A Shared Control Approach to Safely Limiting Patient Motion Based on Tendon Strain during Robotic-Assisted Shoulder Rehabilitation

Abstract

Combining biomechanical modeling with robotic physiotherapy is a promising direction to provide real-time insights during the rehabilitation of patients with musculoskeletal injuries, such as rotator-cuff tears. One aspect is to prevent re-injuries caused by high strain in the injured tissues while allowing patients to perform the required rehabilitation exercises. In this paper, we propose a novel shared control method for robots to limit unsafe patient movements, through physical guidance based on a strain-space representation of the human rotator cuff. The method provides motion corrections through two complementary predictive modules. The first module exerts a lower degree of intervention and is analogous to rumble strips or speed bumps for cars on the road. In this case, an impedance controller induces variable damping to slow down the patient's movement when a danger zone is approached. The second module produces a higher degree of intervention and is analogous to lane-assist in cars. In this case, the robot plans an optimal deflection trajectory and temporarily takes over control of the movement to avoid an unsafe situation. We performed experiments with a healthy participant acting as a patient and evaluated the effect of different human-robot interaction modalities on the resulting human movement in terms of avoidance of high-strain areas of the rotator-cuff tendons and contact forces exchanged.