EP4106707A1

EP4106707A1 - A device for the rehabilitation of limbs

Info

Publication number: EP4106707A1
Application number: EP21714261.1A
Authority: EP
Inventors: Elio Matteo CURCIO; Giuseppe Carbone; Diego MAZZEI; Francesco LAGO; Stefano RODINÒ
Original assignee: Universita della Calabria
Current assignee: Universita della Calabria
Priority date: 2020-02-20
Filing date: 2021-02-20
Publication date: 2022-12-28
Also published as: WO2021165929A1

Abstract

A device for limb rehabilitation, comprising an overturned Delta robot consisting of a base (1) on which three or more movement systems equipped with encoders are housed, in which each of said movement systems activates an arm (22A-C) making it rotate, at the end of each of which a pair of rods (30A-F) is connected through a pair of ball joints (32A-F), and which at the opposite end are then connected through a pair of ball joints to a terminal element (43), a computerized electronic control unit, a software that is programmed to record an end-effector rehabilitation movement to be performed, and a monitor on which the rehabilitation movement of the end-effector is reproduced, characterized by the fact that on the terminal element (43) the base of the end-effector (51) is mounted in a detachable manner, on which three pairs of push-buttons or force sensors are placed which measure the forces exerted by the patient that oppose the rehabilitation movement, of which two push-buttons or force sensors in two directions orthogonal to each other and parallel to the plane of the end-effector base (51), and one pair of push-buttons or force sensors in a direction that is orthogonal to the plane of the end-effector base, that the data on the position of the arms (22°-C) and, therefore, of the end-effector (51), determined by the encoders, and by the data on the forces acting on the end-effector, determined by the pairs of push-buttons or sensors, is transmitted to the electronic control unit which, according to the forces, modifies the rehabilitation trajectory.

Description

A device for the rehabilitation of limbs Technical field of the invention

The present invention regards a limb rehabilitation device. Rehabilitative therapy of limbs for patients can be carried out by an operator or by robotic machinery: in the first case the operator is entrusted with the task of making the patient carry out the correct movement and stimulating the neuroplasticity, in the second case these operations are carried out by a robot or by machinery capable of assisting the patient in the rehabilitative exercise, accompanying him or guiding him.

State of the Art

Rehabilitative machinery is present in diverse kinematic, exoskeletal or end-effector robotic configurations, each designed for the type of exercise to be carried out. All have one or more active and / or passive degrees of freedom.

A first example of this type of device is the Mit Manus based on the patent US5466213, which is a robotic arm activated by two separate motors that move the shoulder and elbow - and it is capable of generating forces that interact with the patient. The patient “grips” the joystick of the device and commences a series of interactive games that trigger a sort of “arm-wrestling” with the robot. The task required of the patient is to move a light cursor on a screen, physically moving the mechanical arm, to reach targets that gradually light up. The aforementioned machinery allows only planar movements of the limb to be performed.

Another example of a robotic end-effector is the device denominated ReoGo US8753296B2, which is capable of carrying out rehabilitation in two or three dimensions; the device in question is able to apply a force that interacts with the patient and is also able to monitor and track the movement. The device is limitedly transportable using the wheels supplied, the volume is 101x58x90 cms with a weight of 79 kgs. It does not have great stiffness in horizontal movements because of the long length of the telescopic arm, which is due to the large distance between the centre of rotation and the patient’s limb.

Examples of exoskeletons are the machinery denominated Armeo Spring, US patent US8347710, and Armeo Power.

A further example of a robotic exoskeleton for rehabilitation is described in the USA Patent US20070225620 / US7862524 B2, which is a portable serial exoskeletal system having three levels of freedom of movement, intended for the rehabilitation of the shoulder. The disadvantage of the system is that its exoskeletal structure uses the patient’s body as a support platform, which can be damaging for elderly people, who constitute the majority of patients suffering from motor disabilities following a stroke.

Another robotic system designed for upper limb rehabilitation is described in CA2581587A1 /US7252644, and is an end-effector type system, composed of an element that interacts with the human body or a part of it, a force sensor, a force generator; the connecting element between them has at least three degrees of freedom of movement. The disadvantage of this device is that it has a sole point of interaction (the end-effector) and the movements of the joints of these devices do not correspond to human mobility. Therefore, without external restrictions being applied to limit the patient, specific therapies for joints cannot be provided by such mechanisms.

Another robotic system for post-stroke rehabilitation of an upper limb is described in EP2723536A1 / US20120330198A1. It is an exoskeleton for human beings that interacts directly or indirectly with the patient’s joints, the device allows only a planar movement of the upper limb. The device can be regulated to adapt to the diverse anatomies of patients. The precision of the exoskeletal structure can easily be compromised, this is because of the manual regulation that must be carried out to adapt the structure to the various physiognomies of each single patient.

A further document connected to the State of the Art is found in the Patent CN107007429. It regards a mechanism of a parallel structure with three degrees of freedom of movement, adapted for the rehabilitative therapy of patients with hemiplegia caused by a stroke. The robotic system proposed uses two linear actuators and a passive connecting rod, it is also completely devoid of a transmission system. There are no components or interface features for interacting with the user that are capable of determining the user’s intentions of movement without requiring an expensive force sensor. Furthermore, a motorized system is mounted on the mobile platform, which does not always guarantee the flatness of the same with respect to the support base.

The invention proposed in the document EP326087A1 which focuses on a support structure for the upper limb, does not allow the three-dimensional movement of the limb. The system is completely without an active actuation system as well as without sensors. It does not have closed kinematic chain kinematics, and there are no interface components or functions that interact with the user that are capable of determining the user’s movement intentions without requiring an expensive force sensor. The device can only be repositioned on a flat, horizontal surface. Furthermore, it limits the movement of the shoulder and does not allow the treatment of multiple points of the upper limb. Document WO2018/213896A1 proposes an electromechanical manipulation device, composed of: a drive system that includes a number of electric motors; an arm operated by the transmission system with three degrees of freedom of movement; a capstan transmission to transmit the drive force from the actuator to the arm; an end member that can be connected to the arm, the end- effector is configured to have at least three degrees of freedom of rotational movement; and a control system to control the drive system in such a way as to provide a force to the end-effector in a selected direction. The proposed system has a single arm with pantograph architecture. There are no graphical interface components or functionalities, and there are also no elements capable of interpreting the patient’s movement intentions or remodulating movement during exercise.

In general, the analysis of the State of the Art highlighted the presence of numerous exoskeletal systems, which have a complex construction scheme and are difficult to use during the entire phase of rehabilitation. The complexity of this type of system represents an obstacle to carrying out the exercises required by specialists and physiotherapists. Similarly, the machinery for rehabilitation is characterized by their excessive size and weight, they are not portable, therefore, and always require fixed installation, with high costs, which cannot be countenanced by users in civil habitations.

The technical problem solved

The system proposed in the present invention allows the rehabilitation of human limbs to be carried out in various autonomous or semi-autonomous ways. It is capable of interpreting the intentions of the patient through monitoring the parameters of force recorded by the terminal organ and transmitted to the control unit, remodulating the movement and trajectory of the limb to be rehabilitated if necessary. Said objective is reached through the creation of a device for the rehabilitation of limbs comprising of an inverted Delta robot, composed of a base on which three or more movement systems equipped with encoders are housed, in which each of said movement systems activates an arm by making it rotate, at the end of each of which a pair of rods that are joined at the end are connected, through a pair of ball-joints, opposed by a second pair of ball-joints joined to a terminal element, a computerized electronic control unit, a software that is programmed to record a rehabilitation movement of the end-effector to be performed and a monitor, on which the rehabilitation movement of the end-effector is reproduced, characterised by the fact that on the terminal element it is mounted so that the base of the end-effector can be disassembled, a base on which three pairs of pushbuttons or force sensors are placed that measure the forces exerted by the patient when opposing the rehabilitation movement, of which two pairs of pushbuttons or force sensors are in two orthogonal directions and parallel to the plane of the end-effector base and one pair of pushbuttons or force sensors lies in a direction that is orthogonal to the plane of the end-effector base, that the data on the position of the arms, and, therefore, of the end-effector, determined by the encoders, and the data on the forces acting on the end- effector, determined by the pairs of buttons or sensors, is transmitted to the electronic control unit which, depending on the forces, modifies the rehabilitation trajectory. The proposed device has reduced dimensions (plan dimensions of maximum 600x600 mm) and a lower weight (< 20 Kg) compared to the existing solutions. The proposed device offers a considerable ease of use, as well as the possibility of rehabilitating various points of the limb, without necessitating structural changes. The solution, subject of the present patent, allows ample one-dimensional, two-dimensional and three-dimensional movements. The base can be repositioned in space, and can therefore be positioned on a horizontal plane, a vertical plane, or a plane with any inclination.

The principal advantages of the proposed solution are the simplicity, versatility, modularity, and adaptability of use of the device, even for less experienced operators, the absence of a fixed structure as well as its complete portability, with weights and dimensions reduced by up to 90% compared to other, existing solutions.

The advantages will appear clear from Figures 1-9, which are shown as illustrative and non-limiting.

A brief description of the Figures

Figure 1 represents an overall view of the device, subject of the present invention.

Figure 2 represents an axonometric view, with indications of the components of the device, subject of the present invention.

Figure 3 represents an exploded view of the gear-motor box of the device subject of the present invention.

Figure 4 represents an exploded view of the end-effector of the device subject of the present invention.

Figure 5 represents a conceptual block diagram of the device subject of the present invention.

Figure 6 represents a conceptual block diagram for carrying out the choice of guided or assisted exercises with the device subject of the present invention. Figure 7 represents a block diagram of the registration logic of new trajectories with the device subject of the present invention.

Figure 8 represents a conceptual block diagram for carrying out the movements of a limb in an assisted manner, using the device subject of the present invention.

Figure 9 represents a conceptual block diagram for the remote evaluation of rehabilitation movements, using the device subject of the present invention.

A description of a preferred form of embodiment

The invention is described with reference to Figures 1-9. Figure 5 shows a conceptual diagram of the proposed invention: the purpose of this invention is that of creating a device that allows the assistance of a patient with limited mobility of the limbs, in the same manner as a therapist would assist.

For this reason, it is necessary that the invention consists of the components represented in Figure 5: an actuation area (101), that allows movement of the limb in the same way as the therapist would perform such movement using his hands; an area with sensors (102), that perceives the patient’s reactions, for example a stiffening during movement, a spasm, etc., which are the elements that a physiotherapist uses to understand how the patient is reacting to the therapy and allows him to correct it; a control area (204), which is composed of a control unit (202) and a management software (203), these components allow the device to move the actuation area, adjusting it according to the type of exercise proposed and the patient’s level of effort, in parallel to what the physiotherapist normally does by mentally processing the stimuli given to him by the patient during the exercises; furthermore, a graphic interface, visible through a monitor, is provided. Figure 1 represents the conceptual scheme of the part of the invention that allows the manipulation of the limb, consisting of an electrically powered mechanism (100); a three- dimensional kinematics of reduced weight and dimensions, capable of carrying out one dimensional, two-dimensional, or three-dimensional movements; a sensorized user interface (102), for specific automated and/or assisted movements of the limb.

The actuation area has the shape of a Delta robotic device, and is composed of two fundamental areas (100) and (101): the area (100) acts as a base and constitutes the actuating area, in fact, there are at least three motors (also equipped with position sensors which can be integrated into the motors, we are therefore talking of motors with an integrated decoder, or that are separated from the motors and arranged on the axis of a rotating part of the actuation area) which drive, through a reduction of gears, the movable arms (elements 22).

The area (101) is, instead, made up of “passive” movable arms (30), that is not directly actuated, whose movement is allowed by the actuation impressed by the arms (22) and by the presence of spherical nodes or ball-joints, which can be of the uniball type (32); the arms (30) proceed to join in a terminal element on the component (43), which will act as the base of the end-effector that constitutes the sensitive area (102).

The end-effector is mounted on the terminal element (43) through the removable element (51). In turn, the component (43) is rigidly fixed to the movable arms, the component (51) is the base for the actual end-effector, which allows for the end-effector to be dismantled from the rest of the structure and which can also be used separately. With reference to Figure 2, the system has a base (1) with housings for three or more movement systems, each of which consists of a motor (14) that may be of the stepper type, that moves a system of reduction, that can be epicyclic, housed in the crankcase (24), and which is closed by the lid (23); to complete the structure, we then find the opposite support (8) coupled to the motor-reducer unit, described in Figure 3, by the spacers (17) and (20). The arm (22) is operated by a system of gear-wheels (4) and (10). The pairs of rods (30) are connected to the arm by ball-joints, which can be of the uniball type (32).

In the preferred embodiment, there are three pairs of rods. At the opposite ends of the rods (30) we find further ball-joints (32), which connect three or more pairs of rods to the base (43) of the end-effector (43) shown in Figure 4; the support plate (51) is fitted to it. A perforated closing lid (39) is provided, to protect the internal mechanism of the end- effector; the terminal part has two machined discs (44) and (49), held together by three spacers (38). The internal mechanism ends with a threaded projection (47), to which the threaded disc (52) is tightened. Connecting an eventual protective shell, it is fixed to the end-effector mechanism by the screw (48) on the support (53) shown in Figure 4. This element performs the function of giving support to the human limb to be rehabilitated.

Figure 3 shows an exploded view of one of the motor-reducer units that operate the arms (22). In the preferred embodiment, there are three motor-reduction units. In the preferred embodiment, the motor (14) is connected to the cover (23) of the casing (24) and screwed to it from the inside by four screws.

In the preferred embodiment, the motor shaft is connected to a toothed wheel (2), which meshes with three toothed wheels (3), each of which is coupled by a bearing (6) to the train-carrier (16); the toothed wheels (3) in turn mesh with a ring toothed area of the mechanism integrated in the casing (24), which also acts as a housing for the gear-motor system.

The shaft (18) is coupled to the train-carrier (16) by key-fitting it, with an appropriate shaping, aimed at allowing coupling with the toothed wheel (10); by means of a ball bearing (6), the same is coupled to the casing (24).

On the opposite side of the toothed wheel (10), the shaft (13) is key-fitted, connected by an additional ball bearing (6), which is fixed to the opposite support (8). The arm (22) and the two toothed wheels (4) are key-fitted onto the shaft (21); two ball bearings (6) are fitted onto the same shaft (21), connecting it to the crankcases (8) and (24). The two crankcases (8) and (24) are fixed to the two spacers (17) and (20) by means of the screws (28). The supports are fixed to the base (1) by 4 screws (27), as shown in Figure 2.

Figure 4 shows an exploded view of the end-effector, which consists of a terminal element (43) which connects to the ball joints (32) by means of the arms (30). The terminal element (43) has a geometry such as to house the base of the end-effector (51) on which the ring (39) is mounted. On this latter there are push-buttons and/or sensors (37) on the vertical walls, operated by a mobile cursor (47) connected to the ring (36).

The cover (42) protects the internal structure of the end-effector, allowing the housing of the machined disc (44) equipped with a push-button and/or a sensor (37). Three spacers (38) couple the machined disc (44), which in turn houses a push-button and/or a sensor (37), with the machined disc /ring (49); the push-buttons and/or sensors have an antagonistic function. There will therefore be a minimum number of two push-buttons and/or sensors. In the preferred embodiment there are 6 push-buttons and/or sensors (37). Inside the device (47) a shaft (53) slides, equipped with a tab capable of operating the push-buttons and/or sensors (37) located in the machined discs (44) and (49). The threaded ring (52) is screwed onto the threaded end of the device (47), tightening all the components of the end-effector.

An eventual covering cap can be fixed to the device described, by a screw (48), which screws into the shaft (53). This cover performs the functions of housing the hand and protecting the end-effector. The end-effector thus composed allows interaction with the user, identifying the intentions of movement in order to support them in the rehabilitative movements. This element therefore allows avoiding the use of expensive force or pressure sensors.

The component (39) constitutes the seat of the sensors (37 C-D-E-F). These sensors can be push-button sensors or sensors of force, and are used to record the thrust that is used to press the limb onto a plane that is parallel to the base of the end-effector, and that is, consequently, parallel to the flat face of the base (51); in the solution adopted, two sensors register a load axis, for example along the X axis, one sensor registers the thrust in the positive X direction and another registers the thrust in the negative X direction, and two sensors arranged orthogonally register a load along a Y axis in a positive Y-direction thrust with one, and register a negative Y-direction thrust with another.

By combining the forces recorded by the sensors described above, force vectors are obtained which, added together, give the force on an X-Y plane. The components (47) and (36) are used to press onto the sensors. Component (36) is only a ring that serves to reduce the friction between the sensors and the component (47), which has two purposes: to move in a plane (a plane parallel to the upper flat face of the component (51)) to press onto the sensors and then to transmit the force of the limb along the X and Y axes; act as a housing for the sliding component (53).

The component (53) can move up and down and is equipped with a rigid tab that presses on two other sensors (which can be push-buttons or force sensors), which are the components (37 A-B) that then record the force that presses the limb along the Z-axis, perpendicular to the flat upper face of the base (51). In this case too, there are two sensors to acquire the data on the force along the X-axis in a positive or negative direction, but in the case of a load cell the sensor can be single to record both the positive and negative directions.

At this point, the sensors have acquired the three forces along the three axes, and this permits the controller to define a resulting force in the space that coincides with the force that the limb is applying to the terminal area of the robot.

The present invention is described with reference to a preferred embodiment. It is to be understood that other embodiments may exist that pertain to the same inventive core, as defined within the scope of the declared claims.

Operation of the device:

The device is positioned and connected to the electric current, the affected area of the limb is placed on the terminal part (end-effector, to which a shaped cap is connected according to the needs, for example, for the hand) and by fixing devices (bands, for example), the limb area is constrained to the shaped shell.

As reported in figure 6_the type of exercise that is desired to be performed is selected through a user interface, that can be both physical (push-buttons, rotating knobs, etc.) and graphic (a display on which the selection is made from a menu).

The signals of the physical interface (buttons) or the graphics from a graphic interface projected onto the screen, are sent to the control unit (204) through the constituent components of the hardware system (202) and are processed by the software (203).

Through the menu selection system described above, it is possible to accede to the operating modes.

The exercises that can be performed can be grouped into two macro categories: fully guided exercise (205), where the limb remains passive and the robot is entrusted with the task of moving the limb according to trajectories that are pre-set (by the therapist, or already present), where this function is achieved by selecting the pre-selected trajectory; assisted exercise (207), in which it is possible to choose between two assistance modes that require the processing of data acquired by the sensors positioned in the end- effector, activities which are carried out through the actions of (208) and/or (209).

In the guided exercise, carried out through action (206), the patient performs a pre-set movement that can be already imprinted in the basic software, or, before letting the patient perform the exercise independently, the physiotherapist can record a new movement, that the robot will then replicate according to the logic described in Figure 7.

The recording logic (210) is then activated, the end-effector is moved by the therapist (211) and drags the structure, which remains passive and in recording mode (212), the encoders acquire the movement (213), which is recorded by the control unit (204) through operation (214), the machinery holds the memory of this new movement to be performed and it is possible to start the exercise through operation (215).

Once the exercise has commenced, the machinery replicates the new trajectory through the logic implemented in the block (216).

In the assisted mode, defined in the block (207), the control unit (204) records the signal acquired by the sensitive area and, through AI logic, decides how to move the motorized zone. Sensors for the heartbeat or the level of oxygenation can be implemented to support the decision-making logic, and which would permit a more precise identification of the level of effort.

In general, following the logic already described for the operation of the sensors, the control unit registers the force that applies the limb to the end-effector. At this point the software intervenes in the choice of the answer that is given by the robot activating the motors.

The operating logic of the two modes is that shown in Figure 8, in which it can be seen how the device processes the signal acquired by the end-effector to make choices as to the type of training to be performed. In all modes, however, there is a visual support for the patient, that is a display that shows the trajectory to follow, rather than augmented reality goggles that permit the vision of a three-dimensional trajectory to follow with the limb.

More specifically, the two assisted modes are divided into an assisted movement that permits the patient’s effort and commitment (220) to be maximized, and ways of correcting the trajectory through the generation of force feedback on the limb (221).

Moving on to better analyse the two modes, we will have for (220) an iterative logic that commences from the action of the robot on the limb (222). The robot drives the motors and moves the limb; at this point the difference in speed will generate an action of the limb on the end-effector, which will acquire a resulting three-dimensional force

(224), which will be recorded, monitored, and interpreted by the control unit in action

(225).

The conditional logic that intervenes, goes to define whether the limb is able to follow the movement imposed by the robot (226); if the limb manages to follow the movement of the robot (223), then the logic (229) is entered into, where the robot understands that in that instant the limb satisfies the conditions of movement, and that the action can therefore continue without modifications; monitoring continues, and the action re commences (229).

If the limb is unable to follow the movement of the robot (232), the software enters the logic (228) in which the exercise is re-modelled; if, for example, the movement is too fast for the patient the robot understands, and slows down the execution, or, to the contrary, if the movement is too slow, it speeds up the robot’s implementation.

The logic is iterative, and the monitoring takes place continuously during the exercise, so the control is carried out moment by moment.

For logic assisted through a guided trajectory (221), the action begins from a movement of the limb that drags the mobile parts of the end-effector, activating the monitoring logic (223). The action exerted by the limb on the end-effector generates forces that are acquired by the sensors according to the logic of the block (224). The controller records and monitors the parameters of the encoder and of the force sensors through the logic (225), and this permits the ideal trajectory to be compared with that carried out by the patient.

The comparison is made in the operating block (227), in which the controller decides how to react to the signals that it receives.

If the limb diverges from the trajectory it falls back into the logic of convergence (234), through which the operations of the block (230) are carried out and which progressively slow the limb according to its divergence from the trajectory.

If the limb follows the ideal trajectory at the right speed of execution, this falls back into the case (235) through which the machinery remains passive and allows the patient to continue the exercise (231).

The loop closes by restarting the monitoring from the operation (223); the monitoring is carried out continuously during the entire duration of the exercise. Operating modes:

The device is designed to perform therapies on limbs but, thanks to the force sensors (240), the encoder (241) and the additional sensors for the biometric data (242), it manages to keep track of the rehabilitative sessions by analysing the physical data found. Furthermore, its compact dimensions (it can be made with plan dimensions of 250 mm x 250 mm, up to dimensions of 600 mm x 600 mm) make it extremely transportable and thus suitable for domestic and/or remote applications.

These characteristics allow the machinery to be used to carry out diagnoses of the sessions, through the logic of analysis (243), and to make the evaluations objective, since they are based on objectively measurable parameters.

As shown in Figure 9, these same parameters can be archived in Cloud (244) and can be processed to carry out prevention through logics (246), or to study behaviour in the rehabilitation phase, or a medical record showing the progress of the sessions can be viewed remotely by the therapist and at any time (245).

Claims

1. A device for limb rehabilitation, comprising an overturned Delta robot consisting of a base (1) on which three or more movement systems equipped with encoders are housed, in which each of said movement systems activates an arm (22A-C) making it rotate, at the end of each of which a pair of rods (30A-F) is connected through a pair of ball joints (32A-F), and which at the opposite end are then connected through a pair of ball joints to a terminal element (43), a computerized electronic control unit, a software that is programmed to record an end-effector rehabilitation movement to be performed, and a monitor on which the rehabilitation movement of the end- effector is reproduced, characterized by the fact that on the terminal element (43) the base of the end-effector (51) is mounted in a detachable manner, on which three pairs of push-buttons or force sensors are placed which measure the forces exerted by the patient that oppose the rehabilitation movement, of which two push-buttons or force sensors in two directions orthogonal to each other and parallel to the plane of the end-effector base (51), and one pair of push-buttons or force sensors in a direction that is orthogonal to the plane of the end-effector base, that the data on the position of the arms (22°-C) and, therefore, of the end-effector (51), determined by the encoders, and by the data on the forces acting on the end-effector, determined by the pairs of push buttons or sensors, is transmitted to the electronic control unit which, according to the forces, modifies the rehabilitation trajectory.

2. A device for limb rehabilitation according to claim 1, characterized by the fact that the two pairs of pushbuttons or force sensors that act in two directions that are orthogonal to each other and are parallel to the plane of the end- effector base (51), are housed in a ring that is integral to the end-effector base.

3. A device for limb rehabilitation according to claim 1 or 2, characterized by the fact that the pair of push-buttons or force sensors that act in an orthogonal direction to the plane of the base of the end-effector (51), are housed in a shaft that is perpendicular to the end-effector base (51).

4. A device for limb rehabilitation according to claim 1, characterized by the fact that the movement systems are electric motors connected to a toothed wheel (2), which meshes with three toothed wheels (3), each of which is coupled through a bearing (6) to a train carrier (16); which in turn mesh with a ring-shaped toothed area of the mechanism integrated into the device (24), which acts as a housing for the movement system. The train carrier (16) is coupled, key -fitting it, to the shaft (18), which has an appropriate shape.

5. A device for limb rehabilitation according to claim 1, characterized by the fact that the computerized electronic control unit has a module for connecting to the internet network for telemonitoring, in order to have a clinical history of the patient, and which can be monitored by an operator, to carry out clinical assessments on the progression of the rehabilitation and modifications to the rehabilitation plan.

6. A device for limb rehabilitation according to a previous claim, characterized by the fact that a shaped cap is fitted to the end-effector, to constrain an area of the limb.

7. A device for limb rehabilitation according to a previous claim, characterized by the fact that said device is made of plastic material or of carbon fibre.

8. A device for limb rehabilitation according to claim 7, characterized by the fact that said device has a weight of less than 20 kgs.

9. A device for limb rehabilitation according to claim 7 or 8, characterized by the fact that said device has a maximum plan dimension of 600 mm x 600 mm.