The 8th IEEE RAS/EMBS International Conference on

Biomedical Robotics
& Biomechatronics

Invited Speakers

Plenary Talks:

V. Reggie Edgerton, PhD
The biology of the control of movement consists of simultaneously transforming in real time all of the multiple modes of sensory information, e.g., vision, proprioception, hearing, etc. In addition to there being multiple modes of sensation, there are enormous anatomical and physiological variations in the type of sensors and the physical and chemical modulations that are sensed. In spite of all of this complexity all of these sources of inputs are converted to essentially the same basic signal, an action potential of some amplitude and frequency. But this basically bipolar response takes place in an environment in which there is a continuous level of analog modulation which defines the nature of the response to sensations. Whereas considerable anatomical and physiological detail is known about many of these sensors and where the output projects to the next neuronal and receptor type, one of the reasons that the knowledge of much of how many different neurons interact to a specific sensor, there remains little understanding of how the nervous system generates and controls even simple behaviors. For example, there is been little focus from the broader perspective as to how the nervous system transforms this enormous amount of information from multiple modes of sensors. There is enormous expertise within each of these sensory modes, but little in regard to how these different types of neurons within a mode and even less when comparing input from two or more different modes. In addition, it is readily apparent that the continuous generation of the different physiological states over time have multiple mechanisms in which experience can be stored, i.e. some aspect of learning and/or adaptation. From this perspective, to match our present technical potential in robotic designs that can generate control motor tasks is in a state of infancy. The central point of this lecture will be that the present and most productive strategy in robotic development is to develop devices that will functionally mesh smoothly with the enormous potential that is intrinsic to the biological systems that are being controlled. Some examples of basic biological concepts that can be considered in robotic designs focused on controlling movement will be discussed.
The Robotic Challenge: Meshing with the Biology
Robert J. Full, PhD
UC Berkeley
Daniel M. Wolpert, PhD
Columbia University
The effortless ease with which humans move our arms, our eyes, even our lips when we speak masks the true complexity of the control processes involved. This is evident when we try to build machines to perform human control tasks. I will review our work on how humans learn to make skilled movements covering probabilistic models of learning, including Bayesian models as well as the role of context in activating motor memories. I will also review our work showing the intimate interactions between decision making and sensorimo-tor control processes. Taken together these studies show that probabilistic models play a fundamental role in human sensorimotor control.
Probabilistic models of sensorimotor control and decision making

Keynote Speakers:

Amy J. Bastian, PhD, PT
Johns Hopkins
It is thought that the brain does not simply react to sensory feedback, but rather uses an internal model of the body to predict the consequences of motor commands before sensory feedback arrives. Time-delayed sensory feedback is used to correct for the unexpected—perturbations, motor noise, or a moving target. The cerebellum has been implicated in this predictive control process. Here we show that the feedback gain in patients with cerebellar ataxia matches that of healthy subjects, but that patients exhibit substantially more phase lag due to increased reliance on feedback control. We then show that we can improve cerebellar patients’ movement control by altering (phase advancing) the visual feedback they receive from their own self movement in a simplified virtual reality setup.
Identifying intact motor control in cerebellar ataxia
Daniel P. Ferris, PhD
University of Florida
Robotic technologies for assisting human movement have greatly advanced in recent years. Powered exoskeletons for human performance augmentation or neurological rehabilitation are becoming common in startup companies and university research laboratories around the globe. Bionic lower limb prostheses are now commercially available for individuals that have lost a limb to amputation. In the drive to create and test these new robotic devices, the gold standard for laboratory assessment has become metabolic energy expenditure. The rationale is that a device that enables the user to expand less energy during walking or running is necessary for user satisfaction. In this presentation, I will make the case that engineers and scientists need to focus more on embodiment and agility as their metrics for success for robotic exoskeletons and prostheses. Users need to feel that a robotic device is part of their body schema. They need to control it without added cognitive load. The controller needs to operate through as normal physiological pathways as possible. To be successful in the real world, robotic assistance devices need to enable users to navigate different types of terrain, dodge pedestrians, cars, and pets, and allow them to locomote in short bursts of acceleration and deceleration. Maintaining a steady, constant speed on a flat, smooth surface for thousands of steps is not the way humans move in the wild. Future research needs to better measure and improve embodiment and agility in our robotic mobility assistance devices.
Embodiment and Agility in Robotic Exoskeletons and Prostheses
Daniela L. Rus, PhD
The digitization of practically everything coupled with the mobile Internet, the automation of knowledge work, and advanced robotics promises a future with democratized use of machines and wide-spread use of robots and customization. While the last 60 years have defined the field of industrial robots, and empowered hard bodied robots to execute complex assembly tasks in constrained industrial settings, the next 60 years will be ushering in our time with Pervasive bio-inspired robots that come in a diversity of forms and materials, helping people with physical tasks. How can we accelerate the creation of robots customized to specific tasks? Where are the gaps that we need to address in order to advance toward a future where robots are common in the world and they help reliably with physical tasks? In this talk I will discuss recent developments toward pervasive robots the role of computation in (1) on demand creation of robots, (2) making robots more capable of reasoning in the world, and (3) making more intuitive interfaces between robots and people.
Bio-Inspired Soft Robots
Nabil Simaan, PhD
Emerging surgical paradigms such as natural orifice surgery and minimally invasive surgery in deep surgical sites present new challenges to surgeons and engineers. These new challenges stem from the limitations of surgeon’s sensing, perception and incomplete situational awareness. The talk will discuss modeling, challenges and applications of continuum and soft robots for addressing these challenges in several domains of surgery. These robots range from continuum robots with force sensing and contact detection capabilities to elastomeric electrode arrays capable of traversing anatomical passageways in the inner ear. Within the context of these surgical applications, we will focus on our efforts in modeling, designing and controlling intelligent surgical robots capable of sensing the environment and using the sensed information for task execution assistance and for situational awareness augmentation. Sample motivating applications in the areas of minimally invasive surgery of the upper airways, cochlear implant surgery, trans-urethral resection of bladder tumors, and OCT-guided retinal micro-surgery will be used to elucidate the potential of these robots.
Continuum and Soft Robots for Surgery: Sensing, Situational Awareness Augmentation and Assistive Control
Qining Wang, PhD
Peking University
This talk will show recent progress on wearable robotics, especially the new area of underwater applications. To date, all the exoskeletons have been studied to assist human motions on land. However, regardless of the exoskeletons being rigid or soft, an exoskeleton for underwater motion assistance has not been realized thus far. This talk will discuss the challenges of using exoskeletons for underwater applications. And recent breakthrough of an underwater soft exoskeleton from my lab will be introduced in detail. Three competitive swimmers participated the experiments to evaluate the proposed soft exoskeleton. Compared with breaststroke without assistance, the peak of surface electromyography in the sweep phase with the exoskeleton assistance decreased by 49.13% (gastrocnemius) and 74.51% (soleus) on an average.
Human-Centered Wearable Robotics: From Land to Underwater Applications

Invited Speakers – Rehab Track:

Sunil K. Agrawal, PhD
Columbia University
Seated postural abilities are critical to functional independence and participation in children with cerebral palsy, Gross Motor Functional Classification System (GMFCS) levels III-IV. In this study, we investigated the feasibility of a motor learning–based seated postural training with a robotic Trunk-Support-Trainer (TruST) in a longitudinal study. TruST is a motorized-cable driven belt placed on the child’s trunk to exert active-assistive forces when the trunk moves beyond stability limits. TruST-intervention addresses postural-task progression by tailoring assistive-force fields to the child’s sitting balance to train trunk control during independent short-sitting posture. We show that our novel robotic TruST-intervention is feasible and can effectively maximize functional independent sitting in children with CP GMFCS III-IV.
Improving Trunk Control in Children with Cerebral Palsy using a Trunk Support Trainer (TruST)
Alberto Esquenazi, MD
Moss Rehab
Stroke high prevalence results in a significant number of individuals with gait dysfunction. Robotics application to gait rehabilitation has the potential to reduce disability, improve healthcare delivery and increase patient satisfaction. This presentation will explore available robotic devices for gait rehabilitation and their utility. The use of different devices including tethered exoskeletons, end effector devices, non-tethered exoskeletons and single joint robotic devices will be discussed.
Robotics for gait rehabilitation after stroke
James C. Galloway, PhD, PT
Univ. of Delaware
Embodied development theory predicts that moving throughout the real world is a critical factor in a range of developmental domains including cognition, language, motor and socialization. In this talk, I will discuss our recent findings from NIH and NSF funded work with modified ride-on cars (MROCs), portable harness systems and 'smart toys'. In general, these technologies are focused on providing high dose, high-value opportunities for young children to advance their mobility within enriched social and physical environments. We believe our design process for these technologies has wide-ranging applications for both adult and pediatric rehabilitation technology. that must perform in the real world.
Mobile learning environments: modified cars and portable harnesses
Preeti Raghavan, MBBS, MD
Johns Hopkins University
Many unmet rehabilitation needs of patients with stroke can be addressed effectively using technology. However, technological solutions have not yet been seamlessly incorporated into clinical care. This talk will describe the A3E framework to address barriers in stroke rehabilitation and how technology-assisted solutions can overcome these barriers by increasing: 1) accessibility to quality rehabilitation, 2) adaptability to patient differences, 3) accountability or compliance with rehabilitation, and 4) engagement with rehabilitation. This framework can guide technology developers and clinicians in designing and deploying technology-assisted rehabilitation solutions for post-stroke rehabilitation, particularly using tele-rehabilitation.
Framework for Designing and Deploying robotics and technology in stroke rehabilitation
Eduardo Rocon de Lima, PhD
Center For Automation and Robotics
Cerebral Palsy (CP) could be defined as a disorder that appears in infancy and permanently affect posture and body movement but does not worsen over time. CP is often associated with sensory deficits, cognitive impairments, communication and motor disabilities, behaviour issues, seizure disorder, pain and secondary musculoskeletal problems. Traditionally, robotic strategies have been focused on the Pe- ripheral Nervous System (PNS) supporting patients to perform repetitive movements (a ‘‘Bottom-Up approach’’). However, CP primarily affects brain structures, and thus suggests that both PNS and Central Nervous System (CNS) should be integrated into a physical and cognitive rehabilitation therapy. Current studies manifest that such integration of the CNS into the human–robot loop maximizes the therapeutic effects, especially in children. During this talk I will present and discuss a robot-based training program for gait rehabilitation of pediatric population with Cerebral Palsy. The robotic-based therapies were implement in the CPWalker device and recreates a situation as similar as possible to a real gait scenario, encouraging the patients to control different movements associated with gait: not only individual movements of lower limb joints but also the synergy between them while maintaining a proper posture of the upper body. We hypothesize that this interaction between the human and the machine, performed following an appropriate progression of the variables, boosted the rehabilitation of our patients.
The role of neurorehabilitation for pediatric population with Cerebral Palsy
Ann M. Spungen, EdD
Icahn School of Medicine
Persons with spinal cord injury (SCI) have adverse secondary medical and quality of life changes as a result of immobilization. A person with SCI who has completed rehabilitation after injury and is unable to ambulate receives a wheelchair as standard of care for mobility. Powered exoskeletons are a technology that has become available (mainly for research purposes) during the past decade. They offer an alternate form of mobility by providing an external framework for support and computer controlled motorized hip and knee joints to assist with standing and overground ambulation. Restoration of ambulatory function and the potential for the subsequent improvement of health has long been a goal of SCI rehabilitation research. The use of powered exoskeletons may offer a partial solution to this problem. Data from two exoskeletal-assisted walking clinical trials performed in participants with SCI will be reviewed. The goals of this presentation are to report the findings from these two trials as evidenced-based data on the following topics: 1) eligibility criteria for screening successes and failures, with an emphasis on the importance of bone mineral density and fracture screening; 2) number of sessions to achieve walking and mobility skills; and 3) select medical/health responses to over ground walking in these powered-robotic walking devices.
2010 to 2020 - The first decade of exoskeletal-assisted walking for persons with paralysis: what have we learned?
Joel Stein, MD
Columbia University
A variety of neurological disorders can affect the use of the upper limb(s), including stroke, brain injury, spinal cord injury, nerve damage, and muscle diseases. The nature of the resulting sensorimotor impairments varies among these different conditions, as does the ability of the nervous system to repair damage and restore functional use. This lecture will review the impact of motor control impairment, weakness, ataxia, movement disorders, and sensory loss on upper limb sensorimotor function. We will discuss the targets that these conditions present for robotic therapies, including devices intended for rehabilitation therapy, as well as those intended to improve function as assistive devices. Both wearable and workstation devices will be discussed.
Upper limb robotic devices: Matching the design to the clinical needs

Leaders Panel:

Paolo Dario, PhD
Neville Hogan, PhD
Robert Riener, PhD
ETH Zürich
Most commercial knee prostheses are still not powered, which makes stair and slope walking challenging. Many people with arm amputations are not using their prosthetic devices. And commercial wheelchairs have still problems to encounter uneven terrain and steps. Therefore, I initiated the Cybathlon, an Olympic-style competition for athletes with physical disabilities who are using advanced robotic technologies. The main goal is to promote development of better technologies for the physically disabled person and encourage the exchange between people with disabilities, the general public and the research. The world first Cybathlon took place in 2016; the next one was on November 13/14 this year organized as a global event, with races at more than 40 hubs from all over the world, life broadcasted from ETH Zurich. In my talk I will present the highlights of the latest global edition.
Highlights from the Cybathlon 2020
Nitish V. Thakor, PhD
Johns Hopkins
NeuroProsthesis has captured the imagination of researchers (and even entrepreneurs) due to the exciting synthesis of the fields: prosthesis and neuroscience/neuroengineering. Both have advanced incredibly rapidly in the past 10 years, with the development of dexterous upper limb prosthesis and high performance lower limb prosthesis. From the traditional body powered, the control has shifted to myoelectric pattern recognition, targeted muscle reinnervation, peripheral nerve interface and cortical control. The peripheral and neural control have been enabled by the advances in neural interface technologies and the field of brain machine interface. I will briefly summarize these topics and then lay out the very recent trends and the technological challenges posed: prosthesis and neural interface technology and machine learning techniques and incorporation of sensory, motor and cognitive interfaces.
NeuroProsthesis: State of the Art and Future Challenges

Government Panel:

Fay Cobb Payton, PhD
Dr. Fay Cobb Payton will present on current NSF funding opportunities in the Directorate for Computer and Information Science and Engineering (CISE) along with some cross-directorate programs. The mission of the Directorate for Computer and Information Science and Engineering (CISE) is to enable the U.S. to uphold its leadership in computing, communications, and information science and engineering; promote understanding of the principles and uses of advanced computing, communications, and information systems in service to society; support advanced cyberinfrastructure that enables and accelerates discovery and innovation across all science and engineering disciplines; and contribute to universal, transparent, and affordable participation in an information-based society. CISE comprises four divisions: Office of Advanced Cyberinfrastructure (OAC); Division of Computing and Communication Foundations (CCF); Division of Computer and Network Systems (CNS); and Division of Information and Intelligent Systems (IIS).
Funding Opportunities at the National Science Foundation relating to Robotics
Moria Bittman, PhD