Robotic therapy devices have been an important part of clinical neurological rehabilitation for several years. Until now such devices are only available for patients receiving therapy inside rehabilitation hospitals. Since patients should continue rehabilitation training after hospital discharge at home, intelligent robotic rehab devices could help to achieve this goal. This paper proposes a novel multimodal home therapy concept and robot based system for motor telerehabilitation which is currently being further developed. The system is based on two haptic rehabilitation devices i) the Bi-Manu-Track (BMT) 2×1 DOF robotic haptic rehabilitation device with assist-as-needed control algorithms and ii) an enhanced version of the 3 DOF passive Reha-Slide system. The paper describes the technical system setup as well as user centered design aspects.

Automation of neurologic rehabilitation becomes more important as the number of age correlated dysfunctions increases. Starting from existing Assist-As-Needed control schemes we designed new algorithms specifically for bilateral tasks. We propose three approaches for controlling an arm rehabilitation device that assists hemiparetic subjects. Design goals are 1) Users should use there healthy arm to generate the desired movement pattern. 2) Force contribution and freedom of movement should be as high as possible for the affected arm. 3) Large errors of the affected arm must be compensated by the device. Simulations and first clinical evaluations support the following results. Goal 1) is achieved by making support independent of time and a set trajectory. Goals 2) and 3) can be achieved with an iterative learning controller that learns a supportive force. Adaptation speed and error sensitivity can be improved with model based approaches. Frequency dependent shifting of the force profile shifts the acceleration to the movement phase in which it is needed resulting in earlier acceleration and deceleration. An additional stiffness should only be used, if the patient's behavior varies to much.

Einleitung Der therapeutische Nutzen robotergestützter Therapie-Übungsgeräte in der Neurologischen Rehabilitation, insbesondere bei schwer betroffenen subakuten Schlaganfallpatienten, konnte inzwischen in klinischen Studien nachgewiesen werden (Hesse et al., 2008; Mehrholz et al., 2008). Bisher sind solche Geräte jedoch nur für die stationäre Reha-Therapie verfügbar. Da jeder Patient die Reha-Behandlung ambulant und zu Hause so intensiv wie möglich fortsetzen sollte, besteht ein großer Bedarf an intelligenten robotergestützten Therapiegeräten, die in neu zu entwickelnde Behandlungskonzepte einer fernbetreuten Therapie eingebunden werden. Hierfür bietet sich die Weiterentwicklung telemedizinischer Therapiekonzepte für eine haptische Telerehabilitation an, über die in diesem Beitrag berichtet wird.