Robotic Rehabilitation Apparatus and Method

Abstract

This patent describes an 8+2 degrees of freedom (DOF) intelligent rehabilitation robot capable of controlling the shoulder, elbow, wrist and fingers individually and allowing functional arm movements with accompanying trunk and scapular motions. The rehabilitation robot uses the following integrated rehabilitation approach: 1) it has unique diagnostic capabilities to determine patient-specific multiple joint and/or multiple DOF biomechanical and neuromuscular changes; 2) it stretches the stiff joints/DOFs under intelligent control to loosen up the specific stiff joints and to reduce excessive cross-coupling torques/movements between the specific joints/DOFs, which can be done based on the above diagnosis for subject-specific treatment; 3) the patients practice voluntary reaching and some functional tasks to regain/improve their motor control capability, which can be done after the stretching loosened up the stiff joints; and 4) the outcome will be evaluated quantitatively at the levels of individual joints, multiple joints/DOFs, and the whole arm.

1 . A process comprising:
 providing a human interface machine that comprises
 a first joint that includes
 a plurality of degrees of freedom, 
 a force/torque sensor positioned to measure the force/torque of the plurality of degrees of freedom, and 
 a motor positioned to move the first joint about at least one of the plurality of degrees of freedom, and 
 
 a second joint that includes
 a plurality of degrees of freedom, 
 a force/torque sensor positioned to measure the force/torque of the plurality of degrees of freedom, and 
 a motor positioned to move the second joint about at least one of the plurality of degrees of freedom; 
 
   actuating the first joint about at least one degree of freedom, while measuring the forces/torques applied to a patient's first joint, and while measuring the forces/torques applied to a patient's second joint; and   actuating the second joint about at least one degree of freedom, while measuring the forces/torques applied to a patient's first joint, and while measuring the forces/torques applied to a patient's second joint.   
     
     
         2 . The process of  claim 1  further comprising repeating the actuation of the first joint and repeating the actuation of the second joint. 
     
     
         3 . The process of  claim 1 , wherein actuating the first joint includes holding the second joint at a fixed position. 
     
     
         4 . The process of  claim 1 , wherein actuating the second joint includes holding the first joint at a fixed position. 
     
     
         5 . The process of  claim 1 , wherein the human interface machine includes a third joint that includes a plurality of degrees of freedom, a force/torque sensor positioned to measure the force/torque of the plurality of degrees of freedom, and a plurality of motors positioned to move about at least two of the plurality of degrees of freedom;
 wherein the first joint is actuated about at least one degree of freedom while holding the second joint and third joint at fixed positions, while measuring the forces/torques applied to a patient's first joint, while measuring the forces/torques applied to a patient's second joint, and while measuring the forces/torques applied to a patient's third joint; and   wherein the second joint is actuated about at least one degree of freedom while holding the first joint and third joint at fixed positions, while measuring the forces/torques applied to a patient's first joint, while measuring the forces/torques applied to a patient's second joint, and while measuring the forces/torques applied to a patient's third joint.   
     
     
         6 . The process of  claim 5  further comprising:
 actuating the third joint about at least one degree of freedom while holding the first joint and second joint at fixed positions, while measuring the forces/torques applied to a patient's first joint, while measuring the forces/torques applied to a patient's second joint, and while measuring the forces/torques applied to a patient's third joint. 
 
     
     
         7 . The process of  claim 6 , wherein the first joint is a wrist joint; wherein the second joint is an elbow joint; and where in the third joint is a shoulder joint. 
     
     
         8 . The process of  claim 1 , wherein the first and second joints are actuated by the motors. 
     
     
         9 . A process comprising:
 executing a multi-joint/multi-degree of freedom diagnosis that includes
 positioning a patient in a human interface machine that includes
 an arm brace having a temporary attachment element adapted to temporarily attach a human arm; the arm brace disposed to move with the human arm while attached and jointed such that an arm joint can move through a first degree of freedom and at least one other degree of freedom; 
 an elbow joint affixed to the upper arm length adjustment including an elbow motor and an elbow force/torque sensor; 
 a forearm length adjustment affixed to the elbow joint; 
 a wrist and hand part affixed to the forearm length adjustment including a supination/pronation motor, a wrist flexion/extension motor, and a wrist force/torque sensor; 
 the plurality of sensors in operative communication with the arm brace such that at least one sensor senses a first force/torque when an arm joint is driven in a first degree of freedom and such that the same sensor senses a second force/torque when the arm joint is driven in a second degree of freedom; and 
 a processor in operative communication with the plurality of sensors and the plurality of motors, the processor configured to calculate a coupling relationship between a movement in the first degree of freedom and the second force/torque sensed in the second degree of freedom, the processor further configured to drive the arm joint through a first degree of motion; 
 
   actuating at least one motor to move a first joint through a first degree of freedom while holding the other joints at their initial positions and measuring the force/torque and angular perturbations of all joints; and then repeating the actuation and measurements for the remaining joints and degrees of freedom.   
     
     
         10 . The process of  claim 9  further comprising executing a passive stretching treatment that includes moving one joint of the patient in the human interface machine until a pre-specified resistance torque is reached. 
     
     
         11 . The process of  claim 10 , wherein the passive stretching includes holding the other joints at their positions. 
     
     
         12 . The process of  claim 9  further comprising executing a voluntary movement training that includes providing a first target position for the patient to achieve, optionally providing assistance or resistance during the voluntary movement training, and providing a second target position when the patient achieves the first target position. 
     
     
         13 . A process comprising:
 positioning a patient in a human interface device;   determining patient-specific multiple joint and/or multiple degrees-of-freedom biomechanical and neuromuscular changes by determining off-diagonal elements of [B ij ] and [K ij ] matrices by multi-joint and multi-degree of freedom analysis, thereby determining patient-specific flexibility, loss of joint individuation, joint stiffness, and degree-or-freedom;   stretching the patient's stiff joints and degrees-of-freedom loss to loosen up the stiff joints, increase the degrees-of-freedom, and reduce excessive cross-coupling torques and movements between the specific joints and degrees-of-freedom;   directing the patient through voluntary reaching and/or functional tasks to regain/improve the patient's flexibility, focusing on the specific joints, loss of joint individuation, and degrees of freedom with movement impairment as determined by biomechanical and neuromuscular changes; and   recording quantitative changes in the patient's joints.   
     
     
         14 . The process of  claim 13 , wherein the human interface device has horizontal abductions of a 60° for the shoulder, 60° for the elbow flexion, 25° for the wrist flexion and 60° for the forearm supination. 
     
     
         15 . The process of  claim 13 , wherein determining patient-specific multiple joint and/or multiple degrees-of-freedom biomechanical and neuromuscular changes comprises:
 actuating the patient's shoulder by horizontal shoulder adduction/abduction while the patient's elbow and wrist are free to move, and measure the coupled elbow and wrist movement to evaluation loss of individuation; and   actuating the patient's shoulder by horizontal shoulder adduction/abduction while the patient's elbow and wrist are held in a fixed position, and measure the coupled elbow and wrist joint torques to evaluation loss of individuation;   
     
     
         16 . The process of  claim 13 , wherein determining patient-specific multiple joint and/or multiple degrees-of-freedom biomechanical and neuromuscular changes comprises:
 actuating the patient's wrist by wrist flexion/extension while the patient's elbow and shoulder are free to move and measure the coupled elbow and shoulder movement to evaluation loss of individuation; and   actuating the patient's wrist by wrist flexion/extension while the patient's elbow and shoulder are held in a fixed position and measure the coupled elbow and shoulder joint torque to evaluation loss of individuation;   
     
     
         17 . The process of  claim 13 , wherein determining patient-specific multiple joint and/or multiple degrees-of-freedom biomechanical and neuromuscular changes comprises:
 actuating the patient's forearm by forearm supination/pronation while the patient's wrist, elbow and shoulder are free to move, and measure the coupled motions at the wrist, elbow and shoulder to evaluate loss of individuation; and   actuating the patient's forearm by forearm supination/pronation while the patient's wrist, elbow and shoulder are held in a fixed position, and measure the coupled wrist, elbow and shoulder joint torque to evaluation loss of individuation.