title: Robotic exoskeletons: a perspective for the rehabilitation of arm coordination in stroke patients.
abstract: Upper-limb impairment after stroke is caused by weakness, loss of individual joint control, spasticity, and abnormal synergies. Upper-limb movement frequently involves abnormal, stereotyped, and fixed synergies, likely related to the increased use of sub-cortical networks following the stroke. The flexible coordination of the shoulder and elbow joints is also disrupted. New methods for motor learning, based on the stimulation of activity-dependent neural plasticity have been developed. These include robots that can adaptively assist active movements and generate many movement repetitions. However, most of these robots only control the movement of the hand in space. The aim of the present text is to analyze the potential of robotic exoskeletons to specifically rehabilitate joint motion and particularly inter-joint coordination. First, a review of studies on upper-limb coordination in stroke patients is presented and the potential for recovery of coordination is examined. Second, issues relating to the mechanical design of exoskeletons and the transmission of constraints between the robotic and human limbs are discussed. The third section considers the development of different methods to control exoskeletons: existing rehabilitation devices and approaches to the control and rehabilitation of joint coordinations are then reviewed, along with preliminary clinical results available. Finally, perspectives and future strategies for the design of control mechanisms for rehabilitation exoskeletons are discussed.
authors.affiliation: UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR) , Paris , France ; UMR 7222, Sorbonne Universités, UPMC Univ Paris , Paris , France ; U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR , Paris , France.
authors.forename: Nathanaël
authors.initials: N
authors.lastname: Jarrassé
authors.affiliation: UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR) , Paris , France ; UMR 7222, Sorbonne Universités, UPMC Univ Paris , Paris , France ; U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR , Paris , France.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Proietti
authors.affiliation: UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR) , Paris , France ; UMR 7222, Sorbonne Universités, UPMC Univ Paris , Paris , France ; Department of Electrical and Electronic Engineering, University of Melbourne , Melbourne, VIC , Australia.
authors.forename: Vincent
authors.initials: V
authors.lastname: Crocher
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hôpital Raymond Poincaré , Garches , France.
authors.forename: Johanna
authors.initials: J
authors.lastname: Robertson
authors.affiliation: UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR) , Paris , France ; UMR 7222, Sorbonne Universités, UPMC Univ Paris , Paris , France ; U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR , Paris , France.
authors.forename: Anis
authors.initials: A
authors.lastname: Sahbani
authors.affiliation: UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR) , Paris , France ; UMR 7222, Sorbonne Universités, UPMC Univ Paris , Paris , France ; U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR , Paris , France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Morel
authors.affiliation: UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR) , Paris , France ; UMR 7222, Sorbonne Universités, UPMC Univ Paris , Paris , France ; U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR , Paris , France ; Department of Physical Medicine and Rehabilitation, Hôpital Raymond Poincaré , Garches , France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Roby-Brami
keywords: arm coordination control; exoskeleton; rehabilitation robotics; synergies; upper-limb