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Background The ankle joint complex (AJC) is of fundamental importance for balance, support, and propulsion. However, it is particularly susceptible to musculoskeletal and neurological injuries, especially neurological injuries such as drop foot following stroke. An important factor in ankle dysfunction is damage to the central nervous system (CNS). Correspondingly, the fundamental goal of rehabilitation training is to stimulate the reorganization and compensation of the CNS, and to promote the recovery of the motor system’s motor perception function. Therefore, an increasing number of ankle rehabilitation robots have been developed to provide long-term accurate and uniform rehabilitation training of the AJC, among which the parallel ankle rehabilitation robot (PARR) is the most studied. The aim of this study is to provide a systematic review of the state of the art in PARR technology, with consideration of the mechanism configurations, actuator types with different trajectory tracking control techniques, and rehabilitation training methods, thus facilitating the development of new and improved PARRs as a next step towards obtaining clinical proof of their rehabilitation benefits. Methods A literature search was conducted on PubMed, Scopus, IEEE Xplore, and Web of Science for articles related to the design and improvement of PARRs for ankle rehabilitation from each site’s respective inception from January 1999 to September 2020 using the keywords “ parallel”, “ ankle”, and “ robot”. Appropriate syntax using Boolean operators and wildcard symbols was utilized for each database to include a wider range of articles that may have used alternate spellings or synonyms, and the references listed in relevant publications were further screened according to the inclusion criteria and exclusion criteria. Results and discussion Ultimately, 65 articles representing 16 unique PARRs were selected for review, all of which have developed the prototypes with experiments designed to verify their usability and feasibility. From the comparison among these PARRs, we found that there are three main considerations for the mechanical design and mechanism optimization of PARRs, the choice of two actuator types including pneumatic and electrically driven control, the covering of the AJC’s motion space, and the optimization of the kinematic design, actuation design and structural design. The trajectory tracking accuracy and interactive control performance also need to be guaranteed to improve the effect of rehabilitation training and stimulate a patient’s active participation. In addition, the parameters of the reviewed 16 PARRs are summarized in detail with their differences compared by using figures and tables in the order they appeared, showing their differences in the two main actuator types, four exercise modes, fifteen control strategies, etc., which revealed the future research trends related to the improvement of the PARRs. Conclusion The selected studies showed the rapid development of PARRs in terms of their mechanical designs, control strategies, and rehabilitation training methods over the last two decades. However, the existing PARRs all have their own pros and cons, and few of the developed devices have been subjected to clinical trials. Designing a PARR with three degrees of freedom (DOFs) and whereby the mechanism’s rotation center coincides with the AJC rotation center is of vital importance in the mechanism design and optimization of PARRs. In addition, the design of actuators combining the advantages of the pneumatic-driven and electrically driven ones, as well as some new other actuators, will be a research hotspot for the development of PARRs. For the control strategy, compliance control with variable parameters should be further studied, with sEMG signal included to improve the real-time performance. Multimode rehabilitation training methods with multimodal motion intention recognition, real-time online detection and evaluation system should also be further developed to meet the needs of different ankle disability and rehabilitation stages. In addition, the clinical trials are in urgent need to help the PARRs be implementable as an intervention in clinical practice.

Purpose The purpose of this paper is to implement a passive compliance training strategy for our newly designed 2-UPS/RRR parallel ankle rehabilitation robot (PARR) to enhance its rehabilitation training safety. Design/methodology/approach First, a kinematic analysis of the PARR is introduced, and the mechanism ensures that the rotation centre of the ankle joint complex (AJC) coincides with robot’s rotation centre. Then, a passive compliance training strategy based on admittance control is described in detail and is implemented on our PARR. Findings Experiments involving healthy subjects were conducted, and the performance of trajectory tracking was quantitatively evaluated, with the results showing excellent compliance and trajectory tracking accuracy, which can ensure that a secondary injury to the AJC during passive rehabilitation training is avoided. The influence of different admittance parameters was also simulated and analysed, which can contribute to the development of adaptive parameter adjustment research. Originality/value The paper can be used to improve the effectiveness of ankle rehabilitation, to alleviate manual therapy problems in terms of labour intensiveness, precision and subjectivity and to ensure safety and comfort during rehabilitation sessions.

Repetitive and intensive physiotherapy is indispensable to patients with ankle disabilities. Increasingly robot-assisted technology has been employed in the treatment to reduce the burden of the therapists and the related costs of the patients. This paper proposes a configuration of a wearable parallel mechanism to supplement the equipment selection for ankle rehabilitation. The kinematic analysis, i.e., the inverse position solution and Jacobian matrices, is elaborated. Several performance indices, including the reachable workspace index, motion isotropy index, force transfer index, and maximum torque index, are developed based on the derived kinematic solution. Moreover, according to the proposed kinematic configuration and wearable design concept, the mechanical structure that contains a basic machine-drive system and a multi-model position/force data collection system is designed in detail. Finally, the results of the performance evaluation indicate that the wearable parallel robot possesses sufficient motion isotropy, high force transfer performance, and large maximum torque performance within a large workspace that can cover all possible range of motion of human ankle complex, and is suitable for ankle rehabilitation.

In order to better perform rehabilitation training on the ankle joint complex in the direction of dorsiflexion/plantarflexion and inversion/eversion, especially when performing the isokinetic muscle strength exercise, we need to calibrate the kinematic model to improve its control precision. The ankle rehabilitation robot we develop is a parallel mechanism, with its movements in the two directions driven by two linear motors. Inverse solution of positions is deduced and the output lengths of the two UPS kinematic branches are calibrated in the directions of dorsiflexion, plantarflexion, inversion, and eversion, respectively. Motion of each branch in different directions is fitted in high-order form according to experimental data. Variances, standard deviation, and goodness of fit are taken into consideration when choosing the best fitting curve, which ensures that each calibration can match the most appropriate fitting curve. Experiments are conducted to verify the effectiveness of the kinematic calibration after finishing the calibration, and the errors before and after calibration of the two kinematic chains in different directions are compared, respectively, which shows that the accuracy after calibration has been significantly improved.