Lower limbs robotic rehabilitation case study with clinical trials

Robotic based lower limbs rehabilitation is addressed in this chapter. Different existing devices are presented to point out the context of mobilization of the limbs. The mechanical constructions of the systems ‘‘Lambda’’ and the ‘‘MotionMaker’’ developed at the Laboratoire de Systèmes Robotiques (LSROEPFL) are reviewed. The MotionMaker allows the mobilization of both legs with a twice 3 degrees of freedom orthosis (hip, knee and ankle of each leg). It has been developed for paraplegics and is the main concern in this chapter. The therapy, combining the mobilization of the legs through flexion/extension and the closed loop muscle electrostimulation is explained and clearly detailed. The results of three clinical studies are presented. In the first one, a simple knee orthosis is used to prove the possibility to follow an isotonic torque during an isokinetic knee extension by closed loop electrical stimulation. In the second clinical study, the academic MotionMaker has been used with 5 paraplegic subjects to evaluate the voluntary force progress and the reduction of the spastic behavior. Finally, the last clinical study describes the use of the commercial MotionMaker provided by the Swiss company Swortec during the last 5 years. More than 24 subjects have been considered and the increase of the voluntary force is clearly observed.