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

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. 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. 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. 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.