Concept Design and Analysis of a Novel Robot for Rehabilitation and

Assistance

Isela Carrera, Alexandre Campos and Hector A. Moreno

Abstract— In this paper we present the concept design andanalysis of a robot for rehabilitation and assistance, namedMagic Ladder. The different tasks that the device is be able toexecute have been determined based on statistical informationon the types of disabilities most common in Spain. In thiswork, we review the different robots for rehabilitation andassistance that have been previously introduced and describethe advantages of the Magic Ladder over these robots.

I. INTRODUCTION

Statistics show that the number of people with disabilities

in Spain is growing due to the population’s age [2], [1].

For this reason, the development of assistive technology

is an important assignment. Robots for rehabilitation and

assistance can produce a significant improvement in the

quality of life of disabled persons.

Robots for the disabled are generally classified into ther-

apy robots and assistance robots. Therapy robots have two

simultaneous users: The disabled person who receives the

therapy, and the physical therapist who adjusts and supervises

the interaction with the robot. A robot is a good alternative

for a physical therapy because, once the robot is properly

adjusted, it can apply a consistent therapy for long periods

of time, without any effort on the part of the physiotherapists.

Furthermore, the robot sensors can measure the performance

of the patient and determine when he/she can continue

progressively with the therapy [10].

Assistance robots can be serial robot manipulators with

mounted on fixed or mobile platforms. Their purpose is

holding or moving objects, and interact with other devices

and equipments, such as opening a door. Mobile robots

can be controlled by voice or other media to transport

manipulators or other objects.

On the other hand, rehabilitation robotics also include

developments such as the robotic prosthesis and orthesis,

Functional Neuromuscular Stimulation (FNS) and technol-

ogy for the diagnostic and supervision of disabled persons

during everyday activities.

In this work we introduce the concept design and analysis

of a novel robotic system for rehabilitation and assistance,

named the Magic Ladder. Based on statistical information on

the types of disabilities most common in Spain, and other

This work is supported by Spanish Ministery of Science and Education.I. Carrera would like to thank to CONACYT-Mexico for their financialsupport.

Isela Carrera and Hector A. Moreno are with the Center for Automationand Robotics, of the Technical University of Madrid - CSIC, 28006 Madrid,Spain. Alexandre Campos is with Universidade do Estado de Santa Catarina,Santa Catarina, Brazil.icarrera@etsii.upm.es

industrialized countries, we have determined the different

tasks that the device should be able to execute.

The layout of this paper is as follows: Section II presents

statistics of disability in Spain. Section III introduces a

survey of different robots for rehabilitation and assistance

that have been previously proposed. Section IV introduces

the proposed robot, we explain its kinematic structure and

applications. Section V demonstrates the kinematic analysis

of this mechanism. Finally, the conclusions are stated.

II. DISABILITY AND POPULATION

A disability is defined as physical or mental impediment

that substantially limits a person’s movements, senses or

activities. In the last decades, the number of disable people

has significantly increased. In particular, in industrialized

countries, it is mainly caused by the increased of live

expectancy [6].

Low birth rate and advancement in health care are key

factors that have contributed to the growth of the aging

population, and it is expected that it will duplicate by the year

2030. This increasing segment of population will generate

changes for the demand in health care, care giving, and

medical expenses.

Therefore, technical assistive aids such as personal and

service robots could be a key factor in solving this demand.

Spain has a remarkable aging process in its population, and

as a consequence, Spain has experienced an increase on the

disable population, as reported in the EDAD 2008 (acronym

in Spanish for Survey on Disabilities, Personal Autonomy

and Dependency Situations) [2] and in EDDS 1999 (acronym

in Spanish for the Survey on Disabilities, Deficiencies and

Health Status) [1].

The report shows that there are 3.5 million of people with

some type of disability or limitation in Spain, , who among

59.8 % are women. The percentage of disabilities in terms

of age is slightly higher up to 44 years of age in males. This

figure is reversed after 45 years of age and this difference

increases with age, see Fig. 1. Of all the disable population,

the 67.2 % presents limitations in moving or carrying objects.

From the EDDS 1999 [1] it was also found that:

• There are two main groups of displacement activities: a)

moving around the home, and b) activities of standing

up, sitting down, lying down.

• In the elderly population, it is observed that capabilities

of the displacement and the usage of arms and hands

are strongly affected with age.

• The activities of standing up, laying down, moving

around inside the home and carrying light objects are

2012 Brazilian Robotics Symposium and Latin American Robotics Symposium

978-0-7695-4906-4/12 $26.00 © 2012 IEEE

DOI 10.1109/SBR-LARS.2012.63

131

Fig. 1: Pyramid of Population.

TABLE I: Disability Types in Spain (Rates per thousands).

Man Woman

Mobility 42,6 77,5Domestic Life 29,5 69,2Self Care 31,3 55,3Hearing 21,9 28,4Vision 17,8 28,4

Communication 16,3 18,6Application of learning and knowledgeto develop tasks

12,7 17,1

Interaction and personal relationships 14,0 15,4

Total 72,6 106,3

closely related.

• Most falls of elderly people occur inside the home.

55.3 % has problems related with domestic tasks and 48.8

% with care and personal health tasks. The main cause

of disability (42%) is the problems related with bones and

articulations. See Table I.

88.9 % of the population with disabilities receives either

technical or personal care. Disabled people who do not

receive any care, need rather technical (27.3 %) than personal

assistance (16,9 %).

From the population with disabilities, 2.8 millions (6.7 %

of the total in population Spain), have some type of disability

that affects directly their Activities of Daily Living (ADL).

81.7 % receives some kind of assistance that let them to

reduce the severity of their disability. However, 19.3% does

not receive any type of assistance.

As it was mentioned before, more than 2 million of people

has personal care and supervision.The profile of a typical

caregiver is a woman between 45 and 65 years of age, and

the 78.8 % is 24/7 live-in care giving. However, the caregiver

may find some difficulties to accomplish their tasks, mainly

caused by their physical limitation and fatigue.

Some conclusions can be drawn from the information

on the surveys: the development of robotic systems for

disabled persons is important because of the expansion of

the handicapped community due to the increase in life

expectancy; this means that elderly are the main consumers

of these applications. The main issues that the robotic device

is to solve are related to moving and transportation, helping

with balance and gait, and standing up. However, we found

it necessary to allow the patient to keep using his or her

own strength in these activities. The robot can be a great aid

for therapists and especially for caregivers, where the robot

would carry the weight of the patient in order to make up

for the lack of physical strength of the caregiver. The robot

can be installed in a rehabilitation center or at home, and

can help in the rehabilitation of ADLs.

III. ASSISTANCE AND REHABILITATION ROBOTS

A. Assistance Robots

There are three types of architectures of assistance

robots: serial robots mounted on a workstation, serial robots

mounted on a wheelchair, and autonomous mobile robots.

In the case of serial robots mounted on a workstation,

the history begins with the robot designed by Roesler in

Heidelberg, East Germany in the mid 70’s. The system

consisted of a manipulator with five degrees of freedom

placed in a specially adapted desktop environment using

rotating shelves units [21]. Other examples of this type of

robots are the DeVAR robot (Desktop Vocational Assistive

Robot) and the RT robot. DeVAR consisted of an industrial

Puma 260 manipulator, mounted upside down on an overhead

track [7]. The RT robot was a modified SCARA manipulator.

The RT had two rotational joints with vertical axis that

allowed the arm to move through the horizontal plane, and

an additional degree of freedom in the vertical axis[13].

One of the most commercially successful robots was

Handy 1 by Rehab Robotics from the United Kingdom.

The project was initially designed to help people who have

serious problems eating on their own. Recently, system

extensions have been made to apply makeup, wash up

and shave [23]. Among the mobile robots it is found that

the Movar robot that is essentially the DEVAR robot with

wheels. The mobile base has sophisticated omni-directional

wheels [8].

Another robot of this type is the KARES II, which includes

the use of an optical mouse, Haptic equipment and a robotic

arm. The arm has been assembled in a number of different

configurations, but mainly on a remote mobile base [4].

Another notable project is the research from Bath Institute

of Medical Engineering with the introduction of the Wessex

robot, mounted on an automated mobile base [13].

The most notable robots mounted on wheelchairs are

Manus and Raptor. Manus work began in 1984. Manus is

a sophisticated robot manipulator that can be mounted on

different wheelchairs. It has 7 degrees of freedom and a

simple claw [9]. Moreover, Raptor is similar to Manus except

for its price, a third of that of Manus [18],[9].

132

B. Therapy Robots

The use of robots for facilitating the motion in rehabili-

tation therapy to stroke patients has been one of the fastest

growing areas of research in recent years. The reason for this

growth is the potential to provide effective therapy at a low,

acceptable cost.

It is known that by exercising the affected part, it could

recover some degree of functionality [17]. A Robot could be

used for replicating the exercises provided by the therapist,

but it also has the potential to reproduce other regimes

that would not be easily carried out by a human being.

Some of the robots with these abilities are the MIME

System from VA Palo Alto that allows the movement of the

affected and the unaffected limbs [22], and the the ARM and

GENTLES [3] projects. On the other hand, a rehabilitation

robotic system driven by pneumatic swivel modules, was

presented in [19]. This robot is intended to assist in the

treatment of stroke patients by applying the Proprioceptive

Neuromuscular Facilitation method.

Other examples of commercial robots for therapy are the

InMotion Arm Robot, based on the pioneering MIT- Manus

[16], and the ARMEO R© [11] series system.

Recently, some works have been focused on gait and

balance rehabilitation for stroke patients. They are able to

support patient’s body, while he or she maintain a nearly

natural walk and can concentrate on other activities. Within

the group of gait rehabilitation, the Walkaround system helps

to walk to people who have suffered from hemiplegia or other

diseases that require assistance in posture [24].

Other highly developed devices for rehabilitation and gait

balance are WHERE I and WHERE II. WHERE I is a mobile

robot that assists with gait, it contains one rotational degree

of freedom arm manipulator that adjusts to different heights

and sizes and supports the body. WHERE II is a mobile

vehicle that consists of four pneumatic bars that are adjusted

to each side of the body [15].

There are commercial robots for children called SAM and

SAM-Y that help in gait rehabilitation. SAM is a techno-

logical transfer done by Enduro Medical Technology. SAM

allows patients to stand and walk around without the help of

a physical therapist [12]. The Lokomat R©, is another example

of commercially available assistant for gait rehabilitation. It

is a driven gait orthosis that automates locomotion therapy

on a treadmill [14].

One of the most complex works is KineAssist which is

a robotic device for gait training and balance. KineAssists

provides a weight partial support to the body in the torso.

It provides various motion axis in the trunk and pelvis. The

KineAssist leaves the legs free to allow a physical therapist

work freely. The robot can follow the patient walking motion

in different directions such as straight, turning or climbing a

step. It can also catch the patient if he or she starts to fall

down or assist in the therapy to stand up.

In addition to the development of gait rehabilitation de-

vices, there are those that help to stand up from the sitting

down position. Chugo et. al. propose a design focused on

elderly people that need assistance for standing and walking

in their daily lives. The system consists of a cushioned

support with three degrees of freedom and a gait system.

The support is actuated by a manipulation mechanism made

up of a four bar system [5].

IV. DESCRIPTION OF THE MAGIC LADDER

The magic ladder is intended to interact with the user in

a hospital or home. Its design should guarantee the integrity

and safety of the user and environmental elements. The

robot is suspended from the ceiling through tracks and

simultaneously supported on the ground (see Fig. 2.) This

idea presents several advantages in the achievement of the

desired objectives over robots that only move on the floor.

These advantages are: there is less risk of collision with the

person, better performance when it serves as a support for

balance, better access to high places, it does not require a

complex navigation system to detect objects on the floor, it

minimizes the use of free spaces in the room, and can be

adapted to perform different tasks by using different tools at

the end-effector.

The robot is composed of four elements. They are: a

traction system on the rails, the parallel frame, the actuated

prismatic joint of the holding bar, and the omni-directional

wheels.

Translational motion ofthe car on the rail

Transnationalmotion of theprismatic jointson the parallelframe

InterchangeableToolHoldingBar

Fig. 2: Robotic System - Motion of the actuated joints

The rail traction system is located on the ceiling and

supports the entire structure. The parallel frame is supported

directly by the traction system; on the lower end it has

two wheels, and also it contains the prismatic joints. These

prismatic joints can move independently or simultaneously

over the parallel frame. Different types of tools can be

fixed on the prismatic joints, depending on the task to be

accomplished.

The rails are located on the roof according to a predefined

route in the house. The rails can be curved and, in some

cases, a special mechanism can be used to make rail changes

with turntables and exchangers. The parallel frame is con-

nected to the carriage that is moved by the rail through a pair

of orthogonal rotational joints. The vertical rotational joint is

actuated, and the other is passive. The carriages are based on

133

Ceiling Hoists, a well known technology used to transport

handicapped persons. The prismatic joints slide along the

parallel frame and allow the mobility of the tool in use. It

is possible to use a holding bar, a harness, a clamp or a

special designed support, at the prismatic joints and perform

different tasks. Some components are available commercially

and are widely used, such as the rail on the ceiling, the

prismatic actuators, etc., however the integration of these

components in the described manner offers the previously

cited advantages over the solutions currently in use.

Applications

The main application of this system is assisting with gait,

a very basic ADL. Additionally, some users with limitations

of leg movement require remaining in a static position,

maintaining balance, while they carry out other ADLs. In

order to avoid accidents, it is required that the robot support

the user and prevents a fall.

On the other hand, a common rehabilitation application

is the training of motion patterns that are used frequently in

daily life. For that reason, therapists guide the patient’s limbs

in a way that simulates the activity for relearning. Depending

on the robot modularity, a device to support the user can be

installed instead of the holding bar. The robot is programmed

in such a way that the support follows a convenient trajectory

that produces predetermined motions in different joints, such

as the desired exercise for rehabilitation is performed.

Fig.3 shows the Magic Ladder assisting with gait. Because

of the possibility of adapting different tools to the robot’s

end effector, it can assist the gait of the user through the use

of a harness as a support tool for the weight of the body,

so that the user’s hands remain free during the gait or in a

static position while carrying out ADLs such as cooking or

washing, see Fig.4. Another end effector could be a hook to

help the user to load heavy objects.

Fig. 3: Robot assisting with gait

The system has the ability to obtain information, for

example the strength or torque of the user. This information

is of significant importance since it may be processed and

considered in the following movements of the robot.

Considering the possibility that the robot follows complex

trajectories, with positions, speed and predefined forces of

Fig. 4: Robot supporting body weight through a harness,

leaving hands free to perform DLA

high precision and repeatability, other application of the

proposed robot is to guide a user’s limb for learning or

training in the corresponding ADL tasks. Such an example

is exercising the legs or arms. An example of a complex

trajectory is standing up; this is one of the main problems

to resolve. The robot would even have the ability to provide

assistance from the squatting to the standing position in case

the user needs to pick something up from the floor.

V. KINEMATIC ANALYSIS

In order to determine the ability of the robot to execute

de different task previously presented, we performed the

kinematic analysis of the robot, which is presented in this

section. For the analysis, consider the kinematic scheme of

the Magic ladder that is shown in fig. 5.

The fixed reference frame is at the floor. For our purposes,

the x− y plane is parallel to the sagittal plane. The joint

variable q1 corresponds to the prismatic joint mounted in the

body of the magic ladder. The joint variable q2 corresponds

to the prismatic joint that provides horizontal movement to

the system. Finally, the joint variable q3 corresponds to the

rotational joint whose axis is parallel to the y axis of the

reference frame.

A. Direct Kinematics

1) Position Analysis: The direct position analysis con-

sist of determining the position of the handle, rt =[rtx rty rtz

]T, the given the values of the joint variables

vector, q =[q1 q2 q3

]T. From fig. 5, the vector rt can be

obtained by the following sum of vectors:

rt = r1 + r2 (1)

where:

r1 =

⎡⎣ q2

h− l

0

⎤⎦ and r2 =

⎡⎣−q1 cos(θ)cos(q3)

−q1 sin(θ)q1 cos(θ)sin(q3)

⎤⎦

Parameters θ (angle in fig. 5), h (the height of rails) and l

(distance between the rails and the end of the the frame at the

rotational joint) depends on the geometrical characteristics of

the system.

2) Velocity Analysis: The direct velocity analysis consist

of determining the velocity of the handle, given the actuators

velocities. By deriving 1, we can obtain the velocity model

of the system in the following form:

rt = Jq (2)

134

1r

2r

2r

1q

3q

2q

2q

�t

r

x

x

y

z

3q

Fig. 5: Kinematic scheme of the Magic ladder

where rt and q denote the time derivatives of rt and q,

respectively. The Jacobian matrix is:

J =

⎡⎣−cos(θ)cos(q3) 1 q1 cos(θ)sin(q3)

−sin(θ) 0 0

cos(θ)sin(q3) 0 q1 cos(θ)cos(q3)

⎤⎦ (3)

3) Acceleration Analysis: By deriving 2, the acceleration

of the handle, rt , can be computed given the velocities and

accelerations in the joints, q and q. The direct acceleration

analysis is obtained by the following equation:

rt = Jq+ Jq (4)

where matrix J is the time derivative of 3 and has the

following form:

J=

⎡⎣cos(θ)sin(q3)q3 0 cos(θ)(q1 sin(q3)+q1 cos(q3)q3)

0 0 0

cos(θ)cos(q3)q3 0 cos(θ)(q1 cos(q3)−q1 sin(q3)q3)

⎤⎦

(5)

B. Inverse Kinematics

1) Position Analysis: The inverse position analysis consist

of determining the joint variables, q1, q2 and q3, given the

position of the handle rt . From the the sum of vectors, in 1,

we can obtain the expressions for the joint variables:

q1 =h− l− rty

sin(θ), (6)

q2 = rtx +(h− l− rty)

tan(θ)

√1−

(rtz tan(θ)

h− l− rty

)2

(7)

and

q3 = arcsin

(rtz tan(θ)

h− l− rty

). (8)

2) Velocity Analysis: In order to obtain the required joint

velocities for a desired velocity in the handle, we solve the

equation 2 for q:

q = J−1rt (9)

3) Acceleration Analysis: The inverse acceleration analy-

sis is obtained in the following form:

q = J−1(rt − Jq) (10)

C. Kinematics of the Robot during the Sit to Standing task

(STS)

Rising from the chair is an important basic task of daily

living, that requires coordination and accurate balance con-

trol. The path of the gait has been investigated in the past,

and a robot with the appropriate end effector (see Fig. 6) will

be capable to reproduce the trajectory to help the patient’s

body to follow it and use the remaining strength of the patient

without exhausting his/her physical ability.

Fig. 6: Robot making movement to help lift a person

Using the information obtained from the movement pattern

that a person does during this operation, we determine, by

inverse kinematics, the movements required in the actuators

to perform the task.

0 500 1000 1500 2000 2500−1.6

−1.4

−1.2

−1

−0.8

−0.6

−0.4

−0.2

0

0.2

t (ms)

rad

θ∗1

θ∗2

Fig. 7: Movement pattern in STS activity

Fig. 7 shows the values of joint angles, these angles are

measured with respect to its initial value, when the person is

seated. The movement pattern was extracted from [20]. Fig.

8 shows the movements of the robot’s joints.

135

0 500 1000 1500 2000 2500800

1000

1200

1400

1600

1800

2000

2200

t (ms)

mm

q1

q2

Fig. 8: Motion of the robot joints

VI. CONCLUSIONS

From the results of the surveys, it can be seen that the

technical solution for the assistance will be an important

topic to cover in the coming years, since the increasing of

the disable population. Some of the principal problems to

solve are related to translation and transportation, balance,

gait and STS tasks.

A rehabilitation robot could be of great help for therapist

or caretakers, specially to help them to carry an manipulate

the patient, effortlessly.

Based on this consideration, we proposed in this document

the design of a robot that can assist to people that have

their locomotion functions limited. It could be installed in

a rehabilitation center or at home in order to assist people

with disabilities in their ADLs and rehabilitation therapy.

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