Hybrid Cooperative Control of Functional Electrical Stimulation and Robot Assistance for Upper Extremity Rehabilitation

Objective:
Hybrid systems that integrate Functional Electrical Stimulation (FES) and robotic assistance have been proposed in neurorehabilitation to enhance therapeutic benefits. This study focuses on designing a cooperative controller capable of distributing the required torque for movement between robotic actuation and FES, thereby eliminating the need for time-consuming calibration procedures.
Methods:
The control schema comprises three main blocks: a motion generation block that defines the desired trajectory, a motor control block including both a weight compensation feedforward and a feedback impedance controller, and an FES control block, based on trial-by-trial Iterative Learning Control (ILC), that adjusts the stimulation intensity according to a predefined stimulation waveform. The feedforward motor assistance can be dynamically regulated using an allocation factor. Experiments involving 12 healthy volunteers were conducted using a one-degree-of-freedom elbow testbed.
Results:
The experimental results showcased the successful integration of Functional Electrical Stimulation (FES) with robotic actuation, ensuring precise trajectory tracking with a Root Mean Square Error (RMSE) below 7°. Notably, allocating more torque to FES led to a 51
$\%$
reduction in motor torque. In conditions where FES operated alone, there was poorer tracking performance with an RMSE of 24° and an early onset of muscle fatigue, as evidenced by a reduced number of achieved repetitions. Furthermore, the hybrid approach enabled 100 fatigue-free elbow flexion repetitions, underscoring the effectiveness of cooperative FES-motor control in extending the benefits of FES-induced exercises.
Significance:
This study proposes a flexible approach which can be extended to a multi-degree-of-freedom hybrid system. Furthermore, it underscores the significance of employing a straightforward and adaptable methodology with a rapid calibration procedure, making it easily transferable to clinical applications.