Therapist-Exoskeleton-Patient Interaction: An Immersive Gait Therapy

2025-07-21

AI Summary

Stroke survivors frequently exhibit impaired gait and balance due to reduced lower-limb muscle strength and compromised joint control. Conventional manual rehabilitation is labor-intensive and struggles with coordinated multi-joint control, while existing exoskeleton systems often diminish therapist engagement and adaptive modulation. To address these limitations, we propose a novel physical human–robot–human interaction (pHRI) gait rehabilitation paradigm: therapist and patient simultaneously wear a shared lower-limb exoskeleton, with hip–knee joints coupled in real time via a virtual spring–damper model to enable bidirectional force feedback and motion synchronization. This first-of-its-kind shared-exoskeleton system synergistically integrates robotic precision with therapist’s intuitive, context-aware regulation. In a pilot study with eight chronic stroke patients, the approach significantly improved joint range of motion, spatiotemporal gait parameters, electromyographic muscle activation, and training adherence—outperforming conventional treadmill-based manual assistance.

Technology Category

• Intelligent Robots: Human-Robot Interaction
• Humans and AI: Interaction Techniques and Devices
• Cognitive Modeling & Cognitive Systems: Simulating Human Behavior

Application Category

• Search and Retrieval-Augmented AI: Assisted, interactive, and conversational search
• Responsible Web: Machine-in-the-loop, human agency and autonomy
• User Modeling, Personalization and Recommendation: Psychology-informed user models and recommender systems

Abstract

Following a stroke, individuals often experience mobility and balance impairments due to lower-limb weakness and loss of independent joint control. Gait recovery is a key goal of rehabilitation, traditionally achieved through high-intensity therapist-led training. However, manual assistance can be physically demanding and limits the therapist's ability to interact with multiple joints simultaneously. Robotic exoskeletons offer multi-joint support, reduce therapist strain, and provide objective feedback, but current control strategies often limit therapist involvement and adaptability. We present a novel gait rehabilitation paradigm based on physical Human-Robot-Human Interaction (pHRHI), where both the therapist and the post-stroke individual wear lower-limb exoskeletons virtually connected at the hips and knees via spring-damper elements. This enables bidirectional interaction, allowing the therapist to guide movement and receive haptic feedback. In a study with eight chronic stroke patients, pHRHI training outperformed conventional therapist-guided treadmill walking, leading to increased joint range of motion, step metrics, muscle activation, and motivation. These results highlight pHRHI's potential to combine robotic precision with therapist intuition for improved rehabilitation outcomes.

Problem

• Addresses mobility and balance impairments post-stroke
• Overcomes limitations of manual therapist-led gait rehabilitation
• Enhances exoskeleton adaptability with therapist involvement

Innovation

• Bidirectional exoskeleton interaction for gait therapy
• Spring-damper virtual connection at hips and knees
• Combines robotic precision with therapist intuition