Bilateral Control of Functional Electrical Stimulation and Robotics-based Telerehabilitation.

Currently a telerehabilitation system includes a therapist and a patient where the therapist interacts with the patient, typically via a verbal and visual communication, for assessment and supervision of rehabilitation interventions. This mechanism often fails to provide physical assistance, which is a modus operandi during physical therapy or occupational therapy. Incorporating an actuation modality such as functional electrical stimulation (FES) or a robot at the patient's end that can be controlled by a therapist remotely, to provide therapy or to assess and measure rehabilitation outcomes can significantly transform current telerehabilitation technology. In this paper, a position-synchronization controller is derived for FES-based telerehabilitation to provide physical assistance that can be controlled remotely. The newly derived controller synchronizes an FES-driven human limb with a remote physical therapist's robotic manipulator despite constant bilateral communication delays. The control design overcomes a major stability analysis challenge: the unknown and unstructured nonlinearities in the FES-driven musculoskeletal dynamics. To address this challenge, the nonlinear muscle model was estimated through two neural networks functions that approximated unstructured nonlinearities and an adaptive control law for structured nonlinearities with online update laws. A Lyapunov-based stability analysis was used to prove the globally uniformly ultimately bounded tracking performance. The performance of the state synchronization controller was validated through experiments on an able-bodied subject. Specifically, we demonstrated bilateral control of FES-elicited leg extension and a human operated robotic manipulator. The controller was shown to effectively synchronize the system despite unknown and different delays in the forward and backward channels.