REST: Reconfigurable lower limb Exoskeleton for effective Stroke Treatment in residential settings

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According to the UK Guidelines for stroke rehabilitation, the national standard for stroke rehabilitation is at least 45 minutes per day of each relevant therapy for a minimum of 5 days per week to people who have the ability to participate. However, this standard has never been met due to the decreasing availability of rehabilitation services and increasing pressures on the NHS. In the UK, over 600,000 people with stroke live further than 20km from a stroke support group, the majority of whom live with severe mobility issues. It would be very challenging and costly, or even impossible for them to travel and receive rehabilitation treatments regularly in hospitals or rehabilitation centres. The NHS Five Year Forward View therefore made recommendations in 2017 to bring rehabilitation to people in their own homes and care homes.People with stroke commonly experience post-stroke movement disorders, particularly weakness, disordered movement patterns, including post-stroke dystonia and spasticity. The majority of stroke patients are disabled and dependent on their family members or others for some or all of their daily living activities.Leveraging our previous success in robotic exoskeletons, our ambition is to deliver innovative rehabilitation through exoskeletons that are modular and reconfigurable to meet individual needs, and have the required intelligence to monitor recovery, personalise treatments and deliver effective rehabilitation in patients' own homes. We will pursue this goal by: 1) introducing new soft muscles and novel reconfigurable robotic mechanisms for the lower limb exoskeletons, enabling them for home rehabilitation use and easy to manufacture, maintain and repair; 2) developing standardised exercise programmes, with innovative disability assessment methods and intelligent personalised treatment strategies. The intelligent lower limb exoskeleton controller will learn the patients' recovery status and continually update the rehabilitation strategy to meet the patients' changing needs and deliver the best possible outcome. Personalised treatment methods will be investigated to enable adaptive rehabilitation training for patients in their own homes; 3) evaluating the functionality, acceptability, robustness, reliability and sustainability of the robotic exoskeletons, initially in laboratory settings, and then in the Leeds Teaching Hospital rehabilitation service and residential settings; and 4) assembling the required pre-clinical documentation to initiate future clinical trials.Our long-term goal is to develop a nationwide robot-assisted home-based rehabilitation programme, which builds upon the technology and the experimental evidence originated from this proposal. Our project partners Devices for Dignity (D4D), Steeper Group, DIH/Hocoma, AiTreat and the National Demonstration Centre for Rehabilitation at Leeds Teaching Hospital NHS Trust will provide adequate links and resources for this project. This project will establish a transferable technology for stroke survivors' rehabilitation at home, with a potential impact on millions of people in the UK and worldwide.