of the entire robotic-type exoskeleton system with a computer, through a PCMCIA interface system.

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The work presented in this paper is our first step toward the develop-ment of an exoskeleton for human gait support. The device we foresee should be suitable for assisting walking in paralyzed subjects and should be based on myoelectrical muscular signals (EMGs) as a communi-cation channel between the human and the machine. This paper concentrates on the design of a biomechanical model of the human lower extremity. The system predicts subject’s intentions from the analysis of his/her electromyographical activity. Our model takes into account three main factors. Firstly, the main muscles spanning the knee articulation. Secondly, the gravity affecting the leg during its movement. Finally, it considers the limits within which the leg swings. Furthermore, it is capable of estimating several knee parameters such as joint moment, angular acceleration, angular velocity, and angular position. In order to have a visual feedback of the predicted movements we have implemented a three-dimensional graphical simulation of a human leg which moves in response to the commands computed by the model.

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