Introduction
System name,references | DOF | Supported movements | Main control inputs | Actuators | Type; field of application | Stage of development; additional information |
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Systems assisting shoulder movements
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Kiguchi [114] | 2 | Shoulder – FE, AA | sEMG | DC motors (x2) | Stationary system (exoskeleton-based); power assistance | C0 study: 1 hs |
Systems assisting elbow movements
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Cheng [9] | 1 | Elbow – FE | sEMG | DC motor | Stationary system; physical therapy | CI study: 5 stroke + 5 hs |
Cozens [10] | 1 | Elbow – FE | Joint angle | Electric servo-motor | Stationary system; physical therapy | CI study: 10 stroke + MS |
Kiguchi [170] | 1 | Elbow – FE | sEMG | DC motor | Stationary system (exoskeleton-based); physical therapy | C0 study: 2 hs |
MARIONET, Sulzer [142] | 1 | Elbow – FE | Joint angle | AC servomotor (SEA) | Stationary system (end-effector-based); physical therapy | C0 study: 6 hs |
Mavroidis [11] | 1 | Elbow – FE | Force/torque | DC motor | Portable orthosis (continuous passive motion device); physical therapy | Prototype |
MEM-MRB, Oda [104] | [1] | [Elbow – flexion] | Joint angular velocity, torque | MRF brake | Stationary system; physical therapy | C0 study: 1 hs |
Myomo e100, Myomo, Inc.; Stein [172] | 1 | Elbow – FE | sEMG | DC motor (x1) | Portable orthosis; physical therapy | Commercial system (FDA clearance); CI study: 8 cS |
Ögce [171] | 1 | Elbow – FE | sEMG | DC step motor | Wearable shoulder-elbow orthosis; physical therapy | CI study: 2 traumatic brachial plexus injury |
Pylatiuk [153] | 1 | Elbow – FE | sEMG | Hydraulic | Wearable orthosis; physical therapy | First prototype |
Rosen [169] | 1 | Elbow – FE | sEMG | DC motor (x1) | Stationary system (exoskeleton-based); power assistance | C0 study: 1 hs; predecessor of CADEN-7 |
Song [12] | 1 | Elbow – FE | sEMG | AC servo motor | Stationary system (end-effector-based); physical therapy | |
Vanderniepen [143] | 1 | Elbow – FE | Joint angle | Electric motors (x2) (SEA) | Wearable orthosis; orthopedic physical therapy | Prototype |
Systems assisting forearm movements
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Kung [15] | 1 | Forearm – PS | Joint angle, torque | AC servomotor (1) | Stationary system; physical therapy | CI study: 7 cS + 8 hs [16] |
Systems assisting wrist movements
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ASSIST, Sasaki [146] | 1 | Wrist – flexion | Joint angle | Rotary-type pneumatic actuators (x2) | Wearable orthosis; power assistance | C0 study: 5 hs |
Colombo [17] | 1 | Wrist – FE | Torque | Not specified | Stationary system; physical therapy | CII study: 20(8) cS |
Hu [18] | 1 | Wrist – FE | sEMG | Electric motor | Stationary system (end-effector-based); physical therapy | CI study: 15 cS |
Loureiro [100] | [1] | [Wrist – FE] | Hand motion (tremor) | MRF brake | Wearable orthosis; tremor suppression | CI study: 1 ET |
PolyJbot, Song [175] | 1 | Wrist – FE | sEMG, joint angle and torque | DC servomotor (x1) | Stationary system; physical therapy | CII study: 27(15) cS [19] |
Systems assisting finger(s) movements
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Amadeo, tyromotion GmbH | 5 | Fingers (each) – FE | End-point position and force | Electric motors | Stationary system (end-effector-based); physical therapy | Commercial system; CI study: 7 aS [20] |
Chen [21] | 5 | Independent linear movement of each finger | Fingers positions and forces, sEMG | DC linear motors (x5) | Stationary system (end-effector-based); physical therapy | C0 study: 1 hs |
CyberGrasp, CyberGlove Systems LLC; Turner [22] | [5] | [Resistive force to each finger] | Joint angles (CyberGlove) | DC motors (x5) | Force-feedback glove; interactions with virtual environment | |
Ertas [23] | 1 | Concurrent FE of 3 joints of a single finger | Joint angles | DC motor (x1) | Finger exoskeleton (underactuated mechanism); tendon physical therapy | C0 study: 4 hs |
Fuxiang [24] | 4 | Index finger– FE (x3), AA | Joint positions and toques | Linear stepping motors | Modular-finger exoskeleton (continuous passive motion device); physical therapy | C0 study: 3 hs |
Gloreha, Idrogenet srl | 5 | Independent passive movement of each finger | Fingers positions | Electric motors (x5) | Portable (Gloreha Lite)/Movable (Gloreha Professional) (end-effector-based, cable-driven); physical therapy | |
Hand of Hope, Rehab-Robotics Comp. Ltd., Ho [28] | 5 | Each finger separately - FE | sEMG | DC linear motors (x5) | Portable system (orthosis); physical therapy | Commercial system (CE Mark), CI study: 8 cS |
HandCARE, Dovat [113] | 5 | Independent linear movement of each finger (1 at a time) | Fingers positions and forces | DC motor (x1!) | Stationary system (end-effector-based, cable-driven); physical therapy | CI study: 5 cS + 8 hs |
HEXORR, Schabowsky [29] | 2 | Thumb – FE, other fingers together – FE | Fingers positions and forces | DC motor (x1), AC motor (x1) | Stationary system (end-effector-based, cable-driven); physical therapy | CI study: 5 cS + 9 hs |
HIFE, Mali [183] | 2 | 1 finger – FE | End-point position | DC motors | Haptic interface (end-effector-based); physical therapy | Prototype |
1 | All fingers together – GR | Not specified | DC brushless motor | Add-on module for InMotion ARM; physical therapy | Commercial system | |
Kline [30] | 1 | All fingers together – extension | Joint angles, sEMG | Pneumatic | Wearable glove; physical therapy | CI study: 1 stroke + hs (np) |
Lucas [147] | 1 | Index finger – flexion (passive extension) | sEMG | Pneumatic (x2) | Wearable orthosis; grasp assistance | CI study: 1 SCI |
MR_CHIROD v.2, Khanicheh [158] | [1] | [All fingers together – GR] | Finger position and torque | ERF brake | Exercising device (handle-like); physical therapy | C0 study: hs (np); fMRI compatible |
MRAGES, Winter [157] | [5] | [Fingers (each) – FE] | Finger positions and torques | MRF brakes (5) | Force-feedback glove; physical therapy | Prototype |
Mulas [31] | 2 | Thumb – FE, other fingers together – FE | sEMG, pulleys position | DC servo motors (x2) | Wearable orthosis; physical therapy | CI study: 1 sS |
Nathan [167] | 1 | All fingers together – grasp (passive release) | Hand-held trigger, index and thumb fingers joint angles | FES | Wearable orthosis (glove); physical therapy | CI study: 2 stroke + 1 hs |
PowerGrip, Broaden Horizons, Inc. | 1 | Thumb, index and middle finger together – GR | Switches or sEMG | DC motor (1) | Wearable orthosis; grasp assistance | Commercial system |
Reha-Digit, Reha-Stim; Hesse [32] | 1 | 4 fingers (except the thumb) together – FE | None | DC motor | Portable system (rotating handle); physical therapy | Commercial system (CE mark); CII study: 8(4) sS, CI study: 1 cS |
Rosati [144] | 1 | 4 fingers (except the thumb) together – FE | Not selected yet | DC motor (SEA) | Wearable orthosis; physical therapy | Design |
Rotella [33] | 4 | Index finger flexion (x2) (passive extension), thumb – flexion, other fingers together – flexion | Not specified | Electric motors | Wearable orthosis; grasp assistance | Design |
Rutgers Master II-ND, Bouzit [184] | 4 | Thumb, index, middle, and ring finger – FE | Actuator translation and inclination | Pneumatic (x4) | Force-feedback glove; interactions with virtual environment | |
Salford Hand Exoskeleton, Sarakoglou [34] | 7 | Index, middle, and ring finger – FE (x2), thumb – FE | Joint angles and end-point force | DC motors | Wearable orthosis (exoskeleton); physical therapy | C0 study: hs (np) |
Tong [35] | 10 | Each finger – FE (x2) | sEMG | Electric linear motors (x10) | Portable system (wearable orthosis); physical therapy | CI study: 2 cS |
TU Berlin Finger Exoskeleton, Wege [36] | 4 | 1 finger – FE (x3), AA | Joint angles | DC motors (x4) | Finger exoskeleton; physical therapy | C0 study: 1 hs |
TU Berlin Hand Exoskeleton, Fleischer [117] | 20 | FE and AA of all major joints of each finger | Joint angles, end-point force, sEMG | DC motors | Wearable orthosis (exoskeleton); physical therapy | Prototype |
Worsnopp [37] | 3 | Index finger – FE (x3) | Joint angles and torques | DC brushless servomotors (x6) | Finger exoskeleton; physical therapy | Prototype |
Xing [38] | 2 | Thumb – FE, other fingers together – FE | Position, force | Pneumatic (PAMs) (x2) | Wearable orthosis; physical therapy | C0 study: 3 hs |
Systems assisting shoulder and elbow movements
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ACRE, Schoone [108] | 5 | Shoulder * elbow | Joint angles | Electrical motors (x5) | Stationary system (end-effector-based); physical therapy | CI: 10 sS |
3 | Shoulder * elbow | End-point torque, position and velocity (HapticMaster) | DC brushed motors (HapticMaster) | Stationary system (end-effector-based); physical therapy and assessment of therapy results | CI study: 6 stroke | |
ARC-MIME, Lum [137] | 1+[2] | Shoulder * elbow (longitudinal movements of the forearm) [forearm’s elevation and yaw] | Forearm position and torque | DC motor (x1), magnetic particle brakes (x2) | Stationary system (end-effector-based); physical therapy | An attempt to commercialize; CI study: 4 cS; merges concepts from MIME and ARM Guide |
ARM Guide, Reinkensmeyer [136] | 1+[2] | Shoulder * elbow (longitudinal movements of the forearm) [forearm’s elevation and yaw] | Forearm position and torque | DC motor (x1), magnetic particle brakes (x2) | Stationary system (end-effector-based); physical therapy | CII study: 19(10) cS [40]; see also: ARC-MIME |
BFIAMT, Chang [41] | 2 | Shoulder * elbow (bilateral longitudinal movements of the forearms) | End point position and torque | DC servomotor (x2), magnetic particle brakes (x2) | Stationary system (end-effector-based); physical therapy | CI study: 20 cS [41] |
BONES, Klein [118] | 4 | Shoulder – FE, AA, RT, elbow – FE | Joint angles, cylinder pressure | Pneumatic (x5) | Stationary system (parallel robot + exoskeleton-based distal part); physical therapy | Prototype; see also: Supinator extender (SUE) |
Dampace, Stienen [154] | [4] | [Shoulder – FE, AA, RT, elbow – FE] | Joint angles and torques | Hydraulic brake actuators (SEA) | Stationary system (exoskeleton-based); physical therapy | CI study: stroke (np); see also Limpact |
Freeman [163] | 2 | Shoulder * elbow (in the plane) | Handle torque and position | DC brusheless servomotors (x2), FES | Stationary system (end-effector-based); physical therapy | C0 study: 18 hs |
InMotion ARM, previous name InMotion 2.0, Interactive Motion Tech., Inc.; based on: MIT Manus, Krebs [107] | 2+[1] | Shoulder * elbow (in the plane + gravity compensation) | Joint positions, angular velocity and torque | DC brushless motors | Stationary system (end-effector-based); physical therapy | |
Ju [44] | 2 | Shoulder * elbow (in the plane) | Handle torque and position | AC motors (x2) | Stationary system (end-effector-based; physical therapy | CI study: stroke (np) |
Kiguchi [45] | 3 | Shoulder – FE, AA, elbow – FE | sEMG | DC motors | Wheelchair mounted system (exoskeleton-based); power assistance | C0 study: hs (np); see also: shoulder, elbow and shoulder-elbow-forearm orthoses developed by Kiguchi and SUEFUL-7 |
Kobayashi [149] | 4 | Shoulder – FE, AA, RT, elbow – FE | Joint angle | Pneumatic (PAMs) (x10) | Wearable (but not portable) orthosis (”muscle suit“); power assistance | C0 study: 5 hs |
Limpact, Stienen [155] | 4 | Shoulder – FE, AA, RT, elbow – FE | Joint angles and torques | Rotational hydroelastic actuator (SEA) | Stationary system (exoskeleton-based); physical therapy | Design; based on Dampace |
MariBot, Rosati [46] | 5 | Shoulder * elbow | Motor positions | DC frameless brushless motors | Stationary system (end-effector-based, cable-driven robot); physical therapy | Prototype; successor of NeReBot |
MEMOS, Micera [132] | 2 | Shoulder * elbow (in the plane) | Torque and handle position | DC motors (x2) | Stationary system (end-effector-based); physical therapy | |
MIME, Burgar [120] | 6 | Shoulder * elbow | Forearm position, orientation, torque | DC brushed servomotors (PUMA 560 robot) | Stationary system (end-effector-based); physical therapy | |
Moubarak [51] | 4 | Shoulder – FE, AA, RT, elbow – FE | Joint position, velocity and torques | DC brushless motors (x4) | Wheelchair-mounted system (exoskeleton-based); physical therapy | Prototype |
NeReBot, Rosati [111] | 3 | Shoulder * elbow | Motor positions | DC motors (x3) | Stationary system (end-effector-based, cable-driven robot); physical therapy | |
REHAROB, Toth [125] | 12 | Shoulder * elbow | End-point torques | Electrical motors (ABB IRB 140 and IRB 1400H robots) | Stationary system (2 modified industrial robots); physical therapy | |
Systems assisting forearm and wrist movements
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Bi-Manu-Track, Reha-Stim; Hesse [55] | 1 | Forearm – PS * wrist – FE | Not specified | Not specified | Stationary system (end-effector-based); physical therapy | |
CRAMER, Spencer [109] | 3 | Forearm – PS, wrist – FE, AA | Hand accelerations (Nintendo Wii console) | Digital servomotors (x4) | Stationary system (parallel robot); physical therapy | Prototype |
3 | Forearm – PS, wrist – FE * AA | Joint angles | DC brushless motors (x3) | Stationary system, may be used as an add-on for InMotion ARM; physical therapy | Commercial system | |
RiceWrist, Gupta [119] | 4 | Forearm – PS, wrist – FE * AA | Joint angles and forces | Frameless DC brushless motors | Wearable orthosis; physical therapy | Prototype; extension for MIME, see also: MAHI |
Supinator extender (SUE), Allington [57] | 2 | Forearm – PS, wrist – FE | Joint angles and forces | Pneumatic | Wearable orthosis; physical therapy | CI study: 8 cS; extension for BONES and ArmeoSpring |
Takaiwa [110] | 3 | Forearm – PS, wrist – FE, AA | Torque | Pneumatic (x6) | Stationary system (parallel robot); physical therapy | Prototype |
W-EXOS, Gopura [174] | 3 | Forearm – PS, wrist – FE, AA | sEMG, hand force, forearm torque | DC motors (x3) | Stationary system (exoskeleton-based); power assistance | C0 study: 2hs; see also: SUEFUL-7 |
Systems assisting wrist and fingers movements
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AMES, Cordo [58] | 1 | wrist and MCP joints of 4 fingers (coupled together) | Flexion/Extension torque, sEMG (optional) | Electric motor + 2 vibrators (for flexor and extensor tendons) | Stationary system (with desktop mounted orthosis), physical therapy (at home) | FDA clearance; CI study: 20(11) cS; a modified version of the system is used for ankle rehabilitation |
Hand Mentor™, Kinematic Muscles, Inc.; Koeneman [59] | 1 | Wrist and 4 fingers (except the thumb) extension | Wrist angle, flexion torque | Pneumatic (PAM) (x1) | Wearable orthosis; physical therapy | |
HWARD, Takahashi [130] | 3 | Wrist – FE, thumb – FE, other fingers together – FE | Joint angles and torques | Pneumatic (x3) | Stationary system (with desktop mounted orthosis); physical therapy | CII study: 13(13) cS |
My Scrivener, Obslap Reseach, LLC; Palsbo [190] | 3 | Wrist * fingers | End-point position and torque (Novint Falcon) | Electric motors (Novint Falcon) | Stationary system (end-effector-based, using haptic device); fine motor hand therapy | CI study: 18 children with weak handwriting skills |
Systems assisting shoulder, elbow and forearm movements
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ADLER, Johnson [63] | 3+{3} | Shoulder * elbow * forearm | End-point torque, position and velocity (HapticMaster) | DC brushed motors (HapticMaster) | Stationary system (end-effector-based); physical therapy | C0 study: 8 hs [64] |
ARAMIS, Pignolo [65] | 6x2 | Shoulder – FE, AA, RT, elbow – FE, forearm – PS | Joint angles and torques | DC brushed motors (x6 per exoskeleton) | Stationary system (2 exoskeletons); physical therapy | CI study: 14 sS |
Gentle/S, Amirabdollahian [121] | 3+{3} | Shoulder * elbow * forearm | End-point torque, position and velocity (HapticMaster) | DC brushed motors (HapticMaster) | Stationary system (end-effector-based); physical therapy | CII study: 31(31) sS + cS [66]; predecessor of Gentle/G |
iPAM, Culmer [67] | 6 | Shoulder * elbow * forearm | Joint torques | Pneumatic | Stationary system (2 robotic arms); physical therapy | CI study: 16 cS |
Kiguchi [68] | 4 | Shoulder – FE, AA, elbow – FE, forearm – AA | sEMG | DC motors | Wheelchair mounted system (exoskeleton-based); power assistance | C0 study: 1 hs; see also: shoulder, elbow and shoulder-elbow orthoses developed by Kiguchi and SUEFUL-7 |
L-Exos, Frisoli [197] | 4 | Shoulder – FE, AA, RT, elbow – FE {forearm – PS} | Joint angles | Electric motors (x4) | Stationary system (exoskeleton-based); physical therapy | CI study: 9 cS [69] |
MGA, Carignan [70] | 5 | Shoulder – FE, AA, RT, VD, elbow – FE, {forearm – PS} | Joint torques | DC brushless motors (x5) | Stationary system (exoskeleton-based); physical therapy | Prototype |
MULOS, Johnson [168] | 5 | Shoulder – FE, AA, RT, elbow – FE, forearm – PS | Joystick (4 DOF) | Electric motors (x5) | Wheelchair-mounted system (exoskeleton-based); power assistance and physical therapy | C0 study: 1 hs |
NJIT-RAVR, Fluet [71] | 3+{3} | Shoulder * elbow * forearm | End-point torque, position and velocity (HapticMaster) | DC brushed motors (HapticMaster) | Stationary system (end-effector-based); physical therapy of children | CI study: 8 CP |
RehabExos, Vertechy [131] | 4 | Shoulder – FE, AA, RT, elbow – FE {forearm – PS} | Joint torques | Custom-made frameless brushless motor (x3), DC motor (x1) | Stationary system (exoskeleton-based); physical therapy | First prototype |
Systems assisting shoulder, elbow and fingers movements
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Pneu-WREX, Wolbrecht [145] | 4+{1} | Shoulder – FE, AA, HD, elbow – FE, {fingers – GR} | Joint angles, grasp force, cylinder pressure | Pneumatic (x4) | Stationary system (exoskeleton-based); physical therapy | |
T-WREX, Sanchez [106] | {5} | {Shoulder – FE, AA, RT, elbow – FE, fingers – GR} | Joint angles, grasp force | None | Wheelchair mounted gravity balancing orthosis; physical therapy | |
Systems assisting elbow, forearm and wrist movements
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Ding [179] | 4 | Elbow – FE, forearm – PS, wrist – FE, AA | Joint angles (a Motion Capture System is used) | Pneumatic (x8) | Wearable (but not portable) orthosis; power assistance for explicitly specified muscles | C0 study: 6 hs |
MAHI, Gupta [76] | 5 | Elbow – FE, forearm – PS, wrist – FE * AA | Joint angles | Frameless DC brushless motors | Wearable orthosis (force-feedback exoskeleton); physical therapy | Prototype; extension for MIME; see also: RiceWrist |
WOTAS, Rocon [99] | [3] | [Elbow – FE, forearm – PS, wrist – FE] | Angular velocity, torques | DC motors (x3) | Wearable orthosis; tremor suppression | CI study: 10 mainly ET |
Systems assisting forearm, wrist and fingers movements
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Haptic Knob, Lambercy [77] | 2 | Forearm – PS * wrist – FE, fingers – GR | Position, torque | DC brushed motors (x2) | Stationary system (2 parallelograms); physical therapy | CI study: 3 cS |
Hasegawa [98] | 11 | Forearm – PS, wrist – FE, AA, thumb – FE (x2), index finger – FE (x3), other fingers together –FE (x3) | sEMG | DC motors (x11) | Wearable orthosis; grasp assistance | C0 study: 1 hs |
Kawasaki [178] | 18 | Forearm – PS, wrist – FE, thumb – FE (x3), AA, other fingers – FE (x2), AA | Joint angles of healthy hand | Servo motors (x22) | Stationary system (exoskeleton-based); physical therapy | C0 study: 1 hs |
Scherer [156] | [1] | [Forearm and fingers twisting movements * wrist – FE] | Position, torque | Magnetic particle brake | Stationary system (end-effector-based, rotating handle); physical therapy | CI study: 2 stroke + 1 MS |
Systems assisting shoulder, elbow, forearm and wrist movements
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Braccio di Ferro, Casadio [134] | 2 | Shoulder * elbow * (forearm) * wrist (in the horizonatal or vertical plane) | Device joint angles, end-point force | AC brushless servomotors (x2) | Stationary system (end-effector-based); physical therapy | |
CADEN-7, Perry [97] | 2x7 | Shoulder – FE, AA, RT, elbow – FE, forearm – PS, wrist – FE, AA | sEMG, joint angles, angular velocities and forces/torques | DC brushed motors (2x7) | Stationary system (exoskeleton-based), 2 robotic arms; power assistance | C0 study: 1 hs |
Denève [82] | 3 | Shoulder * elbow * (forearm) * wrist | Device joint angles, end-point force | AC brushless motors (x3) | Stationary system (end-effector-based); physical therapy | Prototype |
EMUL, Furusho [159] | 3 | Shoulder * elbow * (forearm) * wrist | End-point position | Electric motors + ERF clutches | Stationary system (end-effector-based); physical therapy | CI study: 6 stroke; predecessor of PLEMO, see also: Robotherapist |
ESTEC exoskeleton, Schiele [115] | 9 | Shoulder – FE, AA, RT, VD, HD, elbow – FE, forearm – PS, wrist – FE, AA | Joint angles | Not selected yet | Wearable system (exoskeleton-based); physical therapy | First prototype |
Furuhashi [83] | 3 | Shoulder * elbow * (forearm) * wrist | End-point torque | DC motors (x3) | Stationary system (end-effector-based); physical therapy | Prototype |
Hybrid-PLEMO, Kikuchi [135] | 2 | Shoulder * elbow * (forearm) * wrist (in the adjustable plane) | Device joint angles, end-point force | DC servomotors (x2) + ERF clutches/brakes (x4) | Stationary system (end-effector-based); physical therapy | Prototype; based on PLEMO |
Lam [180] | 2 | Shoulder * elbow * (forearm) * wrist (in the plane) | End-point position, abnormal trunk position detection | Not specified | Stationary system (end-effector-based); physical therapy | C0 study: 8 hs |
Li [176] | 5 | Shoulder – FE, AA, elbow – FE, forearm – PS, wrist – FE | sEMG signals from not affected arm | AC (x3) and DC (x2) servo motors | Wearable system (exoskeleton-based); physical therapy | Prototype |
MACARM, Beer [112] | 6 | Shoulder * elbow * forearm * wrist | End-point position and force | Electric motors (x8) | Stationary system (end-effector-based, cable-driven robot); physical therapy | CI study: 5 cS |
Mathai [84] | 3 | Shoulder * elbow * forearm * wrist | End-point torque, position and velocity (HapticMaster) | DC brushed motors (HapticMaster) | Stationary system (end-effector-based); physical therapy | CI study: 4 cS |
MIME-RiceWrist, Gupta [119] | 10 | Shoulder * elbow * forearm * wrist | See separate information for MIME and RiceWrist system | See separate information for MIME and RiceWrist system | Stationary system (robotic arm + orthosis); physical therapy | CI study: stroke (np) |
PLEMO, Kikuchi [105] | [2] | [Shoulder * elbow * (forearm) * wrist] (in the adjustable plane) | Device joint angles, end-point force | ERF brakes | Stationary system (end-effector-based); physical therapy | CI study: 6 stroke + 27 hs [85]; successor of EMUL, predecessor of Hybrid-PLEMO |
Robotherapist, Furusho [160] | 6 | Shoulder * elbow * forearm * wrist | End-point position | Electric motors + ERF clutches | Stationary system (end-effector-based); physical therapy | Prototype; see also: EMUL |
RUPERT IV, Balasubrama- nian [151] | 5 | Shoulder – AA, RT, elbow – FE, forearm – PS, wrist – FE | Joint torques and actuators pressure | Pneumatic (PAMs) | Wearable system (exoskeleton-based); physical therapy | CI study: 6 cS [86] |
Salford Arm Rehabilitation Exoskeleton, Tsagarakis [148] | 7 | Shoulder – FE, AA, RT, elbow – FE, forearm – PS, wrist – FE, AA | Joint positions and torques | Linear pneumatic actuators (PAMs) (x14) | Stationary system (exoskeleton-based); physical therapy | Prototype |
Sophia-3, Rosati [87] | 2 | Shoulder * elbow * (forearm) * wrist (in the plane) | End-point position and force | AC motors | Stationary system (end-effector-based, planar cable-driven robot); physical therapy | First prototype; see also: Sophia-4 |
Sophia-4, Rosati [87] | 2 | Shoulder * elbow * (forearm) * wrist (in the plane) | End-point position and force | DC motors | Stationary system (end-effector-based, planar cable-driven robot); physical therapy | Prototype; see also: Sophia-3 |
SUEFUL-7, Gopura [166] | 7 | Shoulder – FE, AA, RT, elbow – FE, forearm – PS, wrist – FE, AA | sEMG/joint forces/torques | DC servo motors (x7) | Stationary system (exoskeleton-based); power assistance | C0 study: 2 hs; shoulder-elbow orthosis integrated with W-EXOS system |
Takahashi [182] | 2 | Shoulder * elbow * (forearm) * wrist (in the plane) | End point position | Electric servomotors (x2) | Stationary system (end-effector-based); physical therapy | CI study: 5 stroke + 2 Guillain-Bare syndrome |
Tanaka [88] | 2 | Shoulder * elbow * (forearm) * wrist (in the plane) | End-point force and position | AC linear motor (x2) | Stationary system (end-effector-based); physical therapy | C0 study: 6 hs |
UHD, Oblak [139] | 2 | 3 configurations possible: 1) shoulder * elbow, 2) forearm – PS, wrist – FE, 3) forearm – PS, wrist – AA | Torque and handle position | DC motors (x2), (SEA) | Stationary system (end-effector-based); physical therapy | CI study: 1 cS; reconfigurable robot |
Umemura [152] | 7 | Shoulder – FE, AA, RT, elbow – FE, forearm – PS, wrist – FE, AA | Actuators pressure | Hydraulic | Stationary system (end-effector-based); physical therapy | Prototype |
UMH, Morales [127] | 6 | Shoulder * elbow * forearm * wrist | Joint torques | Pneumatic | Stationary system (two robotic arms); physical therapy | C0 study: hs (np) |
Xiu-Feng [89] | 2 | Shoulder * elbow * (forearm) * wrist (in the plane) | Device joint angles, end-point force | AC servomotors (x2) | Stationary system (end-effector-based); physical therapy | CI study: 30 stroke |
Systems assisting shoulder, elbow, forearm, wrist and finger movements (whole arm)
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6{+1} | Shoulder – FE, AA, RT, elbow – FE, forearm – PS, wrist – FE, {fingers – GR} | Joint angles, grasp force | DC motors (x6) | Stationary system (exoskeleton-based); physical therapy | ||
{7} | {Shoulder – FE, AA, RT, elbow – FE, forearm – PS, wrist – FE, fingers – GR} | Joint angles, grasp force | None | Stationary system (exoskeleton-based); physical therapy | Commercial system (CE Mark, FDA clearance); CI study: 10 MS [93]; see also: T-WREX | |
ARMOR, Mayr [177] | 8 | Shoulder – FE, AA, RT, elbow – FE, forearm – PS, wrist – FE, thumb – FE, other fingers together – FE | Joint angles of the master hand | Electric motor | Stationary master-slave system (exoskeleton-based); physical therapy | CII study: 8(8) sS |
Gentle/G, Loureiro [123] | 6{+3} | Shoulder * elbow (3 DOF, HapticMaster), {forearm – PS, wrist – FE, AA}, thumb – FE, other fingers together – FE (x2) (grasp robot) | End-point torque, position and velocity (HapticMaster) joint angels and end-point force (grasp robot) | DC brushed motors (HapticMaster and grasp robot) | Stationary system (robotic arm + orthosis); physical therapy | CII study: 4(4) sS [94]; based on Gentle/S |
HEnRiE, Mihelj [124] | 4{+2} | Shoulder * elbow (3 DOF, HapticMaster), {wrist – FE, AA}, thumb, middle and index finger together – GR | End-point torque, position and velocity (HapticMaster) joint angels and end-point force | DC brushed motors (HapticMaster) electric motors (grasping device) | Stationary system (robotic arm + orthosis); physical therapy | Prototype (with spring instead of an actuator in the hand part); C0 study: 1 hs; based on Gentle/S |
IntelliArm, Ren [116] | 8{+2} | Shoulder – FE, AA, RT, VD, {HD (x2)}, elbow – FE, forearm – PS, wrist – FE, all fingers together – GR | Joint angles and torques | Not specified | Stationary system (exoskeleton-based); physical therapy | CI study: stroke (np) |
MUNDUS, Pedrocchi [101] | [3]+{2}+1 | [Shoulder – FE, AA, elbow – FE], optional: forearm – PS, wrist – FE (shoulder-elbow-wrist exoskeleton), optional: all fingers together – GR (hand orthosis) | sEMG, button, eye-movement or Bran Computer Interface; object labels – radio frequency identification | elastic elements or DC brakes (shoulder-elbow-wrist exoskeleton), FES (optional), DC motor (optional hand orthosis) | Modular wheelchair-mounted system (exoskeleton-based); movement assistance | CI study: 3 SCI + 2 MS |
ReoGo, Motorica Medical Inc. | 2+{1} | Shoulder * elbow; also {* wrist} or {fingers - FE} if special handle used | End-point position | Electric motors (x4) | Portable system (end-effector-based) with various handles; physical therapy |
The survey
Scope of the survey
Application field and target group
Type of assistance
Term | Description |
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Active device | A device able to move limbs. Under such condition, this device requires active actuators which may increase the weight. It may also apply to subjects completely unable to move their limb. |
Passive device | A device unable to move limbs, but may resist the movement when exerted in the wrong direction. This type of device may only be used for rehabilitation of subjects able to move their limbs. It is usually lighter than active device since it possesses no actuators other than brakes. |
Haptic device | A device that interfaces with the user through the sense of touch. In most cases it provides some amount of resistive force, often also some other sensation (e.g. vibration). It is sometimes also able to generate specific movements. However, the force it generates is usually small. Haptic devices are commonly used in rehabilitation settings with virtual environments. |
Coaching device | A device that neither assists nor resists movement. However, it is able to track the movement and provide feedback related to the performance of the subject. As haptic devices, coaching devices are also commonly used in rehabilitation settings with virtual environments. |
Active exercise | An exercise in which subjects actively move their limb, although some assistance of the device may be provided. Such type of the exercise may be performed using any of the above listed types of devices. |
Passive exercise | An exercise in which the subject remains passive, while a device moves the limb. This type of exercise requires an active device. Continuous passive motion (CPM) training is an example of passive exercise with active devices. |
Mechanical design
Term | Description |
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End-effector based device | Contacts a subject’s limb only at its most distal part. It simplifies the structure of the device. However, it may complicate the control of the limb position in cases with multiple possible degrees of freedom. |
Exoskeleton-based device | A device with a mechanical structure that mirrors the skeletal structure of the limb, i.e. each segment of the limb associated with a joint movement is attached to the corresponding segment of the device. This design allows independent, concurrent and precise control of movements in a few limb joints. It is, however, more complex than an end-effector based device. Orthoses restricting or assisting movement in one or more joints may be also considered exoskeleton-based devices. |
Planar robot | A device, usually end-effector based, moving in a specific plane. Design of planar robots, decreases costs as well as the range of movements that may be exercised. Although this device performs movements in a plane, joints of the limb may still move in a three-dimensional space. |
Back-drivability | A property of mechanical design indicating that the patient is able to move the device, even when the device is in passive state. It increases patient safety, because it does not constrain limb movements and keeps patient’s limb in a comfortable position. |
Modularity | A property of a device indicating that optional parts may adapt it to a specific condition or simply to perform additional exercises. |
Reconfigurability | A property of a device indicating that its mechanical structure may be modified without adding additional parts in order to adapt it to the condition of the subject or to perform other form of training. |
Actuation and power transmission
Term | Description |
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Electric actuators | Actuators powered by electric current. They are the most common because they easily provide a relatively high power and are able to store energy. There is a wide selection of commercially available electric actuators; however, some of them are heavy and/or their impedance is too high for rehabilitation settings. |
Hydraulic actuators | Actuators powered by hydraulic pressure (usually oil). They are able to generate high forces. Their system is relatively complex considering the maintenance of pressurized oil under pressure to prevent leakage. Commercial hydraulic actuators are also heavy, therefore, only specially designed hydraulic actuators are used in rehabilitation robotics. |
Pneumatic actuators | Actuators powered by compressed air. They have lower impedance and weigh less than electric actuators. Special compressors or containers with compressed air are required for power. |
Pneumatic Artificial Muscle (PAM, McKibben type actuator) | A special type of pneumatic actuator with an internal bladder surrounded by a braided mesh shell with flexible, but non-extensible threads. Because of their specific design, an actuator under pressure shortens, similarly to the contracting muscle. It is relatively light and exerts force in a single direction. It is difficult to control because of its slow and non-linear dynamic functions. |
Series Elastic Actuator (SEA) | A generic name used for a mechanism with an elastic element placed in series with an actuator. This solution is relatively often met in the design of rehabilitation robots. It decreases the inertia and intrinsic impedance of the actuator to allow a more accurate and stable force control and increase patient safety. |
Functional Electrical Stimulation (FES) | It is a technique that uses electrical current to activate nerves and contract their innervated muscles. It produces the movement of the limb using natural actuators of the body. However, it is difficult to achieve precise and repeatable movement using this technique and it may be painful for the patient. |
Control signals
Term | Description |
---|---|
Dynamic signals | Signals related to the torque or force exerted by the subject on various joints of the device (exoskeleton-based device) or at its end effector (end-effector-based device). |
Kinematic signals | Signals related to positions, orientations, velocities and accelerations of particular segments or joints of the device or of the limb. |
Trigger signal | A signal initiating a specific action. In simple cases, a switch or a button triggers the signal. In more complex cases, a threshold value of some signal is specified to trigger the action (e.g. a sEMG value corresponding to a level of muscle contraction). |
Feedback to the user
Control strategy
Term | Description |
---|---|
“High-level” control strategy | A control strategy with control algorithms explicitly designed to induce motor plasticity. |
Assistive control | A “high-level” control strategy in which a device provides the physical assistance to aid the patient in accomplishing an intended movement. |
Challenge-based control | A “high-level” control strategy in which a device challenges the patient to accomplish an intended movement. |
Haptic stimulation | A “high-level” control strategy in which a robotic device is used as a haptic interface to perform activities in virtual reality environment. |
Couching control | A “high-level” control strategy in which a robotic device neither physically assists nor resists the movement of the subject. It only quantifies and provides feedback (visual, acoustic or other) concerning the performance of the subject during exercise. |
“Low-level” control strategy | A control strategy considered in the implementation of the “high-level” control strategy in a device by appropriate control of the force, position, impedance or admittance. |
Admittance control | A “low-level” control strategy in which the force exerted by the user is measured, and the device generates the corresponding displacement. |
Impedance control | A “low-level” control strategy in which the motion of the limb is measured and the robot provides the corresponding force feedback. |
“High-level” control strategies
Challenge-based control strategies
Haptic stimulation strategies
Non-contacting coaching strategy
“Low-level” control strategies
Clinical evidence
Clinical studies
Term | Description |
---|---|
Category 0 | Initial feasibility studies: Trials performed with low number of healthy volunteers, often using the prototype of a device, in order to evaluate its safety and clinical feasibility. |
Category I | Pilot Consideration-of-Concept studies: Clinical trials aimed at testing device safety, clinical feasibility and potential benefit. They are performed in a small population of subjects suffering from the target disease. There is either no control group in the trial, or healthy subjects are used as control. |
Category II | Development-of-Concept studies: Clinical studies aiming at verification of device efficacy. Include a standardized description of the intervention, a control group, randomization and blinded outcome assessment. |
Category III/IV | Demonstration-of-Concept-Studies/Proof-of-Concept studies: Further evaluation of the device efficacy. Similar to category II, however, usually these are multicentered studies with high number of participants. |