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Hybrid FES–robotic gait rehabilitation technologies: a review on mechanical design, actuation, and control strategies

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Abstract

Gait disorders in neurologically disabled people can be treated by various techniques available today which include passive orthoses, functional electrical stimulation (FES) and robot assisted gait training devices (RAGT). However, each system has its own drawback. For example, gait rehabilitation with orthosis is physically taxing for the patient with no significant functional improvement. FES uses muscle powers as physiological actuators to promote balance and improve gait but leads to fatigue, along with poor control of joint trajectories. RAGT devices including powered exoskeletons, gait rehabilitation systems employing programmable footplates and mobile training platforms, have shown significant advantages but the devices are not yet mature due to numerous drawbacks associated with physical and cognitive interaction, energy-management and portability issues. The combination of FES technology and RAGT devices, often named hybrid FES–robot technologies, has arisen as a promising approach to aid in gait restoration. This work reports a comprehensive review on the hybrid FES–robot technologies over the last decades, focusing on different mechanical structures, actuator designs, sensing technologies, and control approaches. The hybrid robotic structures are classified into two categories: (i) orthotic-based hybrid systems, where (a) FES is used to stimulate the muscles and produce joint torque while the robotic system acts as energy dissipating device, and (b) FES and robotic systems are both torque-generating devices; and (ii) non-orthotic based hybrid systems. The review compiles a variety of sources and illustrates the technology’s most important challenges in the fields of hybrid rehabilitation robotics which may contribute towards further development of hybrid robot systems.

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Fig. 1

Retrieved from (Goldfarb et al. 2003)

Fig. 2

Retrieved from (Sharma et al. 2014)

Fig. 3

Retrieved from (Chang et al. 2017)

Fig. 4

Retrieved from (Krishnamoorthy et al. 2008)

Fig. 5

Retrieved from (Kobetic et al. 2009)

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Retrieved from (Schmidt et al. 2007)

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Retrieved from (Vallery et al. 2005)

Fig. 8

Retrieved from (Obinata et al. 2007)

Fig. 9

Retrieved from (Metrailler et al. 2006)

Fig. 10

Retrieved from (Schuck et al. 2012) and (Querry et al. 2008)

Fig. 11

Retrieved from (Stauffer et al. 2009)

Fig. 12

Retrieved from (Poboroniuc et al. 2009)

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Retrieved from (Quintero et al. 2011)

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Retrieved from (To et al. 2011)

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Retrieved from (Kurokawa et al. 2012)

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Retrieved from (Chen et al. 2013)

Fig. 17

Retrieved from (Kirsch et al. 2014)

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Retrieved from (del-Ama et al. 2014)

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Retrieved from (Ren et al. 2014)

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Retrieved from (Tu et al. 2016)

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Retrieved from (Cikajlo et al. 2007)

Fig. 22

Retrieved from (Hacoma 2017)

Fig. 23

Retrieved from (Ye et al. 2014)

Fig. 24

Retrieved from (Bellman et al. 2017)

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Abbreviations

FES:

Functional electrical stimulation

RAGT:

Robot assisted gait training

CBO:

Controlled-brake orthosis

SBO:

Spring-brake orthosis

GBO:

Gravity balanced orthosis

JCO:

Joint-coupled orthosis

ESO:

Energy storing orthosis

VCHM:

Variable constraint hip mechanism

SEAHO:

Semi-active hybrid orthosis

IMU:

Inertial measurement units

HyPO:

Hybrid powered orthosis

FES-IM:

Intramuscular functional electrical stimulation

BWS:

Body weight support

PID:

Proportional-integral-derivative

VIKM:

Variable impedance knee mechanism

HNP:

Hybrid neuroprosthesis

GT-FES:

Gait trainer with functional electrical stimulation

CT:

Conventional therapy

AFO:

Ankle-foot orthosis

LEE:

Lower-extremity exoskeleton

BLERE:

Bionic lower extremity rehabilitation exoskeleton

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Funding

The work was funded in part by the FRC Tier 1 Grant R-397-000-218-112, Faculty of Engineering, National University of Singapore, and in part by the NMRC B&B Grant No. NMRC/BnB/0019b/2015, Ministry of Health, Singapore.

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  1. Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore, 117575, Singapore

    Francisco Anaya, Pavithra Thangavel & Haoyong Yu

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Anaya, F., Thangavel, P. & Yu, H. Hybrid FES–robotic gait rehabilitation technologies: a review on mechanical design, actuation, and control strategies. Int J Intell Robot Appl 2, 1–28 (2018). https://doi.org/10.1007/s41315-017-0042-6

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  • DOI: https://doi.org/10.1007/s41315-017-0042-6

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