Therapist-Exoskeleton-Patient Interaction for Gait Therapy
For stroke rehabilitation, this work provides a new paradigm that combines robotic precision with therapist intuition, addressing the limitations of manual therapy and existing exoskeleton control strategies.
This paper introduces a physical Human-Robot-Human Interaction (pHRHI) paradigm for gait rehabilitation, where both therapist and patient wear exoskeletons connected via virtual spring-damper elements. 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.
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.