This research presents an Assist-as-Needed (AAN) Algorithm for controlling a bio-inspired exoskeleton, specifically designed to aid in elbow-rehabilitation exercises. The algorithm is based on a Force Sensitive Resistor (FSR) Sensor and utilizes machine-learning algorithms that are personalized to each patient, allowing them to complete the exercise by themselves whenever possible. The system was tested on five participants, including four with Spinal Cord Injury and one with Duchenne Muscular Dystrophy, with an accuracy of $91.22\%$. In addition to monitoring the elbow range of motion, the system uses Electromyography signals from the biceps to provide patients with real-time feedback on their progress, which can serve as a motivator to complete the therapy sessions. The study has two main contributions: (1) providing patients with real-time, visual feedback on their progress by combining range of motion and FSR data to quantify disability levels, and (2) developing an assist-as-needed algorithm for rehabilitative support of robotic/exoskeleton devices.

Neuromuscular and sensorimotor degeneration caused by stroke or any other disease significantly reduce the physical, cognitive, and social well-being across the life span. Mostly, therapeutic interventions are employed in order to restore the lost degrees-of-freedom (DOF) caused by such impairments and automating these therapeutic tasks through exoskeletons/robots is becoming a common practice. However, aligning these robotic devices with the complex anatomical and geometrical motions of the joints is very challenging. At the same time, a good alignment is required in order to establish a better synergy of human-exoskeleton system for an effective intervention procedure. In this paper, a case study of an exoskeleton and shoulder joint alignment were studied through different size and orientation impairment models through motion capture data and musculoskeletal modeling in OpenSim. A preliminary result indicates that shoulder elevation is very sensitive to misalignment and varies with shoulder joint axes orientation; this is partly due to drastic displacement of the upper arm axes with respect to the shoulder joint origin during elevation. Additional study and analysis is required to learn any possible restraint on shoulder elevation that could potentially help in the exoskeleton development.

This paper presents an adaptive Fuzzy Sliding Mode Control approach for an Assist-as-Needed (AAN) strategy to achieve effective human–exoskeleton synergy. The proposed strategy employs an adaptive instance-based learning algorithm to estimate muscle effort, based on surface Electromyography (sEMG) signals. To determine and control the inverse dynamics of a highly nonlinear 4-degrees-of-freedom exoskeleton designed for upper-limb therapeutic exercises, a modified Recursive Newton-Euler Algorithm (RNEA) with Sliding Mode Control (SMC) was used. The exoskeleton position error and raw sEMG signal from the bicep’s brachii muscle were used as inputs for a fuzzy inference system to produce an output to adjust the sliding mode control law parameters. The proposed robust control law was simulated using MATLAB-Simulink, and the results showed that it could instantly adjust the necessary support, based on the combined motion of the human–exoskeleton system’s muscle engagement, while keeping the state trajectory errors and input torque bounded within $\pm 5\times {10}^{-2}$ rads and $\pm 5$ N.m, respectively.

Human-exoskeleton misalignment could lead to permanent damages upon the targeted limb with long-term use in rehabilitation. Hence, achieving proper alignment is necessary to ensure patient safety and an effective rehabilitative journey. In this study, a joint-based and task-based exoskeleton for upper limb rehabilitation were modeled and assessed. The assessment examined and quantified the misalignment present at the elbow joint as well as its effects on the main flexor and extensor muscles’ tendon length during elbow flexion-extension. The effects of the misalignments found for both exoskeletons resulted to be minimal in most muscles observed, except the anconeus and brachialis. The anconeus muscle demonstrated a relatively higher variation in tendon length with the joint-based exoskeleton misalignment, indicating that the task-based exoskeleton is favored for tasks that involve this particular muscle. Moreover, the brachialis demonstrated a significantly higher variation with the task-based exoskeleton misalignment, indicating that the joint-based exoskeleton is favored for tasks that involve the muscle.