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The basic routine movements for elderly people are not easily accessible due to the weak muscles and impaired nerves in their lower extremity. In the last few years, many robotic-based rehabilitation devices, like orthosis and exoskeletons, have been designed and developed by researchers to provide locomotion assistance to support gait behavior and to perform daily activities for elderly people. However, there is still a need for improvement in the design, actuation and control of these devices for making them cost-effective in the worldwide market. In this work, a systematic review is presented on available lower limb orthosis and exoskeleton devices, to date. The devices are broadly reviewed according to joint types, actuation modes and control strategies. Furthermore, tabular comparisons have also been presented with the types and applications of these devices. Finally, the needful improvements for realizing the efficacy of lower limb rehabilitation devices are discussed along with the development stage. This review will help the designers and researchers to develop an efficient robotic device for the rehabilitation of the lower limb.

Our access to computer-generated worlds changes the way we feel, how we think, and how we solve problems. In this review, we explore the utility of different types of virtual reality, immersive or non-immersive, for providing controllable, safe environments that enable individual training, neurorehabilitation, or even replacement of lost functions. The neurobiological effects of virtual reality on neuronal plasticity have been shown to result in increased cortical gray matter volumes, higher concentration of electroencephalographic beta-waves, and enhanced cognitive performance. Clinical application of virtual reality is aided by innovative brain–computer interfaces, which allow direct tapping into the electric activity generated by different brain cortical areas for precise voluntary control of connected robotic devices. Virtual reality is also valuable to healthy individuals as a narrative medium for redesigning their individual stories in an integrative process of self-improvement and personal development. Future upgrades of virtual reality-based technologies promise to help humans transcend the limitations of their biological bodies and augment their capacity to mold physical reality to better meet the needs of a globalized world.

Introduction: The field of artificial intelligence (AI) is rapidly expanding, with many applications seen routinely in health care, industry, and education, and increasingly in workplaces. Although there is growing evidence of applications of AI in workplaces across all industries to simplify and/or automate tasks there is a limited understanding of the role that AI contributes in addressing occupational safety and health (OSH) concerns. Methods: This paper introduces a new framework called Risk Evolution, Detection, Evaluation, and Control of Accidents (REDECA) that highlights the role that AI plays in the anticipation and control of exposure risks in a worker’s immediate environment. Two hundred and sixty AI papers across five sectors (oil and gas, mining, transportation, construction, and agriculture) were reviewed using the REDECA framework to highlight current applications and gaps in OSH and AI fields. Results: The REDECA framework highlighted the unique attributes and research focus of each of the five industrial sectors. The majority of evidence of AI in OSH research within the oil/gas and transportation sectors focused on the development of sensors to detect hazardous situations. In construction the focus was on the use of sensors to detect incidents. The research in the agriculture sector focused on sensors and actuators that removed workers from hazardous conditions. Application of the REDECA framework highlighted AI/OSH strengths and opportunities in various industries and potential areas for collaboration. Conclusions: As AI applications across industries continue to increase, further exploration of the benefits and challenges of AI applications in OSH is needed to optimally protect worker health, safety and well-being.

This article aims to give an overall review of research status in hand rehabilitation robotic technology, evaluating a number of devices. The main scope is to explore the current state of art to help and support designers and clinicians make better choices among varied devices and components. The review also focuses on both mechanical design, usability and training paradigms since these parts are interconnected for an effective hand recovery. In order to study the rehabilitation robotic technology status, the devices have been divided in two categories: end-effector robots and exoskeleton devices. The end-effector robots are more flexible than exoskeleton devices in fitting the different size of hands, reducing the setup time and increasing the usability for new patients. They suffer from the control of distal joints and haptic aspects of object manipulation. In this way, exoskeleton devices may represent a new opportunity. Nevertheless their design is complex and a deep investigation of hand biomechanics and physical human–robot interaction is required. The main hand exoskeletons have been developed in the last decade and the results are promising demonstrated by the growth of the commercialized devices. Finally, a discussion on the complexity to define which design is better and more effective than the other one is summarized for future investigations.

BackgroundWithin surgery, assistive robotic devices (ARD) have reported improved patient outcomes. ARD can offer the surgical team a “third hand” to perform wider tasks and more degrees of motion in comparison with conventional laparoscopy. We test an eye-tracking based robotic scrub nurse (RSN) in a simulated operating room based on a novel real-time framework for theatre-wide 3D gaze localization in a mobile fashion.MethodsSurgeons performed segmental resection of pig colon and handsewn end-to-end anastomosis while wearing eye-tracking glasses (ETG) assisted by distributed RGB-D motion sensors. To select instruments, surgeons (ST) fixed their gaze on a screen, initiating the RSN to pick up and transfer the item. Comparison was made between the task with the assistance of a human scrub nurse (HSNt) versus the task with the assistance of robotic and human scrub nurse (R&HSNt). Task load (NASA-TLX), technology acceptance (Van der Laan’s), metric data on performance and team communication were measured.ResultsOverall, 10 ST participated. NASA-TLX feedback for ST on HSNt vs R&HSNt usage revealed no significant difference in mental, physical or temporal demands and no change in task performance. ST reported significantly higher frustration score with R&HSNt. Van der Laan’s scores showed positive usefulness and satisfaction scores in using the RSN. No significant difference in operating time was observed.ConclusionsWe report initial findings of our eye-tracking based RSN. This enables mobile, unrestricted hands-free human–robot interaction intra-operatively. Importantly, this platform is deemed non-inferior to HSNt and accepted by ST and HSN test users.

Background Spinal cord injury (SCI) is characterized by a total or partial deficit of sensory and motor pathways. Impairments of this injury compromise muscle recruitment and motor planning, thus reducing functional capacity. SCI patients commonly present psychological, intestinal, urinary, osteomioarticular, tegumentary, cardiorespiratory and neural alterations that aggravate in chronic phase. One of the neurorehabilitation goals is the restoration of these abilities by favoring improvement in the quality of life and functional independence. Current literature highlights several benefits of robotic gait therapies in SCI individuals. Objectives The purpose of this study was to compare the robotic gait devices, and systematize the scientific evidences of these devices as a tool for rehabilitation of SCI individuals. Methods A systematic review was carried out in which relevant articles were identified by searching the following databases: Cochrane Library, PubMed, PEDro and Capes Periodic. Two authors selected the articles which used a robotic device for rehabilitation of spinal cord injury. Results Databases search found 2941 articles, 39 articles were included due to meet the inclusion criteria. The robotic devices presented distinct features, with increasing application in the last years. Studies have shown promising results regarding the reduction of pain perception and spasticity level; alteration of the proprioceptive capacity, sensitivity to temperature, vibration, pressure, reflex behavior, electrical activity at muscular and cortical level, classification of the injury level; increase in walking speed, step length and distance traveled; improvements in sitting posture, intestinal, cardiorespiratory, metabolic, tegmental and psychological functions. Conclusions This systematic review shows a significant progress encompassing robotic devices as an innovative and effective therapy for the rehabilitation of individuals with SCI.

Recent advancements in soft robotics have been emerging as an exciting paradigm in engineering due to their inherent compliance, safe human interaction, and ease of adaptation with wearable electronics. Soft robotic devices have the potential to provide innovative solutions and expand the horizons of possibilities for biomedical applications by bringing robots closer to natural creatures. In this review, we survey several promising soft robot technologies, including flexible fluidic actuators, shape memory alloys, cable‐driven mechanisms, magnetically driven mechanisms, and soft sensors. Selected applications of soft robotic devices as medical devices are discussed, such as surgical intervention, soft implants, rehabilitation and assistive devices, soft robotic exosuits, and prosthetics. We focus on how soft robotics can improve the effectiveness, safety and patient experience for each use case, and highlight current research and clinical challenges, such as biocompatibility, long‐term stability, and durability. Finally, we discuss potential directions and approaches to address these challenges for soft robotic devices to move toward real clinical translations in the future. The use of soft actuation mechanisms in robotics has expanded the horizons of possibilities for biomedical applications and brought robots closer to humans. This review surveys several promising soft robotic technologies and presents selected applications of soft robotic devices as medical devices. Current research and clinical challenges are highlighted, and potential future directions to address these challenges for soft robotic devices to move toward real clinical translations are discussed.

Objective: To assess safety and mobility outcomes utilizing the Indego powered exoskeleton in indoor and outdoor walking conditions with individuals previously diagnosed with a spinal cord injury (SCI). Methods: We conducted a multicenter prospective observational cohort study in outpatient clinics associated with 5 rehabilitation hospitals. A convenience sample of nonambulatory individuals with SCI (N = 32) completed an 8-week training protocol consisting of walking training 3 times per week utilizing the Indego powered exoskeleton in indoor and outdoor conditions. Participants were also trained in donning/doffing the exoskeleton during each session. Safety measures such as adverse events (AEs) were monitored and reported. Time and independence with donning/doffing the exoskeleton as well as walking outcomes to include the 10-meter walk test (10MWT), 6-minute walk test (6MWT), Timed Up & Go test (TUG), and 600-meter walk test were evaluated from midpoint to final evaluations. Results: All 32 participants completed the training protocol with limited device-related AEs, which resulted in no interruption in training. The majority of participants in this trial were able to don and doff the Indego independently. Final walking speed ranged from 0.19 to 0.55 m/s. Final average indoor and outdoor walking speeds among all participants were 0.37 m/s (SD = 0.08, 0.09, respectively), after 8 weeks of training. Significant (p < .05) improvements were noted between midpoint and final gait speeds in both indoor and outdoor conditions. Average walking endurance also improved among participants after training. Conclusion: The Indego was shown to be safe for providing upright mobility to 32 individuals with SCIs who were nonambulatory. Improvements in speed and independence were noted with walking in indoor and outdoor conditions as well as with donning/doffing the exoskeleton.

This work presents a pilot study to analyze the effect of aging on motor performance of young adults (YAs) and older adults (OAs) through wrist movement assessment, using an upper limb rehabilitation robot (ULRR) in passive mode coupled to a maze-solving task serious video game. The proposed approach considers the use of kinematic metrics, such as ROM, path accuracy, and movement smoothness, as quantitative biomarkers that evidence differences between YAs and OAs. An experimental protocol was conducted with 20 participants: 10 OAs and 10 YAs. Standardized wrist movements corresponding to flexion (F), extension (E), radial deviation (R), and ulnar deviation (U) were assessed at each level of the maze. The kinematic analysis was based on metrics for range of motion (ROM), path accuracy, smoothness, and root-mean-square error (RMSE) in trajectory tracking. The results revealed clear differences between the groups: the YAs achieved a greater ROM and made fewer errors on mean (2.167 errors for YAs compared to 6.000 errors for OAs), and showed a lower RMSE, while the OAs showed greater smoothness in their movements, because the YAs exhibit greater variability and disturbances in movement when correcting and controlling their movements to achieve good performance, reflecting more precise motor control and a greater capacity for error correction during movements with trajectory constraints.

Stroke is a debilitating clinical condition resulting from a brain infarction or hemorrhage that poses significant challenges for motor function restoration. Previous studies have shown the potential of applying transcranial direct current stimulation (tDCS) to improve neuroplasticity in patients with neurological diseases or disorders. By modulating the cortical excitability, tDCS can enhance the effects of conventional therapies. While upper-limb recovery has been extensively studied, research on lower limbs is still limited, despite their important role in locomotion, independence, and good quality of life. As the life and social costs due to neuromuscular disability are significant, the relatively low cost, safety, and portability of tDCS devices, combined with low-cost robotic systems, can optimize therapy and reduce rehabilitation costs, increasing access to cutting-edge technologies for neuromuscular rehabilitation. This study explores a novel approach by utilizing the following processes in sequence: tDCS, a motor imagery (MI)-based brain-computer interface (BCI) with virtual reality (VR), and a motorized pedal end-effector. These are applied to enhance the brain plasticity and accelerate the motor recovery of post-stroke patients. The results are particularly relevant for post-stroke patients with severe lower-limb impairments, as the system proposed here provides motor training in a real-time closed-loop design, promoting cortical excitability around the foot area (Cz) while the patient directly commands with his/her brain signals the motorized pedal. This strategy has the potential to significantly improve rehabilitation outcomes. The study design follows an alternating treatment design (ATD), which involves a double-blind approach to measure improvements in both physical function and brain activity in post-stroke patients. The results indicate positive trends in the motor function, coordination, and speed of the affected limb, as well as sensory improvements. The analysis of event-related desynchronization (ERD) from EEG signals reveals significant modulations in Mu, low beta, and high beta rhythms. Although this study does not provide conclusive evidence for the superiority of adjuvant mental practice training over conventional therapy alone, it highlights the need for larger-scale investigations.