Development of robots for rehabilitation therapy: The Palo Alto VA/Stanford experience

For over 25 years, personal assistant robots for severely disabled individu als have been in development. More recently, using robots to deliver rehabi litation therapy has been proposed. This paper summarizes the development a nd clinical testing of three mechatronic systems for post-stroke therapy co nducted at the VA Pale Alto in collaboration with Stanford University. We d escribe the philosophy and experiences that guided their evolution. Unique to the Pale Alto approach is provision for bimanual, mirror-image, patient- controlled therapeutic exercise. Proof-of-concept was established with 2-de gree-of-freedom (DOF) elbow/forearm manipulator. Tests of a second-generati on therapy robot producing planar forearm movements in 19 hemiplegic and co ntrol subjects confirmed the validity and reliability of interaction forces during mechanically assisted upper-limb movements. Clinical trials compari ng 3-D robot-assisted therapy to traditional therapy in 21 chronic stroke s ubjects showed significant improvement in the Fugl-Meyer (FM) measure of mo tor recovery in the robot group, which exceeded improvements in the control group.