{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T22:30:24Z","timestamp":1774305024832,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Science Foundation","award":["CBET-1915872"],"award-info":[{"award-number":["CBET-1915872"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>This research presents an Assist-as-Needed (AAN) Algorithm for controlling a bio-inspired exoskeleton, specifically designed to aid in elbow-rehabilitation exercises. The algorithm is based on a Force Sensitive Resistor (FSR) Sensor and utilizes machine-learning algorithms that are personalized to each patient, allowing them to complete the exercise by themselves whenever possible. The system was tested on five participants, including four with Spinal Cord Injury and one with Duchenne Muscular Dystrophy, with an accuracy of 91.22%. In addition to monitoring the elbow range of motion, the system uses Electromyography signals from the biceps to provide patients with real-time feedback on their progress, which can serve as a motivator to complete the therapy sessions. The study has two main contributions: (1) providing patients with real-time, visual feedback on their progress by combining range of motion and FSR data to quantify disability levels, and (2) developing an assist-as-needed algorithm for rehabilitative support of robotic\/exoskeleton devices.<\/jats:p>","DOI":"10.3390\/s23052460","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T02:57:34Z","timestamp":1677121054000},"page":"2460","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Integration of Task-Based Exoskeleton with an Assist-as-Needed Algorithm for Patient-Centered Elbow Rehabilitation"],"prefix":"10.3390","volume":"23","author":[{"given":"Pablo","family":"Delgado","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, Wichita State University, Wichita, KS 67260, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2869-170X","authenticated-orcid":false,"given":"Yimesker","family":"Yihun","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Wichita State University, Wichita, KS 67260, USA"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.1161\/STR.0b013e318296aeca","article-title":"An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"44","author":"Sacco","year":"2013","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1080\/096382899297855","article-title":"Handicap in stroke survivors","volume":"21","author":"Clarke","year":"1999","journal-title":"Disabil. Rehabil."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1177\/03635465010290052401","article-title":"Motion loss after ligament injuries to the knee: Part I: Causes","volume":"29","author":"Millett","year":"2001","journal-title":"Am. J. Sport. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/j.jse.2013.04.019","article-title":"Surgical treatment of elbow stiffness caused by post-traumatic heterotopic ossification","volume":"22","author":"Koh","year":"2013","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"130","DOI":"10.2519\/jospt.2005.35.3.130","article-title":"The effect of rotator cuff tear size on shoulder strength and range of motion","volume":"35","author":"McCabe","year":"2005","journal-title":"J. Orthop. Sport. Phys. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/S1474-4422(09)70150-4","article-title":"Motor recovery after stroke: A systematic review","volume":"8","author":"Langhorne","year":"2009","journal-title":"Lancet Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kyrarini, M., Lygerakis, F., Rajavenkatanarayanan, A., Sevastopoulos, C., Nambiappan, H.R., Chaitanya, K.K., Babu, A.R., Mathew, J., and Makedon, F. (2021). A survey of robots in healthcare. Technologies, 9.","DOI":"10.3390\/technologies9010008"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Lee, M.H., Siewiorek, D.P., Smailagic, A., Bernardino, A., and Badia, S.B. (September, January 31). Towards personalized interaction and corrective feedback of a socially assistive robot for post-stroke rehabilitation therapy. Proceedings of the 2020 29th IEEE International Conference on Robot and Human Interactive Communication (RO-MAN), Naples, Italy.","DOI":"10.1109\/RO-MAN47096.2020.9223462"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1109\/TMECH.2016.2618888","article-title":"Design of a 7-DOF cable-driven arm exoskeleton (CAREX-7) and a controller for dexterous motion training or assistance","volume":"22","author":"Cui","year":"2016","journal-title":"IEEE\/ASME Trans. Mechatron."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"041008","DOI":"10.1115\/1.4040132","article-title":"Kinematic analysis and design of a novel shoulder exoskeleton using a double parallelogram linkage","volume":"10","author":"Christensen","year":"2018","journal-title":"J. Mech. Robot."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"17298806221118855","DOI":"10.1177\/17298806221118855","article-title":"A novel end-effector upper limb rehabilitation robot: Kinematics modeling based on dual quaternion and low-speed spiral motion tracking control","volume":"19","author":"Li","year":"2022","journal-title":"Int. J. Adv. Robot. Syst."},{"key":"ref_12","first-page":"021110","article-title":"Task-based knee rehabilitation with assist-as-needed control strategy and recovery tracking system","volume":"3","author":"Yihun","year":"2020","journal-title":"J. Eng. Sci. Med. Diagn. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/09602010343000101","article-title":"Assistive technology for cognitive rehabilitation: State of the art","volume":"14","author":"Mihailidis","year":"2004","journal-title":"Neuropsychol. Rehabil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s12369-011-0128-5","article-title":"Stiffness and impedance control using Lyapunov theory for robot-aided rehabilitation","volume":"4","author":"Mehdi","year":"2012","journal-title":"Int. J. Soc. Robot."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"700823","DOI":"10.3389\/fnbot.2021.700823","article-title":"Robust torque predictions from electromyography across multiple levels of active exoskeleton assistance despite non-linear reorganization of locomotor output","volume":"15","author":"George","year":"2021","journal-title":"Front. Neurorobotics"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Hu, B., Zhang, F., Lu, H., Zou, H., Yang, J., and Yu, H. (2021). Design and assist-as-needed control of flexible elbow exoskeleton actuated by nonlinear series elastic cable driven mechanism. Actuators, 10.","DOI":"10.3390\/act10110290"},{"key":"ref_17","first-page":"V001T10A002","article-title":"Design of bio-exoskeleton for elbow rehabilitation","volume":"Volume 84812","author":"Delgado","year":"2021","journal-title":"Proceedings of the Frontiers in Biomedical Devices"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/0094-114X(88)90092-4","article-title":"The Bennett linkage and its associated quadric surfaces","volume":"23","author":"Baker","year":"1988","journal-title":"Mech. Mach. Theory"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Palazzi, E., Luzi, L., Dimo, E., Meneghetti, M., Vicario, R., Luzia, R.F., Vertechy, R., and Calanca, A. (2022). An Affordable Upper-Limb Exoskeleton Concept for Rehabilitation Applications. Technologies, 10.","DOI":"10.3390\/technologies10010022"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Abdelbar, M., Mohamed, I., Abdellatif, A., and Hegaze, M.M. (2022). Towards the Mechatronic Development of a New Upper-Limb Exoskeleton (SAMA). Designs, 6.","DOI":"10.3390\/designs6050080"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Li, S., Wang, Z., Pang, Z., Duan, Z., and Gao, M. (2022, January 17\u201322). Design and analysis of an upper limb exoskeleton robot for stroke rehabilitation. Proceedings of the 2022 IEEE International Conference on Real-time Computing and Robotics (RCAR), Guiyang, China.","DOI":"10.1109\/RCAR54675.2022.9872238"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1002\/jor.1100180206","article-title":"Assessment of elbow joint kinematics in passive motion by electromagnetic motion tracking","volume":"18","author":"Bottlang","year":"2000","journal-title":"J. Orthop. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1007\/s42235-022-00226-9","article-title":"Human-Exoskeleton Joint Coordination Assessment: A Case Study on the Shoulder and Elbow Joints","volume":"19","author":"Delgado","year":"2022","journal-title":"J. Bionic Eng."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Yaniger, S. (1991, January 16\u201318). Force sensing resistors: A review of the technology. Proceedings of the Electro International, New York, NY, USA.","DOI":"10.1109\/ELECTR.1991.718294"},{"key":"ref_25","first-page":"012084","article-title":"Ordinary least square regression, orthogonal regression, geometric mean regression and their applications in aerosol science","volume":"Volume 78","author":"Leng","year":"2007","journal-title":"Proceedings of the Journal of Physics: Conference Series"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1136\/bmj.331.7521.903","article-title":"Standard deviations and standard errors","volume":"331","author":"Altman","year":"2005","journal-title":"BMJ"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0140-6736(02)07603-1","article-title":"Spinal-cord injury","volume":"359","author":"McDonald","year":"2002","journal-title":"Lancet"},{"key":"ref_28","first-page":"1","article-title":"Duchenne muscular dystrophy","volume":"7","author":"Duan","year":"2021","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"7185","DOI":"10.1109\/LRA.2021.3097832","article-title":"Human joint torque modelling with MMG and EMG during lower limb human-exoskeleton interaction","volume":"6","author":"Caulcrick","year":"2021","journal-title":"IEEE Robot. Autom. Lett."},{"key":"ref_30","first-page":"30","article-title":"The abc of emg","volume":"Volume 1","author":"Konrad","year":"2005","journal-title":"A Practical Introduction to Kinesiological Electromyography"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/5\/2460\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:40:09Z","timestamp":1760121609000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/5\/2460"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,23]]},"references-count":30,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["s23052460"],"URL":"https:\/\/doi.org\/10.3390\/s23052460","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,23]]}}}