Multidisciplinary collaboration on exoskeleton development adopting user-centered design: a systematic integrative review

Purpose: The world population is ageing, along with an increasing possibility of functional limitations that affect independent living. Assistive technologies such as exoskeletons for rehabilitative purposes and daily activities assistance maintaining the independence of people with disabilities, especially older adults who wish to ageing-in-place. The purpose of this systematic integrative review was threefold: to explore the development team compositions and involvement, to understand the recruitment and engagement of stakeholders, and to synthesise reported or anticipated consequences of multidisciplinary collaboration.Methods: Databases searched included PubMed, CINAHL Plus, PsycINFO, Web of Science, Scopus, and IEEE Xplore. A total of 34 studies that reported the development of exoskeleton adopting user-centered design (UCD) method in healthcare or community settings that were published in English from 2000 to July 2022 were included.Results: Three major trends emerged from the analysis of included studies. First, there is a need to redefine multidisciplinary collaboration, from within-discipline collaboration to cross-discipline collaboration. Second, the level of engagement of stakeholders during the exoskeleton development remained low. Third, there was no standardised measurement to quantify knowledge production currently.Conclusion: As suggested by the synthesised results in this review, exoskeleton development has been increasing to improve the functioning of people with disabilities. Exoskeleton development often required expertise from different disciplines and the involvement of stakeholders to increase acceptance, thus we propose the Multidisciplinary Collaboration Appraisal Tool to assess multidisciplinary collaboration using the UCD approach. Future research is required to understand the effectiveness of multidisciplinary collaboration on exoskeleton development using the UCD approach.IMPLICATIONS FOR REHABILITATIONGlobal trend of population ageing causes a higher risk of disability in older adults who require rehabilitation and assistance in daily living.Assistive technologies such as exoskeletons have the potential to contribute to rehabilitation training and daily activity assistance demand closer multidisciplinary collaboration.A Multidisciplinary Collaboration Appraisal Tool using user-centered design approach (MCAT) is proposed to understand the effectiveness as well as limitations and barriers associated with multidisciplinary collaboration in developing exoskeletons.

An Optimized Stimulation Control System for Upper Limb Exoskeleton Robot-Assisted Rehabilitation Using a Fuzzy Logic-Based Pain Detection Approach

The utilization of robotic systems in upper limb rehabilitation has shown promising results in aiding individuals with motor impairments. This research introduces an innovative approach to enhance the efficiency and adaptability of upper limb exoskeleton robot-assisted rehabilitation through the development of an optimized stimulation control system (OSCS). The proposed OSCS integrates a fuzzy logic-based pain detection approach designed to accurately assess and respond to the patient's pain threshold during rehabilitation sessions. By employing fuzzy logic algorithms, the system dynamically adjusts the stimulation levels and control parameters of the exoskeleton, ensuring personalized and optimized rehabilitation protocols. This research conducts comprehensive evaluations, including simulation studies and clinical trials, to validate the OSCS's efficacy in improving rehabilitation outcomes while prioritizing patient comfort and safety. The findings demonstrate the potential of the OSCS to revolutionize upper limb exoskeleton-assisted rehabilitation by offering a customizable and adaptive framework tailored to individual patient needs, thereby advancing the field of robotic-assisted rehabilitation.

Lightweight Soft Robotic Glove with Whole-Hand Finger Motion Tracking for Hand Rehabilitation in Virtual Reality

Soft robotic gloves have attracted significant interest in hand rehabilitation in the past decade. However, current solutions are still heavy and lack finger-state monitoring and versatile treatment options. To address this, we present a lightweight soft robotic glove actuated by twisted string actuators (TSA) that provides whole-hand finger motion tracking. We have developed a virtual reality environment for hand rehabilitation training, allowing users to interact with various virtual objects. Fifteen small inertial measurement units are placed on the glove to predict finger joint angles and track whole-hand finger motion. We performed TSA experiments to identify design and control rules, by understanding how their response varies with input load and voltages. Grasping experiments were conducted to determine the grasping force and range of motion. Finally, we showcase an application of the rehabilitation glove in a Unity-based VR interface, which can actuate the operator's fingers to grasp different virtual objects.

Design, Control, and Experimental Evaluation of A Novel Robotic Glove System for Patients with Brachial Plexus Injuries

This paper presents the development of an exoskeleton glove system for people who suffer from brachial plexus injuries, aiming to assist their lost grasping functionality. The robotic system consists of a portable glove system and an embedded controller. The glove system consists of Linear Series Elastic Actuators (LSEA), Rotary Series Elastic Actuators (RSEA), and optimized finger linkages to provide imitated human motion to each finger and a coupled motion of the hand. The design principles and optimization strategies were investigated to balance functionality, portability, and stability. The model-based force control strategy compensated with a backlash model and model-free force control strategy are presented and compared. Results show that our proposed model-free control method achieves the goal of accurate force control. Finally, experiments were conducted with the prototype of the developed integrated exoskeleton glove system. Results from 3 subjects with 150 trials show that our proposed exoskeleton glove system has the potential to be used as a rehabilitation device for patients.