Physical therapy keeps exploiting more and more the capabilities of the robot of adapting the treatments to patients’ needs. This paper aims at presenting a psychophysiological-aware control strategy for upper limb robot-aided orthopedic rehabilitation. The main features are the capability of i) generating point-to-point trajectories inside an adaptable workspace, ii) providing assistance in guiding the patients’ limbs in accomplishing the assigned task allowing them to freely move with a certain degree of spatial and temporal autonomy and iii) tuning the control parameters according to the patients’ kinematics performance and psychophysiological state. The implemented control strategy is validated in a real clinical setting on eight orthopedic patients undergoing twenty daily robot-aided rehabilitation sessions. The psychophysiological-aware control strategy evidenced a positive impact on the enrolled participants since they are effectively conducted in a calmer condition with respect to the patients who did not receive the psychophysiological adaptation. Moreover, clinical performance indicators suggest that the proposed tailored control strategy improves motor functions.

The design of patient-tailored rehabilitative protocols represents one of the crucial factors that influence motor recovery mechanisms, such as neuroplasticity. This approach, including the patient in the control loop and characterized by a control strategy adaptable to the user's requirements, is expected to significantly improve functional recovery in robot-aided rehabilitation. In this paper, a novel 3D bio-cooperative robotic platform is developed. A new arm-weight support system is included into an operational robotic platform for 3D upper limb robot-aided rehabilitation. The robotic platform is capable of adapting therapy characteristics to specific patient needs, thanks to biomechanical and physiological measurements, and thus closing the subject in the control loop. The level of arm-weight support and the level of the assistance provided by the end-effector robot are varied on the basis of muscular fatigue and biomechanical indicators. An assistance-as-needed approach is applied to provide the appropriate amount of assistance. The proposed platform has been experimentally validated on 10 healthy subjects; they performed 3D point-to-point tasks in two different conditions, i.e., with and without assistance-as-needed. The results have demonstrated the capability of the proposed system to properly adapt to real needs of the patients. Moreover, the provided assistance was shown to reduce the muscular fatigue without negatively influencing motion execution.

The widespread adoption of robotic technologies in healthcare has opened up new perspectives for enhancing accuracy, effectiveness and quality of medical procedures and patients’ care. Special attention has been given to the reliability of robots when operating in environments shared with humans and to the users’ safety, especially in case of mobile platforms able to navigate autonomously. From the analysis of the literature, it emerges that navigation tests carried out in a hospital environment are preliminary and not standardized. This paper aims to overcome the limitations in the assessment of autonomous mobile robots navigating in hospital environments by proposing: (i) a structured benchmarking protocol composed of a set of standardized tests, taking into account conditions with increasing complexity, (ii) a set of quantitative performance metrics. The proposed approach has been used in a realistic setting to assess the performance of two robotic platforms, namely HOSBOT and TIAGo, with different technical features and developed for different applications in a clinical scenario.

Pedicle screw fixation is a fundamental surgical procedure which requires high accuracy and strength from the surgeon who may be exposed to uncomfortable postures and muscular fatigue. The objective of this paper is to propose a novel approach to robot-aided pedicle screw fixation based on a Surgeon-Robot Shared control that makes the tapping procedure i.e. threading the patient's pedicle, semi-autonomous. The surgeon continues to have a full control over the surgical intervention by i) accurately move the robot end-effector using a hands-on control interface, i.e. the surgical tapper, along a pre-planned axis, ii) continuously controlling the forces exerted onto the patient spine during the tapping phase, iii) modulating the torque about the tapping axis by adequately tuning the tool-bone interaction force along the same axis. Furthermore, the procedure appears to be more comfortable and less tiring for the surgeon. The proposed approach was tested on eight subjects who were asked to perform the tapping procedure onto an anthropomorphic spine phantom. A comparative analysis among the proposed approach and the ones typically adopted in literature to perform pedicle screw placement was carried out. The experimental results demonstrated that proposed approach, with respect to the traditional robot-aided procedure, guarantees comparable accuracy and efficiency in the screw placement and lower fatigue and more comfortable postures for the surgeon.

The communication channels between physiotherapists and patients are many and varied. Rehabilitation robots are able to deliver intensive treatments and improve the patient's quality of life. However, rehabilitation robots in the literature do not integrate physical manipulation with natural verbal communication yet. This article proposes an innovative integrated system for motor rehabilitation based on the combination of physical and cognitive components to emulate the natural interaction between physiotherapists and patients. The proposed approach was validated in a laboratory setting with 20 healthy subjects. The cognitive system's ability to interact linguistically as well as the participants' kinematic performance and the emotional impact generated by two different robotic systems were assessed. The former integrates advanced linguistic capabilities and the latter lacks any verbal communication. The results showed that the presence of linguistic interaction promotes the quality of interaction, leading to improvements both in the execution of movements and in emotional terms.