en.Wedoany.com Reported - Scientists at Northwestern University and the Shirley Ryan AbilityLab have developed a rehabilitation system called "Therapist-Exoskeleton-Patient Interaction" (TEPI), which establishes a virtual connection between therapist and patient through a robotic exoskeleton. This system enables the therapist to respond to patient movements in real time, dynamically adjusting support and assistance. The research findings were published in the journal Science Robotics, under the title "Therapist-Exoskeleton-Patient Interaction for Gait Therapy."

According to the U.S. Centers for Disease Control and Prevention (CDC), nearly 800,000 people in the United States survive a stroke each year, and many require rehabilitation to relearn walking. In traditional physical therapy, therapists must provide manual support, but can only assist with limited movements at a time, and complex full-body training often requires multiple therapists. While existing rehabilitation exoskeletons can increase training intensity, they often rely on fixed movement patterns and struggle to fully adapt to patient performance in real time.

The TEPI system requires the therapist and the stroke survivor to each wear a lower-limb exoskeleton that is virtually connected at the hip and knee. This virtual connection behaves like a combination of a spring and a shock absorber, allowing both parties to influence each other's movements in real time, enabling the therapist to create a more personalized rehabilitation experience.

In an evaluation involving eight stroke survivors, TEPI outperformed traditional therapist-guided treadmill training on multiple gait performance indicators. Participants showed increased joint range of motion, longer stride lengths, higher leg lifts, and muscle activation levels similar to those in conventional therapy, while also reporting high levels of motivation and enjoyment.

José L. Pons, who conceptualized, led, and supervised the research project, noted that therapist-led rehabilitation remains the foundation of recovery for many patients, and this study shows promise in complementing standard care. Pons is the Scientific Chair at the Shirley Ryan AbilityLab, a Professor of Physical Medicine and Rehabilitation at Northwestern University's Feinberg School of Medicine, and a (courtesy) Professor of Mechanical Engineering at Northwestern's McCormick School of Engineering. Lorenzo Vianello, a postdoctoral fellow at the Shirley Ryan AbilityLab and co-first author of the paper, stated that TEPI combines the manual adaptability of physical therapy with the scalability and precision of robotic systems, enabling more comprehensive full-body gait training without requiring multiple therapists, and introducing real-time responsiveness to patient performance, allowing dynamic adjustments of support, resistance, and feedback. Co-first author Emek Barış Küçüktabak added that by allowing the therapist to guide patient movements with their own leg motions, TEPI can provide an impactful supplement to traditional gait training in stroke rehabilitation, reducing the risk of therapist fatigue and injury from physical exertion during manual therapy. He completed this research while serving as a graduate research assistant at Northwestern University and the Shirley Ryan AbilityLab.

Other authors of the paper include: Daniel Ludvig, Research Scientist at the Shirley Ryan AbilityLab and Research Assistant Professor at McCormick; Levi Hargrove, Scientific Chair of the Regenstein Foundation Center for Bionic Medicine at the Shirley Ryan AbilityLab, Professor of Physical Medicine and Rehabilitation at Feinberg, and (courtesy) Professor of Biomedical Engineering at McCormick; Kevin Lynch, Professor of Mechanical Engineering at McCormick and Director of the Center for Robotics and Biosystems at Northwestern University; and Matthew R. Short, a postdoctoral fellow at the University of Delaware and co-first author of the paper. The research team plans to apply the TEPI framework to activities such as overground walking, stair climbing, and sit-to-stand transitions in the future, and to explore the development of more accessible and scalable systems to extend therapist-guided rehabilitation to home settings and support remote care.

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