Learning Varying Physical Therapist-Patient Interactions for Robot-mediated Upper Limb Task-Specific Training

Post-stroke rehabilitation is often necessary for patients to regain proper walking gait. However, the typical therapy process can be exhausting and physically demanding for therapists, potentially reducing therapy intensity, duration, and consistency over time. We propose a Patient-Therapist Force Field (PTFF) to visualize therapist responses to patient kinematics and a Synthetic Therapist (ST) machine learning model to support the therapist in dyadic robot-mediated physical interaction therapy. The first encodes patient and therapist stride kinematics into a shared low-dimensional latent manifold using a Variational Autoencoder (VAE) and models their interaction through a Gaussian Mixture Model (GMM), which learns a probabilistic vector field mapping patient latent states to therapist responses. This representation visualizes patient-therapist interaction dynamics to inform therapy strategies and robot controller design. The latter is implemented as a Long Short-Term Memory (LSTM) network trained on patient-therapist interaction data to predict therapist-applied joint torques from patient kinematics. Trained and validated using leave-one-out cross-validation across eight post-stroke patients, the model was integrated into a ROS-based exoskeleton controller to generate real-time torque assistance based on predicted therapist responses. Offline results and preliminary testing indicate the potential of their use as an alternative approach to post-stroke exoskeleton therapy. The PTFF provides understanding of the therapist's actions while the ST frees the human therapist from the exoskeleton, allowing them to continuously monitor the patient's nuanced condition.

Robotic systems can enhance the amount and repeatability of physically guided motor training. Yet their real-world adoption is limited, partly due to non-intuitive trainer/therapist-trainee/patient interactions. To address this gap, we present a haptic teleoperation system for trainers to remotely guide and monitor the movements of a trainee wearing an arm exoskeleton. The trainer can physically interact with the exoskeleton through a commercial handheld haptic device via virtual contact points at the exoskeleton's elbow and wrist, allowing intuitive guidance. Thirty-two participants tested the system in a trainer-trainee paradigm, comparing our haptic demonstration system with conventional visual demonstration in guiding trainees in executing arm poses. Quantitative analyses showed that haptic demonstration significantly reduced movement completion time and improved smoothness, while speech analysis using large language models for automated transcription and categorization of verbal commands revealed fewer verbal instructions. The haptic demonstration did not result in higher reported mental and physical effort by trainers compared to the visual demonstration, while trainers reported greater competence and trainees lower physical demand. These findings support the feasibility of our proposed interface for effective remote human-robot physical interaction. Future work should assess its usability and efficacy for clinical populations in restoring clinicians' sense of agency during robot-assisted therapy.

In this paper, we propose a novel framework that allows therapists to teach robot-assisted rehabilitation exercises remotely via RGB-D video. Our system encodes demonstrations as 6-DoF body-centric trajectories using Cartesian Dynamic Movement Primitives (DMPs), ensuring accurate posture-independent spatial generalisation across diverse patient anatomies. Crucially, we execute these trajectories through a decoupled hybrid control architecture that constructs a spatially compliant virtual tunnel, paired with an effort-based temporal dilation mechanism. This architecture is applied to three distinct rehabilitation modalities: Passive, Active-Assisted, and Active-Resistive, by dynamically linking the exercise's execution phase to the patient's tangential force contribution. To guarantee safety, a Gaussian Mixture Regression (GMR) model is learned on-the-fly from the patient's own limb. This allows the detection of abnormal interaction forces and, if necessary, reverses the trajectory to prevent injury. Experimental validation demonstrates the system's precision, achieving an average trajectory reproduction error of 3.7cm and a range of motion (ROM) error of 5.5 degrees. Furthermore, dynamic interaction trials confirm that the controller successfully enforces effort-based progression while maintaining strict spatial path adherence against human disturbances.