Rehabilitation robotics is a field of research dedicated to understanding and augmenting
rehabilitation through the application of
robotic
Robotics is the interdisciplinary study and practice of the design, construction, operation, and use of robots.
Within mechanical engineering, robotics is the design and construction of the physical structures of robots, while in computer s ...
devices. Rehabilitation robotics includes development of robotic devices tailored for assisting different sensorimotor functions(e.g. arm, hand, leg, ankle
[), development of different schemes of assisting therapeutic training, and assessment of sensorimotor performance (ability to move) of patient; here, robots are used mainly as therapy aids instead of assistive devices.] Rehabilitation using robotics is generally well tolerated by patients, and has been found to be an effective adjunct to therapy in individuals with motor impairments, especially due to stroke
Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...
.
Overview
Rehabilitation robotics can be considered a specific focus of biomedical engineering
Biomedical engineering (BME) or medical engineering is the application of engineering principles and design concepts to medicine and biology for healthcare applications (e.g., diagnostic or therapeutic purposes). BME also integrates the logica ...
, and a part of human-robot interaction. In this field, clinicians, therapists, and engineers collaborate to help rehabilitate patients.
Prominent goals in the field include: developing implementable technologies that can be easily used by patients, therapists, and clinicians; enhancing the efficacy of clinician's therapies; and increasing the ease of activities in the daily lives of patients.
History
Early Developments (1960s–1980s)
The origins of rehabilitation robotics can be traced to early research in exoskeletons and powered orthoses. In the 1960s, the first powered exoskeletons, such as the Hardiman project by General Electric
General Electric Company (GE) was an American Multinational corporation, multinational Conglomerate (company), conglomerate founded in 1892, incorporated in the New York (state), state of New York and headquartered in Boston.
Over the year ...
, were developed, though they were primarily intended for military applications. By the 1980s, research shifted toward medical applications, with early robotic aids designed to assist stroke patients and individuals with spinal cord injuries.
Growth and Clinical Applications (1990s–2000s)
The 1990s saw the introduction of dedicated robotic rehabilitation devices. One of the most notable early systems was th
MIT-Manus
developed at the Massachusetts Institute of Technology
The Massachusetts Institute of Technology (MIT) is a Private university, private research university in Cambridge, Massachusetts, United States. Established in 1861, MIT has played a significant role in the development of many areas of moder ...
, which provided robotic-assisted therapy for stroke patients. Around the same time, Lokomat, a robotic gait training system developed by Hocoma, revolutionized lower-limb rehabilitation by enabling repetitive, intensive walking therapy.
During the 2000s, the field expanded significantly, integrating robotics with neuroplasticity research to enhance patient recovery. The use of robotic therapy was supported by studies showing improved outcomes for patients undergoing post-stroke rehabilitation. Key advancements included the introduction of brain-computer interfaces (BCIs) to improve control mechanisms and adaptive algorithms to tailor therapy to individual needs.
Modern Advances (2010s–Present)
In the 2010s, rehabilitation robotics evolved with the advent of soft robotics, wearable exoskeletons, and AI-driven rehabilitation strategies. Companies and research institutions developed lightweight, portable devices, such as the ReWalk and Ekso Bionics exoskeletons, to assist individuals with mobility impairments in regaining movement.
Recent trends include the integration of virtual reality (VR) and machine learning to personalize rehabilitation programs further. Tele-rehabilitation, allowing remote monitoring and therapy using robotic systems, has gained traction, particularly following the COVID-19 pandemic, which accelerated the need for remote healthcare solutions.
Function
Designers develop rehabilitation robots with applications of techniques that determine the adaptability
Adaptability ( "fit to, adjust") is a feature of a system or of a process. This word has been put to use as a specialised term in different disciplines and in business operations. Word definitions of adaptability as a specialised term differ littl ...
level of the patient. Techniques include but are not limited to: active assisted exercise, active constrained exercise, active resistive exercise, passive exercise, and adaptive exercise. In active assisted exercise, the patient moves his or her hand in a predetermined pathway without any force pushing against it. Active constrained exercise is the movement of the patient's arm with an opposing force; if it tries to move outside of what it is supposed to. Active resistive exercise involves movement with opposing forces.
Over the years the number of rehabilitation robotics has grown but they are very limited due to the clinical trials. Many clinics have trials but do not accept the robots because they wish they were remotely controlled. Having robots involved in the rehabilitation of a patient has a few positive aspects. One of the positive aspects involves the potential repetition of the process or exercise as many times as required. Another positive aspect is the availability of exact measurements of patient improvement or decline. Exact measurements can come from the sensors on the device. While the device is taking a measurement you need to be careful because the device can be disrupted once it is done because of the different movements the patient does to get out. The rehabilitation robot can apply constant therapy for long periods. In the process of a recovery the rehabilitation robot is unable to understand the patient's needs like a well-experienced therapist would. The robot is unable to understand now, but in the future the device will be able to understand. Another plus of having a rehabilitation robot is that there is no physical effort put into work by the therapist.
Lately, rehabilitation robotics have been used in training in medicine, surgery, remote surgery
Remote surgery (also known as cybersurgery or telesurgery) is the ability for a doctor to perform surgery on a patient even though they are not physically in the same location. It is a form of telepresence. A robot surgical system generally cons ...
and other areas, but there have been too many complaints about the robot not being controlled by a remote. Many people might think that an industrial robot
An industrial robot is a robot system used for manufacturing. Industrial robots are automated, programmable and capable of movement on three or more axes.
Typical applications of robots include robot welding, welding, painting, assembly, Circu ...
could function like a rehabilitation robot, but this is not true. Rehabilitation robots need to be adjustable and programmable, because the robot may be used for multiple purposes. On the other hand, an industrial robot is always the same; there is no need to change the robot unless the product it is working with is bigger or smaller. In order for an industrial robot to work it would have to be more adjustable to its new task.
Types of robots
There are primarily two types of robots that can be used for rehabilitation: End-effector based robots and powered exoskeletons. Each system has their own advantages and limitations. End-effector systems are faster to set up and are more adaptable. On the other hand, exoskeletons offer more precise joint isolation and improve gait transparency.
Current areas of research
Current robotic devices include exoskeletons for aiding limb or hand movement, enhanced treadmills, robotic arms to retrain motor movement of the limb, and finger rehabilitation devices. Some devices are meant to aid strength development of specific motor movements, while others seek to aid these movements directly. Often robotic technologies attempt to leverage the principles of neuroplasticity
Neuroplasticity, also known as neural plasticity or just plasticity, is the ability of neural networks in the brain to change through neurogenesis, growth and reorganization. Neuroplasticity refers to the brain's ability to reorganize and rewir ...
by improving quality of movement, and increasing the intensity and repetition of the task. Over the last two decades, research into robot mediated therapy for the rehabilitation of stroke
Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...
patients has grown significantly as the potential for cheaper and more effective therapy has been identified. Though stroke
Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...
has been the focus of most studies due to its prevalence in North America, rehabilitation robotics can also be applied to individuals (including children) with cerebral palsy
Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, spasticity, stiff muscles, Paresis, weak muscles, and tremors. There may b ...
, or those recovering from orthopedic surgery
Orthopedic surgery or orthopedics ( alternative spelling orthopaedics) is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...
.
An additional benefit to this type of adaptive robotic therapy is a marked decrease in spasticity
Spasticity () is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles. ...
and muscle tone
In physiology, medicine, and anatomy, muscle tone (residual muscle tension or tonus) is the continuous and passive partial contraction of the muscles, or the muscle's resistance to passive stretch during resting state.O’Sullivan, S. B. (2007) ...
in the affected arm. Different spatial orientations of the robot allow for horizontal or vertical motion, or a combination in a variety of planes. The vertical, anti-gravity setting is particularly useful for improving shoulder and elbow function.
See also
* Hybrid Assistive Limb
The Hybrid Assistive Limb (also known as HAL) is a powered, soft-bodied exoskeleton suit developed by Japan's Tsukuba University and the robotics company Cyberdyne. It is designed to support and expand the physical capabilities of its users, p ...
* Rehabilitation engineering
* Robotics
Robotics is the interdisciplinary study and practice of the design, construction, operation, and use of robots.
Within mechanical engineering, robotics is the design and construction of the physical structures of robots, while in computer s ...
* Prosthetics
In medicine, a prosthesis (: prostheses; from ), or a prosthetic implant, is an artificial device that replaces a missing body part, which may be lost through physical trauma, disease, or a condition present at birth (congenital disorder). Prosthe ...
References
Further reading
*
*{{cite book , title=Rehabilitation Engineering Applied to Mobility and Manipulation , year=1995 , first=Rory A. , last=Cooper , bibcode=1995ream.book.....C
*Gimigliano F, Palomba A, Arienti C, et al. Robot-assisted arm therapy in neurological health conditions: rationale and methodology for the evidence synthesis in the CICERONE Italian Consensus Conference. Eur J Phys Rehabil Med. 2021 Jun 15. doi: 10.23736/S1973-9087.21.07011-8. Epub ahead of print. PMID 34128606.
External links
*International Conference for Rehabilitation Robotics http://icorr2019.org/
*Journal of NeuroEngineering and Rehabilitation: http://www.jneuroengrehab.com/
*IEEE Robotics and Automation Society special issue on rehabilitation robotics: https://web.archive.org/web/20121022224415/http://www.ieee-ras.org/issue/rehabilitation-robotics.html
*IEEE RAS Technical Committee on Rehabilitation & Assistive Robotics.: https://web.archive.org/web/20101204064448/http://tab.ieee-ras.org/committeeinfo.php?tcid=18
*IEEE EMBS Transactions on Neural Robotics and Engineering: https://www.embs.org/tnsre/
Assistive technology
Medical robotics