Evaluation of the effects of the Arm Light Exoskeleton on movement execution and muscle activities: a pilot study on healthy subjects

I bet this will never  make it to your rehab department. Your stroke department head probably has no policy to analyze research and bring promising ones into the department. Everyone is waiting because  SOMEONE ELSE WILL SOON SOLVE THESE PROBLEMS.
I have 12 posts on exoskeleton and upper limb and I'm sure your stroke department has not done one damn thing about them.
http://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-016-0117-x 

ALEx, the new Arm Light Exoskeleton

• Elvira Pirondini,
• Martina CosciaEmail author,
• Simone Marcheschi,
• Gianluca Roas,
• Fabio Salsedo,
• Antonio Frisoli,
• Massimo Bergamasco and
• Silvestro Micera

Journal of NeuroEngineering and Rehabilitation201613:9

DOI: 10.1186/s12984-016-0117-x

©  Pirondini et al. 2016

Received: 18 February 2015

Accepted: 18 January 2016

Published: 23 January 2016

Abstract

Background

Exoskeletons for lower and upper extremities have been introduced in neurorehabilitation because they can guide the patient’s limb following its anatomy, covering many degrees of freedom and most of its natural workspace, and allowing the control of the articular joints. The aims of this study were to evaluate the possible use of a novel exoskeleton, the Arm Light Exoskeleton (ALEx), for robot-aided neurorehabilitation and to investigate the effects of some rehabilitative strategies adopted in robot-assisted training.

Methods

We studied movement execution and muscle activities of 16 upper limb muscles in six healthy subjects, focusing on end-effector and joint kinematics, muscle synergies, and spinal maps. The subjects performed three dimensional point-to-point reaching movements, without and with the exoskeleton in different assistive modalities and control strategies.

Results

The results showed that ALEx supported the upper limb in all modalities and control strategies: it reduced the muscular activity of the shoulder’s abductors and it increased the activity of the elbow flexors. The different assistive modalities favored kinematics and muscle coordination similar to natural movements, but the muscle activity during the movements assisted by the exoskeleton was reduced with respect to the movements actively performed by the subjects. Moreover, natural trajectories recorded from the movements actively performed by the subjects seemed to promote an activity of muscles and spinal circuitries more similar to the natural one.

Conclusions

The preliminary analysis on healthy subjects supported the use of ALEx for post-stroke upper limb robotic assisted rehabilitation, and it provided clues on the effects of different rehabilitative strategies on movement and muscle coordination.