{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T10:00:34Z","timestamp":1780912834075,"version":"3.54.1"},"reference-count":51,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T00:00:00Z","timestamp":1711756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Navantia University-Enterprise Chair on Underwater Robotics and Deeptech Technologies","award":["CAT2356180007"],"award-info":[{"award-number":["CAT2356180007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>The present work proposes a comprehensive metaheuristic methodology for the development of a medical robot for the upper limb rehabilitation, which includes the topological optimization of the device, kinematic models (5 DOF), human\u2013robot interface, control and experimental tests. This methodology applies two cutting-edge triads: (1) the three points of view in engineering design (client, designer and community) and (2) the triad formed by three pillars of Industry 4.0 (autonomous machines and systems, additive manufacturing and simulation of virtual environments). By applying the proposed procedure, a robotic mechanism was obtained with a reduction of more than 40% of its initial weight and a human\u2013robot interface with three modes of operation and a biomechanically viable kinematic model for humans. The digital twin instance and its evaluation through therapeutic routines with and without disturbances was assessed; the average RMSEs obtained were 0.08 rad and 0.11 rad, respectively. The proposed methodology is applicable to any medical robot, providing a versatile and effective solution for optimizing the design and development of healthcare devices. It adopts an innovative and scalable approach to enhance their processes.<\/jats:p>","DOI":"10.3390\/s24072231","type":"journal-article","created":{"date-parts":[[2024,3,31]],"date-time":"2024-03-31T13:32:56Z","timestamp":1711891976000},"page":"2231","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Innovative Metaheuristic Optimization Approach with a Bi-Triad for Rehabilitation Exoskeletons"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3290-2039","authenticated-orcid":false,"given":"Deira","family":"Sosa M\u00e9ndez","sequence":"first","affiliation":[{"name":"Escuela T\u00e9cnica Superior de Ingenier\u00eda y Dise\u00f1o Industrial, Center for Automation and Robotics, UPM-CSIC, Universidad Polit\u00e9cnica de Madrid, Ronda de Valencia, 3, 28012 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1067-0564","authenticated-orcid":false,"given":"Cecilia E.","family":"Garc\u00eda Cena","sequence":"additional","affiliation":[{"name":"Escuela T\u00e9cnica Superior de Ingenier\u00eda y Dise\u00f1o Industrial, Center for Automation and Robotics, UPM-CSIC, Universidad Polit\u00e9cnica de Madrid, Ronda de Valencia, 3, 28012 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8552-6842","authenticated-orcid":false,"given":"David","family":"Bedolla-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Electrical Engineering, \u00c9cole de Technologie Sup\u00e9rieure, 1100 Notre-Dame St. W, Montreal, QC H3C 1K3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Mart\u00edn Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Unidad de Tecnolog\u00edas Avanzadas en Dise\u00f1o e Impresi\u00f3n 3D, Hospital Universitario 12 de Octubre, Av. de C\u00f3rdoba, s\/n, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1128332","DOI":"10.3389\/fnins.2023.1128332","article-title":"Design methodology of portable upper limb exoskeletons for people with strokes","volume":"17","author":"Zhao","year":"2023","journal-title":"Front. Neurosci."},{"key":"ref_2","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_3","first-page":"20556683211045837","article-title":"Effects of therapy with a free-standing robotic exoskeleton on motor function and other health indicators in people with severe mobility impairment due to chronic stroke: A quasi-controlled study","volume":"8","author":"Postol","year":"2021","journal-title":"J. Rehabil. Assist. Technol. Eng."},{"key":"ref_4","first-page":"2055668319863557","article-title":"Evaluating the use of robotic and virtual reality rehabilitation technologies to improve function in stroke survivors: A narrative review","volume":"6","author":"Clark","year":"2019","journal-title":"J. Rehabil. Assist. Technol. Eng."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"103822","DOI":"10.1016\/j.robot.2021.103822","article-title":"An assistive upper-limb exoskeleton controlled by multi-modal interfaces for severely impaired patients: Development and experimental assessment","volume":"143","author":"Gandolla","year":"2021","journal-title":"Robot. Auton. Syst."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Struijk, L.L.N.S.A., Kanstrup, A.M., Bai, S., Bak, T., Thogersen, M.B., Mohammadi, M., Bengtson, S.H., Kobbelgaard, F.V., Gull, M.A., and Bentsen, B. (2022, January 25\u201329). The impact of interdisciplinarity and user involvement on the design and usability of an assistive upper limb exoskeleton\u2014A case study on the EXOTIC. Proceedings of the International Conference on Rehabilitation Robotics (ICORR), Rotterdam, The Netherlands.","DOI":"10.1109\/ICORR55369.2022.9896500"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Aole, S., Elamvazuthi, I., Waghmare, L., Patre, B., Bhaskarwar, T., and Prasetyo, T. (2022, January 6\u20138). ADRC for Upper Limb Exoskeleton: A Simulation Study. Proceedings of the 2022 IEEE 5th International Symposium in Robotics and Manufacturing Automation (ROMA), Malacca, Malaysia.","DOI":"10.1109\/ROMA55875.2022.9915692"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Pons, J.L. (2008). Wearable Robots: Biomechatronic Exoskeletons, John Wiley & Sons.","DOI":"10.1002\/9780470987667"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Rocon, E., and Pons, J.L. (2011). Exoskeletons in Rehabilitation Robotics: Tremor Suppression, Springer.","DOI":"10.1007\/978-3-642-17659-3"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/s13690-023-01100-8","article-title":"Overview of the role of robots in upper limb disabilities rehabilitation: A scoping review","volume":"81","author":"Moulaei","year":"2023","journal-title":"Arch. Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Gull, M.A., Bai, S., and Bak, T. (2020). A review on design of upper limb exoskeletons. Robotics, 9.","DOI":"10.3390\/robotics9010016"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Cruz Mart\u00ednez, G.M., and Z.-Avil\u00e9s, L.A. (2020). Design Methodology for Rehabilitation Robots: Application in an Exoskeleton for Upper Limb Rehabilitation. Appl. Sci., 10.","DOI":"10.20944\/preprints202006.0160.v1"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Tr\u00f6ster, M., Wagner, D., M\u00fcller-Graf, F., Maufroy, C., Schneider, U., and Bauernhansl, T. (2020). Biomechanical model-based development of an active occupational upper-limb exoskeleton to support healthcare workers in the surgery waiting room. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17145140"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Buccelli, S., Tessari, F., Fanin, F., De Guglielmo, L., Capitta, G., Piezzo, C., Bruschi, A., Van Son, F., Scarpetta, S., and Succi, A. (2022). A gravity-compensated upper-limb exoskeleton for functional rehabilitation of the shoulder complex. Appl. Sci., 12.","DOI":"10.3390\/app12073364"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s10846-018-0902-9","article-title":"Evolutionary modular robotics: Survey and analysis","volume":"95","author":"Alattas","year":"2019","journal-title":"J. Intell. Robot. Syst."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1177\/09544119211032010","article-title":"Exoskeleton robots for lower limb assistance: A review of materials, actuation, and manufacturing methods","volume":"235","author":"Hussain","year":"2021","journal-title":"Proc. Inst. Mech. Eng. Part J. Eng. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Peres, F., and Castelli, M. (2021). Combinatorial optimization problems and metaheuristics: Review, challenges, design, and development. Appl. Sci., 11.","DOI":"10.3390\/app11146449"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5003","DOI":"10.1007\/s00366-021-01552-y","article-title":"Topology-based geometry optimization for a new compliant mechanism using improved adaptive neuro-fuzzy inference system and neural network algorithm","volume":"38","author":"Dinh","year":"2021","journal-title":"Eng. Comput."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.compstruc.2016.03.010","article-title":"Seismic design optimization of multi-storey steel-concrete composite buildings","volume":"170","author":"Papavasileiou","year":"2016","journal-title":"Comput. Struct."},{"key":"ref_20","first-page":"72","article-title":"Optimizaci\u00f3n topol\u00f3gica aplicada al dise\u00f1o de componentes estructurales mec\u00e1nicos de peso reducido","volume":"46","author":"Meza","year":"2015","journal-title":"El Hombre y la M\u00e1quina"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1007\/s00366-023-01786-y","article-title":"A comparison of manufacturing constraints in 3D topologically optimized heat sinks for forced air cooling","volume":"39","author":"Wang","year":"2023","journal-title":"Eng. Comput."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Mahmoud, I., and Saidi, I. (2022, January 22\u201324). Trajectory Tracking Control of Upper-Limb Rehabilitaion Exoskeleton Based on Robust Control. Proceedings of the 2022 5th International Conference on Advanced Systems and Emergent Technologies (IC ASET), Hammamet, Tunisia.","DOI":"10.1109\/IC_ASET53395.2022.9765896"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Fei, F., Wang, H., and Tian, Y. (2017, January 26\u201327). Robust Time Delay Estimation Based Intelligent PID Control of a 6DOF Upper-Limb Exoskeleton Robot. Proceedings of the 2017 9th International Conference on Intelligent Human-Machine Systems and Cybernetics (IHMSC), Hangzhou, China.","DOI":"10.1109\/IHMSC.2017.198"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ali, S.K., and Tokhi, M.O. (2018, January 3\u20134). Control Design of a De-Weighting Upper Limb Exoskeleton. Proceedings of the 2018 International Conference on Applied Engineering (ICAE), Batam, Indonesia.","DOI":"10.1109\/INCAE.2018.8579374"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Fellag, R., Benyahia, T., Drias, M., Guiatni, M., and Hamerlain, M. (2017, January 29\u201331). Sliding mode control of a 5 dofs upper limb exoskeleton robot. Proceedings of the 2017 5th International Conference on Electrical Engineering - Boumerdes (ICEE-B), Boumerdes, Algeria.","DOI":"10.1109\/ICEE-B.2017.8192098"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Qureshi, M.U., and Mudassir, M. (2021, January 22\u201323). Robust Control Design For 3 Degree Of Freedom Fully Actuated Upper Limb Exoskeleto. Proceedings of the 2021 16th International Conference on Emerging Technologies (ICET), Islamabad, Pakistan.","DOI":"10.1109\/ICET54505.2021.9689919"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Greco, C., Weerakkody, T.H., Cichella, V., Pagnotta, L., and Lamuta, C. (2023). Lightweight Bioinspired Exoskeleton for Wrist Rehabilitation Powered by Twisted and Coiled Artificial Muscles. Robotics, 12.","DOI":"10.3390\/robotics12010027"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"V\u00e9lez-Guerrero, M.A., Callejas-Cuervo, M., and Mazzoleni, S. (2021). Design, Development, and Testing of an Intelligent Wearable Robotic Exoskeleton Prototype for Upper Limb Rehabilitation. Sensors, 21.","DOI":"10.3390\/s21165411"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Delgado, P., Arachchige Don, T.A., Gomez, J., Mir, a.V., and Yihun, Y. (2021, January 12\u201315). Design of bio-exoskeleton for elbow rehabilitation. Proceedings of the Conference: 2021 Design of Medical Devices Conference, Minneapolis, MN, USA.","DOI":"10.1115\/DMD2021-1035"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5721","DOI":"10.1007\/s12206-022-1034-5","article-title":"An eight-degree-of-freedom upper extremity exoskeleton rehabilitation robot: Design, optimization, and validation","volume":"36","author":"Ning","year":"2022","journal-title":"J. Mech. Sci. Technol."},{"key":"ref_31","first-page":"2055668318800672","article-title":"A task-based design methodology for robotic exoskeletons","volume":"5","author":"Heidari","year":"2018","journal-title":"J. Rehabil. Assist. Technol. Eng."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1017\/S0263574719001085","article-title":"Kinematic design optimization of an eight degree-of-freedom upper-limb exoskeleton","volume":"37","author":"Zeiaee","year":"2019","journal-title":"Robotica"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Sanjuan De Caro, J.D., Sunny, M.S.H., Mu\u00f1oz, E., Hernandez, J., Torres, A., Brahmi, B., Wang, I., Ghommam, J., and Rahman, M.H. (2022). Evaluation of Objective Functions for the Optimal Design of an Assistive Robot. Micromachines, 13.","DOI":"10.3390\/mi13122206"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1080\/24725838.2021.1954565","article-title":"Model-based comparison of passive and active assistance designs in an occupational upper limb exoskeleton for overhead lifting","volume":"9","author":"Zhou","year":"2021","journal-title":"Iise Trans. Occup. Ergon. Hum. Factors"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"108427","DOI":"10.1016\/j.cie.2022.108427","article-title":"Optimization design method of upper limb exoskeleton cam mechanism\u2019s motion trajectory model","volume":"171","author":"Gao","year":"2022","journal-title":"Comput. Ind. Eng."},{"key":"ref_36","first-page":"932305","article-title":"Survey of mechatronic techniques in modern machine design","volume":"2012","author":"Shetty","year":"2012","journal-title":"J. Robot."},{"key":"ref_37","unstructured":"Kapandji, A.I. (2006). Fisiolog\u00eda Articular. Tomo 1: Miembro Superior, Maloine. [6th ed.]."},{"key":"ref_38","unstructured":"Avila-Chaur, R., Prado-Le\u00f3n, L.R., and Gonz\u00e1lez-Mu\u00f1oz, E.L. (2023, December 01). Dimensiones antropom\u00e9tricas de Poblaci\u00f3n Latinoamericana; M\u00e9xico, Cuba, Colombia, Chile. Available online: https:\/\/www.academia.edu\/8966152\/Dimensiones_Antropomtricas_Poblacion_Latinoamericana_1."},{"key":"ref_39","unstructured":"Williams, M., and Lissner, H.R. (1991). Biomec\u00e1nica del Movimiento Humano, Trillas."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1162\/pres.1996.5.4.393","article-title":"Real-time inverse kinematics of the human arm","volume":"5","author":"Tolani","year":"1996","journal-title":"Presence: Teleoperators Virtual Environ."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.compstruc.2015.09.013","article-title":"Life-cycle cost structural design optimization of steel wind towers","volume":"174","author":"Lagaros","year":"2016","journal-title":"Comput. Struct."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.istruc.2020.03.032","article-title":"Optimal design of planar steel frame structures utilizing meta-heuristic optimization algorithms","volume":"Volume 25","author":"Kaveh","year":"2020","journal-title":"Structures"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s00366-018-0598-2","article-title":"Parts internal structure definition using non-uniform patterned lattice optimization for mass reduction in additive manufacturing","volume":"35","author":"Chougrani","year":"2019","journal-title":"Eng. Comput."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"100165","DOI":"10.1016\/j.dajour.2023.100165","article-title":"Digital Twin: Benefits, use cases, challenges, and opportunities","volume":"6","author":"Attaran","year":"2023","journal-title":"Decis. Anal. J."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Huang, Z., Shen, Y., Li, J., Fey, M., and Brecher, C. (2021). A survey on AI-driven digital twins in industry 4.0: Smart manufacturing and advanced robotics. Sensors, 21.","DOI":"10.3390\/s21196340"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e13359","DOI":"10.1016\/j.heliyon.2023.e13359","article-title":"Towards next generation digital twin in robotics: Trends, scopes, challenges, and future","volume":"9","author":"Mazumder","year":"2023","journal-title":"Heliyon"},{"key":"ref_47","unstructured":"(2024, February 21). Hocoma a DIH Brand. Armeo\u00aePower: Technical Data Sheet. Available online: https:\/\/www.hocoma.com\/solutions\/armeo-power\/technical-data-sheet\/."},{"key":"ref_48","unstructured":"(2024, February 21). JACE Systems GmbH. Jace Leben Ist Bewegung. Available online: https:\/\/www.jace-systems.com\/produkte\/schulter-artromot-s3\/s603."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1177\/0278364917706743","article-title":"An upper-body rehabilitation exoskeleton Harmony with an anatomical shoulder mechanism: Design, modeling, control, and performance evaluation","volume":"36","author":"Kim","year":"2017","journal-title":"Int. J. Robot. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"3649","DOI":"10.1109\/LRA.2019.2926958","article-title":"ANYexo: A versatile and dynamic upper-limb rehabilitation robot","volume":"4","author":"Zimmermann","year":"2019","journal-title":"IEEE Robot. Autom. Lett."},{"key":"ref_51","first-page":"6","article-title":"Industry 4.0 and Digital Manufacturing: A design method applying Reverse Engineering","volume":"24","year":"2019","journal-title":"Ingenier\u00eda"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/7\/2231\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:21:36Z","timestamp":1760106096000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/7\/2231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,30]]},"references-count":51,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["s24072231"],"URL":"https:\/\/doi.org\/10.3390\/s24072231","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,30]]}}}