Erin McGonigle

Robot-assisted telerehabilitation (RAT) combines rehabilitation robotics with digital health workflows to extend access to upper-limb (UL) therapy after stroke. Mixed reality (MR) may support therapist–patient interaction and task visualization; however, early-stage systems require rigorous evaluation of safety and usability before deployment in the home. In a formative, mixed-methods usability study conducted in a controlled setting using a telerehabilitation workflow, six individuals post-stroke (≥3 months) and six occupational therapists (OTs) completed a single supervised session with a desktop-mounted end-effector type therapeutic robot (iTbot) integrated with Microsoft HoloLens 2. Participants performed structured passive and active UL exercises while therapists supervised and interacted with the system via the MR control interfaces. Safety was evaluated by documenting observed adverse events and safety-stop activations. Usability and user experience were assessed using the System Usability Scale (SUS), study-specific satisfaction questionnaires (reported with scale ranges), and semi-structured follow-up interviews analyzed using thematic analysis. All participants completed the session without observed adverse events or safety-stop activations. Overall usability was favorable, with a mean (SD) SUS total score of 78.3 (15.9) out of 100 (stroke: 74.2 [18.1]; occupational therapists: 82.5 [13.5]). Qualitative feedback indicated that MR was perceived as engaging and intuitive by many users, while also identifying implementation needs relevant to real-world telerehabilitation, including clearer onboarding, simplification of certain MR interactions, and improved physical interfaces (e.g., handle options). Therapists highlighted workflow considerations for remote supervision and patient independence. Together, these findings support progression to multi-session, in-home studies to quantify remote assistance needs, technical reliability, adherence, and clinical outcomes.

Background Robot-assisted telerehabilitation (RAT) is an emerging field that integrates digital health technologies with robotics to deliver remote therapy, offering significant potential to overcome geographical and accessibility barriers in stroke rehabilitation. This approach holds great promise for enhancing upper limb (UL) recovery in stroke survivors. This study aims to assess the safety and usability of a new tele-rehabilitation system that uses the desktop-mounted rehabilitation (DMRbotV3) device and the HoloLens 2, designed to assist stroke survivors with UL dysfunction in performing therapy. Methods Six individuals with chronic stroke (onset ≥ 3 months) and six occupational therapists (OTs) participated in a single-session usability study. They interacted with the DMRbotV3 robotic device to perform structured passive and active therapeutic exercises within mixed-reality (MR) environments powered by the HoloLens 2 platform. Safety, usability, and user experience were assessed using the System Usability Scale (SUS), a customized gamification and satisfaction questionnaire, an experience evaluation survey, and follow-up interviews. Results The DMRbotV3 system was deemed secure, as evidenced by all twelve participants successfully completing the study without any adverse events. Usability evaluations showed a high level of user satisfaction, with a mean (SD) SUS score of 86.7 (8.5)%. The participants provided positive and constructive feedback on the integration of MR with HoloLens 2, which was determined to substantially increase their engagement and motivation during the exercises. Additional feedback emphasized the system’s ease of use, the need for a variety of handle designs, and the importance of simplifying certain exercise games. Conclusion The study demonstrated that the DMRbotV3 system integrated with HoloLens 2 is a safe, feasible, and well-accepted approach for UL rehabilitation in post-stroke individuals. This approach, by enabling more frequent and comprehensive self-administered practice in-home or remote settings, has the potential to enhance telerehabilitation outcomes and support functional recovery in stroke survivors.

Home-based hand rehabilitation has excellent potential as it may reduce patient dropouts due to travel, transportation, and insurance constraints. Being able to perform exercises precisely, accurately, and in a repetitive manner, robot-aided portable devices have gained much traction these days in hand rehabilitation. However, existing devices fall short in allowing some key natural movements, which are crucial to achieving full potential motion in performing activities of daily living. Firstly, existing exoskeleton type devices often restrict or suffer from uncontrolled wrist and forearm movement during finger exercises due to their setup of actuation and transmission mechanism. Secondly, they restrict passive metacarpophalangeal (MCP) abduction–adduction during MCP flexion–extension motion. Lastly, though a few of them can provide isolated finger ROM, none of them can offer isolated joint motion as per therapeutic need. All these natural movements are crucial for effective robot-aided finger rehabilitation. To bridge these gaps, in this research, a novel lightweight robotic device, namely “Flexohand”, has been developed for hand rehabilitation. A novel compliant mechanism has been developed and included in Flexohand to compensate for the passive movement of MCP abduction–adduction. The isolated and composite digit joint flexion–extension has been achieved by integrating a combination of sliding locks for IP joints and a wire locking system for finger MCP joints. Besides, the intuitive design of Flexohand inherently allows wrist joint movement during hand digit exercises. Experiments of passive exercises involving isolated joint motion, composite joint motions of individual fingers, and isolated joint motion of multiple fingers have been conducted to validate the functionality of the developed device. The experimental results show that Flexohand addresses the limitations of existing robot-aided hand rehabilitation devices.

The research presents a novel controller designed for robotic systems subject to nonlinear uncertain dynamics and external disturbances. The control scheme is based on the modified super-twisting method, input/output feedback linearization, and time delay approach. In addition, to minimize the chattering phenomenon and ensure fast convergence to the selected sliding surface, a new reaching law has been integrated with the control law. The control scheme aims to provide high performance and enhanced accuracy via limiting the effects brought by the presence of uncertain dynamics. Stability analysis of the closed-loop system was conducted using a powerful Lyapunov function, showing finite time convergence of the system’s errors. Lastly, experiments shaping rehabilitation tasks, as performed by healthy subjects, demonstrated the controller’s efficiency given its uncertain nonlinear dynamics and the external disturbances involved.

In this paper, we focus on the human upper limb rehabilitation scheme that utilizes the concept ofteleoperation. Teleoperation can help the therapist demonstrate different rehab exercises to a different group of people at the same time remotely. Different groups of people from a different place connected to the same network can get therapy from the same therapist at the same time using the telerehabilitation scheme. Here, we presented a humanoid robot NAO that can be operated remotely by a therapist to demonstrate the exercise to a patient. To mimic the movement demonstrated by the therapist, Kinect V2 sensor which is a markerless vision-based motion-tracking device, was used. Modified Denavit-Hartenberg (DH) convention was used for the kinematic modeling of the human upper arm. From the Kinect data, a geometric solution was developed to find a unique inverse kinematic solution of human upper-extremity. Experimental results revealed that NAO could be teleoperated successfully to instruct and demonstrate patients to perform different arm movement exercises in real-time.