Integration of neuromuscular control for multidirectional horizontal planar reaching movements in a portable upper limb exoskeleton for enhanced stroke rehabilitation

Biomed Tech (Berl). 2025 Jan 21. doi: 10.1515/bmt-2023-0622. Online ahead of print.

Abstract

Globally, the prevalence of stroke is significant and increasing annually. This growth has led to a demand for rehabilitation services that far exceeds the supply, leaving many stroke survivors without adequate rehabilitative care. In response to this challenge, this study introduces a portable exoskeleton system that integrates neural control mechanisms governing human arm movements. This design leverages neuroplasticity principles to simulate natural movements, aiming to reactivate and strengthen neuromuscular connections and thus enhance rehabilitation outcomes. A tailored musculoskeletal model of the human arm and an associated cost function were developed to accurately replicate the planar motion trajectories of a healthy human arm across 32 directions. The application of a Proportional-Derivative (PD) controller enables precise tracking of these trajectories by the exoskeleton. Individual testing has demonstrated high consistency between the exoskeleton-driven motion paths and the simulated trajectories, especially in trajectory accuracy along the X and Y axes. These findings support the efficacy of integrating advanced neural control strategies with practical exoskeleton designs in stroke rehabilitation.

Keywords: arm movements; neuromechanics; neuromuscular control; portable exoskeleton; stroke rehabilitation.