Upper-Limb Exoskeletons for Stroke Rehabilitation

Upper-limb exoskeletons provide high-intensity, repetitive, task-specific, interactive and individualized training, making effective use of neuroplasticity for functional recovery in neurological patients. Most exoskeletons have robot axes aligned with the anatomical axes of the subject and provide direct control of individual joints. Recently, novel mechanical structures and actuation mechanisms have been proposed, but still result in bulky and heavy exoskeletons, limiting their applicability into clinical practice. Technological efforts are needed to promote light and wearable exoskeletons that implement active-assistive controllers, providing “assisted-as-needed” rehabilitation therapy, towards patient’s motivation and self-esteem. An overview of upper-limb exoskeletons, including mechanical design and control algorithms, will be provided. Special focus will be put on the current evidence about the efficacy of wearable robotic technologies on motor recovery and about other therapies that can be combined with exoskeletons to improve their therapeutic effects.