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Exoskeletons for rehabilitation can help enhance motor recovery in individuals suffering from neurological disorders. Precision in movement execution, especially in arm rehabilitation, is crucial to prevent maladaptive plasticity. However, current exoskeletons, while providing arm support, often lack the necessary 3D feedback capabilities to show how well rehabilitation exercises are being performed. This reduces therapist acceptance and patients' performance. Augmented Reality technologies offer promising solutions for feedback and gaming systems in rehabilitation. In this work, we leverage HoloLens 2 with its advanced hand-tracking system to develop an application for personalized rehabilitation. Our application generates custom holographic trajectories based on existing databases or therapists' demonstrations, represented as 3D tunnels. Such trajectories can be superimposed on the real training environment. They serve as a guide to the users and, thanks to colour-coded real-time feedback, indicate their performance. To assess the efficacy of the application in improving kinematic precision, we tested it with 15 healthy subjects. Comparing user tracking capabilities with and without the use of our feedback system in executing 4 different exercises, we observed significant differences, demonstrating that our application leads to improved kinematic performance. 12 clinicians tested our system and positively evaluated its usability (System Usability Scale score of 67.7) and acceptability (4.4 out of 5 in the 'Willingness to Use' category in the relative Technology Acceptance Model). The results from the tests on healthy participants and the feedback from clinicians encourage further exploration of our framework, to verify its potential in supporting arm rehabilitation for individuals with neurological disorders., Comment: 25 pages, 9 figures, 3 tables, journal submission

Accurate detection of locomotion transitions, such as walk to sit, walk to stair ascent, and descent, is crucial to effectively control robotic assistive devices, such as lower-limb exoskeletons, as each locomotion mode requires specific assistance. Variability in collected sensor data introduced by user- or system-specific characteristics makes it challenging to maintain high transition detection accuracy while avoiding latency using non-adaptive classification models. In this study, we identified key factors influencing transition detection performance, including variations in user behavior, and different mechanical designs of the exoskeletons. To boost the transition detection accuracy, we introduced two methods for adapting a finite-state machine classifier to system- and user-specific variability: a Statistics-Based approach and Bayesian Optimization. Our experimental results demonstrate that both methods remarkably improve transition detection accuracy across diverse users, achieving up to an 80% increase in certain scenarios compared to the non-personalized threshold method. These findings emphasize the importance of personalization in adaptive control systems, underscoring the potential for enhanced user experience and effectiveness in assistive devices. By incorporating subject- and system-specific data into the model training process, our approach offers a precise and reliable solution for detecting locomotion transitions, catering to individual user needs, and ultimately improving the performance of assistive devices., Comment: 10 pages, 11 figures

Cable-driven exosuits have the potential to support individuals with motor disabilities across the continuum of care. When supporting a limb with a cable, force sensors are often used to measure tension. However, force sensors add cost, complexity, and distal components. This paper presents a design and control approach to remove the force sensor from an upper limb cable-driven exosuit. A mechanical design for the exosuit was developed to maximize passive transparency. Then, a data-driven friction identification was conducted on a mannequin test bench to design a model-based tension controller. Seventeen healthy participants raised and lowered their right arms to evaluate tension tracking, movement quality, and muscular effort. Questionnaires on discomfort, physical exertion, and fatigue were collected. The proposed strategy allowed tracking the desired assistive torque with an RMSE of 0.71 Nm (18%) at 50% gravity support. During the raising phase, the EMG signals of the anterior deltoid, trapezius, and pectoralis major were reduced on average compared to the no-suit condition by 30%, 38%, and 38%, respectively. The posterior deltoid activity was increased by 32% during lowering. Position tracking was not significantly altered, whereas movement smoothness significantly decreased. This work demonstrates the feasibility and effectiveness of removing the force sensor from a cable-driven exosuit. A significant increase in discomfort in the lower neck and right shoulder indicated that the ergonomics of the suit could be improved. Overall this work paves the way towards simpler and more affordable exosuits., Comment: 19 pages, 10 figures, and 3 tables in the main manuscript. 12 pages, 4 figures, and 13 tables in the supplementary materials

Assistive devices, such as exoskeletons and prostheses, have revolutionized the field of rehabilitation and mobility assistance. Efficiently detecting transitions between different activities, such as walking, stair ascending and descending, and sitting, is crucial for ensuring adaptive control and enhancing user experience. We here present an approach for real-time transition detection, aimed at optimizing the processing-time performance. By establishing activity-specific threshold values through trained machine learning models, we effectively distinguish motion patterns and we identify transition moments between locomotion modes. This threshold-based method improves real-time embedded processing time performance by up to 11 times compared to machine learning approaches. The efficacy of the developed finite-state machine is validated using data collected from three different measurement systems. Moreover, experiments with healthy participants were conducted on an active pelvis orthosis to validate the robustness and reliability of our approach. The proposed algorithm achieved high accuracy in detecting transitions between activities. These promising results show the robustness and reliability of the method, reinforcing its potential for integration into practical applications., Comment: Submitted for a conference. 7 pages including references, 8 figures, 3 tables