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The elbow joint is a complex articulation composed of the humeroulnar and humeroradial joints (for flexion-extension movement) and the proximal radioulnar articulation (for pronation-supination movement). During the flexion-extension movement of the elbow joint, the rotation center changes and this articulation cannot be truly represented as a simple hinge joint. The main goal of this project is to design and assemble a medical rehabilitation exoskeleton for the elbow with one degree of freedom for flexion-extension, using the rotation center for proper patient elbow joint articulation. Compared with the current solutions, which align the exoskeleton axis with the elbow axis, this offers an ergonomic physical human-robot interface with a comfortable interaction. The exoskeleton is actuated with shape memory alloy wire-based actuators having minimum rigid parts, for guiding the actuators. Thanks to this unusual actuation system, the proposed exoskeleton is lightweight and has low noise in operation with a simple design 3D-printed structure. Using this exoskeleton, these advantages will improve the medical rehabilitation process of patients that suffered stroke and will influence how their lifestyle will change to recover from these diseases and improve their ability with activities of daily living, thanks to brain plasticity. The exoskeleton can also be used to evaluate the real status of a patient, with stroke and even spinal cord injury, thanks to an elbow movement analysis.

A large number of musculoskeletal and neurological disorders can affect the upper limb limiting the subject's ability to perform activities of daily living. In recent years, rehabilitation therapies based on robotics have been proposed as complement to the work of therapists. This paper introduces a prototype of exoskeleton for the evaluation and rehabilitation therapy of the elbow joint in flexion extension and pronation-supination. The main novelty is the use of bioinspired actuators based on shape memory alloys (for the first time) in an upper limb rehabilitation exoskeleton. Because of this, the device presents a light weight, less than 1 kg, and noiseless operation, both characteristics are very beneficial for rehabilitation therapies. In addition, the prototype has been designed with low-cost electronics and materials, and the result is a wearable, comfortable, and cheap rehabilitation exoskeleton for the elbow joint. The exoskeleton can generate the joint torque (active mode) or it can be used as a passive tool. (The patient performs therapy by itself, carrying the device while it collects relevant movement data for evaluation.) The simulations and experimental tests validate the solution in the first phases of rehabilitation therapies when slow and repetitive movements are required. INDEX TERMS Antagonist control, elbow rehabilitation, exoskeleton, shape memory alloy (SMA), wearable robotics.

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A high-level control algorithm capable of generating position and torque references from surface electromyography signals (sEMG) was designed. It was applied to a shape memory alloy (SMA)-actuated exoskeleton used in active rehabilitation therapies for elbow joints. The sEMG signals are filtered and normalized according to data collected online during the first seconds of a therapy session. The control algorithm uses the sEMG signals to promote active participation of patients during the therapy session. In order to generate the reference position pattern with good precision, the sEMG normalized signal is compared with a pressure sensor signal to detect the intention of each movement. The algorithm was tested in simulations and with healthy people for control of an elbow exoskeleton in flexion–extension movements. The results indicate that sEMG signals from elbow muscles, in combination with pressure sensors that measure arm–exoskeleton interaction, can be used as inputs for the control algorithm, which adapts the reference for exoskeleton movements according to a patient’s intention.