Following a stroke, individuals often experience mobility and balance impairments due to lower-limb weakness and loss of independent joint control. Gait recovery is a key goal of rehabilitation, traditionally achieved through high-intensity therapist-led training. However, manual assistance can be physically demanding and limits the therapist's ability to interact with multiple joints simultaneously. Robotic exoskeletons offer multi-joint support, reduce therapist strain, and provide objective feedback, but current control strategies often limit therapist involvement and adaptability. We present a novel gait rehabilitation paradigm based on physical Human-Robot-Human Interaction (pHRHI), where both the therapist and the post-stroke individual wear lower-limb exoskeletons virtually connected at the hips and knees via spring-damper elements. This enables bidirectional interaction, allowing the therapist to guide movement and receive haptic feedback. In a study with eight chronic stroke patients, pHRHI training outperformed conventional therapist-guided treadmill walking, leading to increased joint range of motion, step metrics, muscle activation, and motivation. These results highlight pHRHI's potential to combine robotic precision with therapist intuition for improved rehabilitation outcomes.

Spasticity is a common movement disorder symptom in individuals with cerebral palsy, hereditary spastic paraplegia, spinal cord injury and stroke, being one of the most disabling features in the progression of these diseases. Despite the potential benefit of using wearable robots to treat spasticity, their use is not currently recommended to subjects with a level of spasticity above ${1^+}$ on the Modified Ashworth Scale. The varying dynamics of this velocity-dependent tonic stretch reflex make it difficult to deploy safe personalized controllers. Here, we describe a novel adaptive torque controller via deep reinforcement learning (RL) for a knee exoskeleton under joint spasticity conditions, which accounts for task performance and interaction forces reduction. To train the RL agent, we developed a digital twin, including a musculoskeletal-exoskeleton system with joint misalignment and a differentiable spastic reflexes model for the muscles activation. Results for a simulated knee extension movement showed that the agent learns to control the exoskeleton for individuals with different levels of spasticity. The proposed controller was able to reduce maximum torques applied to the human joint under spastic conditions by an average of 10.6\% and decreases the root mean square until the settling time by 8.9\% compared to a conventional compliant controller.

Partial-assistance exoskeletons hold significant potential for gait rehabilitation by promoting active participation during (re)learning of normative walking patterns. Typically, the control of interaction torques in partial-assistance exoskeletons relies on a hierarchical control structure. These approaches require extensive calibration due to the complexity of the controller and user-specific parameter tuning, especially for activities like stair or ramp navigation. To address the limitations of hierarchical control in exoskeletons, this work proposes a three-step, data-driven approach: (1) using recent sensor data to probabilistically infer locomotion states (landing step length, landing step height, walking velocity, step clearance, gait phase), (2) allowing therapists to modify these features via a user interface, and (3) using the adjusted locomotion features to predict the desired joint posture and model stiffness in a spring-damper system based on prediction uncertainty. We evaluated the proposed approach with two healthy participants engaging in treadmill walking and stair ascent and descent at varying speeds, with and without external modification of the gait features through a user interface. Results showed a variation in kinematics according to the gait characteristics and a negative interaction power suggesting exoskeleton assistance across the different conditions.

This work presents a novel rehabilitation framework designed for a therapist, wearing an inertial measurement unit (IMU) suit, to virtually interact with a lower-limb exoskeleton worn by a patient with motor impairments. This framework aims to harmonize the skills and knowledge of the therapist with the capabilities of the exoskeleton. The therapist can guide the patient's movements by moving their own joints and making real-time adjustments to meet the patient's needs, while reducing the physical effort of the therapist. This eliminates the need for a predefined trajectory for the patient to follow, as in conventional robotic gait training. For the virtual interaction medium between the therapist and patient, we propose an impedance profile that is stiff at low frequencies and less stiff at high frequencies, that can be tailored to individual patient needs and different stages of rehabilitation. The desired interaction torque from this medium is commanded to a whole-exoskeleton closed-loop compensation controller. The proposed virtual interaction framework was evaluated with a pair of unimpaired individuals in different teacher-student gait training exercises. Results show the proposed interaction control effectively transmits haptic cues, informing future applications in rehabilitation scenarios.

The manipulation of deformable linear objects (DLOs) via model-based control requires an accurate and computationally efficient dynamics model. Yet, data-driven DLO dynamics models require large training data sets while their predictions often do not generalize, whereas physics-based models rely on good approximations of physical phenomena and often lack accuracy. To address these challenges, we propose a physics-informed neural ODE capable of predicting agile movements with significantly less data and hyper-parameter tuning. In particular, we model DLOs as serial chains of rigid bodies interconnected by passive elastic joints in which interaction forces are predicted by neural networks. The proposed model accurately predicts the motion of an robotically-actuated aluminium rod and an elastic foam cylinder after being trained on only thirty seconds of data. The project code and data are available at: \url{https://tinyurl.com/neuralprba}

Human-robot physical interaction contains crucial information for optimizing user experience, enhancing robot performance, and objectively assessing user adaptation. This study introduces a new method to evaluate human-robot co-adaptation in lower limb exoskeletons by analyzing muscle activity and interaction torque as a two-dimensional random variable. We introduce the Interaction Portrait (IP), which visualizes this variable's distribution in polar coordinates. We applied this metric to compare a recent torque controller (HTC) based on kinematic state feedback and a novel feedforward controller (AMTC) with online learning, proposed herein, against a time-based controller (TBC) during treadmill walking at varying speeds. Compared to TBC, both HTC and AMTC significantly lower users' normalized oxygen uptake, suggesting enhanced user-exoskeleton coordination. IP analysis reveals this improvement stems from two distinct co-adaptation strategies, unidentifiable by traditional muscle activity or interaction torque analyses alone. HTC encourages users to yield control to the exoskeleton, decreasing muscular effort but increasing interaction torque, as the exoskeleton compensates for user dynamics. Conversely, AMTC promotes user engagement through increased muscular effort and reduced interaction torques, aligning it more closely with rehabilitation and gait training applications. IP phase evolution provides insight into each user's interaction strategy development, showcasing IP analysis's potential in comparing and designing novel controllers to optimize human-robot interaction in wearable robots.

Controlling the interaction forces between a human and an exoskeleton is crucial for providing transparency or adjusting assistance or resistance levels. However, it is an open problem to control the interaction forces of lower-limb exoskeletons designed for unrestricted overground walking. For these types of exoskeletons, it is challenging to implement force/torque sensors at every contact between the user and the exoskeleton for direct force measurement. Moreover, it is important to compensate for the exoskeleton's whole-body gravitational and dynamical forces, especially for heavy lower-limb exoskeletons. Previous works either simplified the dynamic model by treating the legs as independent double pendulums, or they did not close the loop with interaction force feedback. The proposed whole-exoskeleton closed-loop compensation (WECC) method calculates the interaction torques during the complete gait cycle by using whole-body dynamics and joint torque measurements on a hip-knee exoskeleton. Furthermore, it uses a constrained optimization scheme to track desired interaction torques in a closed loop while considering physical and safety constraints. We evaluated the haptic transparency and dynamic interaction torque tracking of WECC control on three subjects. We also compared the performance of WECC with a controller based on a simplified dynamic model and a passive version of the exoskeleton. The WECC controller results in a consistently low absolute interaction torque error during the whole gait cycle for both zero and nonzero desired interaction torques. In contrast, the simplified controller yields poor performance in tracking desired interaction torques during the stance phase.

Physical interaction between individuals plays an important role in human motor learning and performance during shared tasks. Using robotic devices, researchers have studied the effects of dyadic haptic interaction mostly focusing on the upper-limb. Developing infrastructure that enables physical interactions between multiple individuals' lower limbs can extend the previous work and facilitate investigation of new dyadic lower-limb rehabilitation schemes. We designed a system to render haptic interactions between two users while they walk in multi-joint lower-limb exoskeletons. Specifically, we developed an infrastructure where desired interaction torques are commanded to the individual lower-limb exoskeletons based on the users' kinematics and the properties of the virtual coupling. In this pilot study, we demonstrated the capacity of the platform to render different haptic properties (e.g., soft and hard), different haptic connection types (e.g., bidirectional and unidirectional), and connections expressed in joint space and in task space. With haptic connection, dyads generated synchronized movement, and the difference between joint angles decreased as the virtual stiffness increased. This is the first study where multi-joint dyadic haptic interactions are created between lower-limb exoskeletons. This platform will be used to investigate effects of haptic interaction on motor learning and task performance during walking, a complex and meaningful task for gait rehabilitation.