This paper presents a novel electromyography (EMG)-driven hand exoskeleton for bilateral rehabilitation of grasping in stroke. The developed hand exoskeleton was designed with two distinctive features: (a) kinematics with intrinsic adaptability to patient's hand size, and (b) free-palm and free-fingertip design, preserving the residual sensory perceptual capability of touch during assistance in grasping of real objects. In the envisaged bilateral training strategy, the patient's non paretic hand acted as guidance for the paretic hand in grasping tasks. Grasping force exerted by the non paretic hand was estimated in real-time from EMG signals, and then replicated as robotic assistance for the paretic hand by means of the hand-exoskeleton. Estimation of the grasping force through EMG allowed to perform rehabilitation exercises with any, non sensorized, graspable objects. This paper presents the system design, development, and experimental evaluation. Experiments were performed within a group of six healthy subjects and two chronic stroke patients, executing robotic-assisted grasping tasks. Results related to performance in estimation and modulation of the robotic assistance, and to the outcomes of the pilot rehabilitation sessions with stroke patients, positively support validity of the proposed approach for application in stroke rehabilitation.

This paper proposes a new multimodal architecture for gaze-independent brain-computer interface (BCI)-driven control of a robotic upper limb exoskeleton for stroke rehabilitation to provide active assistance in the execution of reaching tasks in a real setting scenario. At the level of action plan, the patient's intention is decoded by means of an active vision system, through the combination of a Kinect-based vision system, which can online robustly identify and track 3-D objects, and an eye-tracking system for objects selection. At the level of action generation, a BCI is used to control the patient's intention to move his/her own arm, on the basis of brain activity analyzed during motor imagery. The main kinematic parameters of the reaching movement (i.e., speed, acceleration, and jerk) assisted by the robot are modulated by the output of the BCI classifier so that the robot-assisted movement is performed under a continuous control of patient's brain activity. The system was experimentally evaluated in a group of three healthy volunteers and four chronic stroke patients. Experimental results show that all subjects were able to operate the exoskeleton movement by BCI with a classification error rate of 89.4±5.0% in the robot-assisted condition, with no difference of the performance observed in stroke patients compared with healthy subjects. This indicates the high potential of the proposed gaze-BCI-driven robotic assistance for neurorehabilitation of patients with motor impairments after stroke since the earliest phase of recovery.

In this paper we propose a full upper limb exoskeleton for motor rehabilitation of reaching, grasping and releasing in post-stroke patients. The presented system takes into account the hand pre-shaping for object affordability and it is driven by patient's intentional control through a self-paced asynchronous Motor Imagery based Brain Computer Interface (MI-BCI). The developed antropomorphic eight DoFs exoskeleton (two DoFs for the hand, two for the wrist and four for the arm) allows full support of the manipulation activity at the level of single upper limb joint. In this study, we show the feasibility of the proposed system through experimental rehabilitation sessions conducted with three chronic post-stroke patients. Results show the potential of the proposed system for being introduced in a rehabilitation protocol.