Anticipatory assistance-as-needed control algorithm for a multijoint upper limb robotic orthosis in physical neurorehabilitation

Robotic devices are becoming a popular alternative to the traditional physical therapy as a mean to enhance functional recovery after stroke; they offer more intensive practice opportunities without increasing time spent on supervision by the treating therapist. An ideal behavior for these systems would consist in emulating real therapists by providing anticipated force feedback to the patients in order to encourage and modulate neural plasticity. However, nowadays there are no systems able to work in an anticipatory fashion. For this reason, the authors propose an anticipatory assistance-as-needed control algorithm for a multijoint robotic orthosis to be used in physical ABI neurorehabilitation. This control algorithm, based on a dysfunctional-adapted biomechanical prediction subsystem, is able to avoid patient trajectory deviations by providing them with anticipatory force-feedback. The system has been validated by means of a robotic simulator. Obtained results demonstrate through simulations that the proposed assistance-as-needed control algorithm is able to provide anticipatory actuation to the patients, avoiding trajectory deviations and tending to minimize the degree of actuation. Thus, the main novelty and contribution of this work is the anticipatory nature of the proposed assistance-as-needed control algorithm, that breaks with the current robotic control strategies by not waiting for the trajectory deviations to take place. This new actuation paradigm avoids patient slacking and increases both participation and muscle activity in such a way that neural plasticity is encouraged and modulated to reinforce motor recovery.