Neuro-muscular disorders and diseases such as cerebral palsy and Duchenne Muscular Dystrophy can severely limit a person’s ability to perform activities of daily living (ADL). Exoskeletons can provide an active or passive support solution to assist these groups of people to perform ADL. This study presents an artificial neural network-trained adaptive controller mechanism that uses surface electromyography (sEMG) signals from the human forearm to detect hand gestures and navigate an in-house-built wheelchair-mounted upper limb robotic exoskeleton based on the user’s intent while ensuring safety. To achieve the desired position of the exoskeleton based on human intent, 10 hand gestures were recorded from 8 participants without upper limb movement disabilities. Participants were tasked to perform water bottle pick and place activities while using the exoskeleton, and sEMG signals were collected from the forearm and processed through root mean square, median filter, and mean feature extractors prior to training a scaled conjugate gradient backpropagation artificial neural network. The trained network achieved an average of more than 93% accuracy, while all 8 participants who did not have any prior experience of using an exoskeleton were successfully able to perform the task in less than 20 s using the proposed artificial neural network-trained adaptive controller mechanism. These results are significant and promising thus could be tested on people with muscular dystrophy and neuro-degenerative diseases.

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.

Distraction osteogenesis (DO) is an emerging method for bone tissue reconstruction. In oral and maxillofacial reconstruction applications, DO is playing an important role as a technique without the need of bone graft. In addition, in a DO treatment procedure, a superior outcome could be achieved compared to conventional reconstruction techniques. Recently, a few automatic continuous distraction osteogenesis (ACDO) devices have been designed and developed to be used in human reconstruction applications. Experiments and animal studies have validated the functionality of the developed ACDO devices. It has shown that by using such ACDO devices in a DO procedure, compared to conventional manual DO methods, superior outcomes could be obtained. However, the application of such ACDO devices is still limited. More research and investigation need to be undertaken to study all requirements of ACDO devices to be used in successful human mandibular DO treatment. It is important to determine all requirements and standards that need to be considered and applied in the design and development of ACDO devices. The purpose of this review paper is to highlight the designed and developed ACDO procedures thus far in terms of their working principles, working parameters, and technical aspects for providing a better perspective of the development progress of ACDO devices for oral and maxillofacial reconstruction applications. In this paper, design principles, device specifications, and working parameters of ACDO devices are compared and discussed. Subsequently, current limitations and gaps have been addressed, and future works for enabling an ultimate automatic DO procedure have been suggested.

Distraction osteogenesis (DO) is a novel technique widely used in human body reconstruction. DO has got a significant role in maxillofacial reconstruction applications (MRA); through this method, bone defects and skeletal deformities in various cranio-maxillofacial areas could be reconstructed with superior results in comparison to conventional methods. Recent studies revealed in a DO solution, using an automatic continuous distractor could significantly improve the results while decreasing the existing issues. This study is aimed at designing and developing a novel automatic continuous distraction osteogenesis (ACDO) device to be used in the MRA. The design is comprised of a lead screw translation mechanism and a stepper motor, placed outside of the mouth to generate the desired continuous linear force. This externally generated and controlled distraction force (DF) is transferred into the moving bone segment via a flexible miniature transition system. The system is also equipped with an extra-oral ACDO controller, to generate an accurate, reliable, and stable continuous DF. Simulation and experimental results have justified the controller outputs and the desired accuracy of the device. Experiments have been conducted on a sheep jaw bone and results have showed that the developed device could offer a continuous DF of 38 N with distraction accuracy of 7.6 nm on the bone segment, while reducing the distraction time span. Continuous DF with high resolution positioning control, along with the smaller size of the distractor placed in the oral cavity will help in improving the result of the reconstruction operation and leading to a successful DO procedure in a shorter time period. The developed ACDO device has less than 1% positioning error while generating sufficient DF. These features make this device a suitable distractor for an enhanced DO treatment in MRA.