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17th IEEE Mediterranean Electrotechnical Conference, Beirut, Lebanon, 13-16 April 2014.

High Energy Efficiency Biped Robot controlled by


the Human Brain for people with ALS disease*
P. Fedele1, P. Federighi2, R. Molfino3, G. G. Muscolo3,4,a, C. T. Recchiuto5, A. Rufa2b
1

Liquidweb s.r.l., Via XXIV Maggio, 21, Siena, Italy.


Eye-tracking & Visual Application Lab Department of Medicine, Surgery and Neurosciences University of Siena, Siena,
Italy.
3
PMAR Lab., DIME-MEC, Applied Mechanics and Machine Design, Scuola Politecnica, University of Genova, Via
allOpera Pia, 15, Genova, Italy.
4
Creative and Visionary Design Laboratory, Humanot s.r.l., Via Amedeo Modigliani, 7, 59100, Prato, Italy.
5
Electro-Informatic Laboratory, Humanot s.r.l., Via Amedeo Modigliani, 7, 59100, Prato, Italy.
b

Authors listed in alphabetical order, equal contribution.


in prostate interventions [3]), or can be general-purpose,
with robotic arms equipped with various instruments
(scissors, endoscopes,) [4] and controlled by a surgeon by
means of a tele-operated robotic system (e.g. Zeus, da Vinci
[5] and CyberKnife [6]). The last frontier of robotic surgery
is nanorobotics, which include nanodevices that can operate
at molecular levels to, for example, reconstruct damaged
tissues or identify and destroy cancerous cells [7].

AbstractThis paper analyses the adoption of novel robotic


technologies to help people suffering from amyotrophic lateral
sclerosis (ALS). The work starts with the analysis of problems
that mostly affect these patients in order to understand where
science and technology can be used to help them. In particular
brain-computer interfaces and their implementation with a
high energy efficiency humanoid robot for domestic assistance
will be taken into account. The features that this kind of
technology must have in order to satisfy the required need will
be discussed, with some preliminary tests implemented in
existing platforms.

Invasive and non-invasive robotics also play a


fundamental role in diagnosis. Some examples include
ecographic robotics systems [8] or robotic endoscopes
included in the ZEUS and da Vinci systems [5]. The most
modern approach is focusing on the development of
miniature diagnostic robots endowed with locomotion
abilities, including small energy sources and wireless
communication devices [9].

Keywords-ALS, Humanoid Robots, BCIs, Human-Machine


Interface, Energy Efficiency, Cognitive Rehabilitation,
Biomechanics.

I.

INTRODUCTION

Robotics is widely used also in the prosthetics field.


Thanks to myoelectric signals, robotics arm or legs can be
finely controlled. Examples are the i-Limb hand of
Edinburgh or the European project Smarthand [10,11].

The rapid development of robotic technologies in the last


thirty years has created a tight connection between the health
care sector and robotic technologies. Advanced technologies
have been applied to medical fields such as surgery,
diagnosis, rehabilitation, prosthetics, and assistance to
disabled and elderly people and the implementation of
robotics artifacts in these sectors is a growing trend.

Another health-care sector where robotics is assuming a


leading role is rehabilitation. Rehabilitation robotics focuses
on machines that can be used to help people to recover from
severe physical trauma. One quite recent tool for physical
therapy in this field is the robotic exoskeleton. The most
promising one being used is the LOPES (LOwer-extremity
Powered Exo Skeleton) [12]. The LOPES system is intended
to help people to regain lost motor control, such as after a
serious stroke. On the other side, upper limb rehabilitation
robots which are typically constituted by robotic arms linked
to the patients upper limbs. One example of this kind of
structures is the MANUS system of the MIT [13].

The use of robotic surgery systems in medical procedures


dates back to the 1980s, aiming at reducing the invasiveness
of interventions and ensuring a high level of accuracy [1]. In
this context, robots can be designed in order to provide
support to surgeons, performing tasks that are usually done
by human assistants [2] or may be directly involved in
surgical interventions, manipulating instruments and
performing crucial stages of the process. Robots that are
directly involved in surgical procedures can be designed to
perform a specific intervention (e.g. PROBOT, specialized
* This joint research was partly supported by the BrainHuRo Italian
Project (Tuscany POR-CREO Fesr 2007-2013 Le ali alle tue idee) and
partly supported by University of Siena, Liquidweb s.r.l. and Humanot s.r.l.
as active partners in the BrainHuRo project.
a Corresponding author: Giovanni Gerardo Muscolo
(muscolo@dimec.unige.it) (g.muscolo@humanot.it)

978-1-4799-2337-3/14/$31.00 2014 IEEE

386

But robots can be used also in another typology of


rehabilitation, such as cognitive rehabilitation therapies.
Cognitive rehabilitation therapies usually use animaloid
robots: for example, the robot PARO, which is shaped like a
baby harp seal, is an advanced interactive robot developed
by AIST that has the ability of reduce patient stress and
stimulate the interaction between patients and caregivers

17th IEEE Mediterranean Electrotechnical Conference, Beirut, Lebanon, 13-16 April 2014.

[14]. PARO has five kinds of sensors in order to perceive


people and the environment, and it can interact with people
by moving its head and legs, making sound and showing a
preferred behavior. For this purpose, robot can have also a
human shape: the F.A.C.E. system, developed at the
University of Pisa, is a human android, provided with a
simple communication interface focused on the reproduction
of facial expressions and meant to meet the patients affective
needs, building a close relationship and stimulating the
interaction capabilities in its users [15].

movements of a robotic arm [22]. In a different research


project, BCI technologies were used by the patients to
control a wheelchair [23]. The results showed the feasibility
of continuously controlling complex robotic devices using
non-invasive BCI. These technologies can therefore be
applied to assistive and humanoid robots.
Some artificial intelligence systems have already been
implemented in order to assist disabled and elderly people,
but they were rarely inspired by the human anatomy.
Humanoid robotics took its first step in Japan in 1973 with
the WABOT-project. In Europe, the research related to
humanoid robots is in a fast expansion; the German
ARMAR III [24], a robot with head, torso and hands
mounted on a motorized platform, is an example of this
increasing interest of the European research centers. The EU
founded RobotCub [25] research project is another great
example; it allowed the design and development of a
humanoid robot with characteristics similar to a child.

Humanoid robots can also be extremely useful when


applied in therapies with children suffering from autism
spectrum disorders (ASD) [16]. People with autism
generally feel comfortable in predictable environments and
enjoy interacting with computers and robots [17]. Many
projects that see a strict connection between children
suffering from ASD and humanoid robotic artifacts have
been carried out and are currently being developed: the
AuRoRa project used child-sized humanoid robot (Kaspar,
Robota) to engage children in coordinated and synchronized
interactions with the environment thus helping them to
develop and increase their communication and social
interaction skills [18]. The humanoid robot NAO was also
used for these studies, achieving a 30 percent increase in
social interactions and verbal communication when the robot
was in the same room with children [19].

Many of these studies were synthesized in the realization


of the humanoid platform WABIAN 2-R, and then in its
Italian version SABIAN (SantAnna BIped humANoid) [26,
27, 28].
Based on these premises, the aim of this work is to
analyze the problems and the needs related to people
suffering from ALS and describe how BCI technologies and
humanoid robotics can help to solve both practical and
psychological issues. In particular, the collaboration among
neuroscientists, engineers and computer scientists lead to the
realization of a project called BRAINHURO (start:
December 2012 - end: December 2014), in which techniques
of a BCI system, are integrated with a humanoid robot in
order to assist ALS patients and provide them with a user
friendly instrument that makes their daily living activities
quite autonomous and facilitates communication with other
people. This approach makes easier the interaction of
patients with people even in very advanced conditions such
as the looked in syndrome.

Based on all these good results of the connection between


health-care and robotics, the authors believe that people
suffering from Amyotrophic Lateral Sclerosis can also
benefit from the assistance and the help of humanoid
robotics technologies. Amyotrophic Lateral Sclerosis (ALS)
is a debilitating neurological disease characterized by
progressive weakness and muscle atrophy.
No cure has yet been found for ALS. The principal
treatments for ALS are designed to relieve symptoms and
improve the quality of life of patients. Clinicians often
expect that ALS patients will experience depression and
anxiety during the course of the disease [20]. In these cases
patients are usually treated with drugs having an
antidepressant or anxiolytic effect with inconstant and often
partial efficacy. A cognitive and behavioral approach can be
applied also in these cases, encouraging engagement in
activities that are still practicable and pleasant. Advanced
robotics can be applied also for these patients with a dual
objective: assistive to improve the quality of life and
behavioral motivating the use of the residual abilities. In
particular, we suggest the implementation of BrainComputer Interface technologies and humanoid robotics as
personal assistance.

The paper is structured as follows: Section II describes in


detail the most important issues not yet solved related to
locked-in patients, and their most urgent needs. Section III
discusses the features needed of a BCI system in order to be
useful for patients suffering from ALS. Section IV describes
the characteristics of a humanoid robot that can be used for
assistance in this context, analyzing a fundamental issue
such as the energy efficiency, in comparison with human
data. Finally, the expected results of the integration of these
technologies and the future works are discussed.
II.

PEOPLE SUFFERING FROM ALS: PROBLEMS, NEEDS


AND STATE OF THE ART

Brain-Computer Interfaces (BCIs) enable to connect


computers and robotic devices with the human brain [21].
The sensors to detect the activity of the brain can be invasive
(inserted deep inside brain tissues), partially invasive (under
the scalp but externally to the cerebral cortex) or noninvasive (resting on the scalp). Non-invasive configurations
are easier to wear, does not require surgery and cost less but
generally produce a weaker signal quality. Another
fundamental issue related to BCI concerns the choice of the
neural properties to be recorded.

Amyotrophic lateral sclerosis (ALS) is a progressive


neurodegenerative disease involving the motor neurons. The
disease has an incidence of ~ 1.9/100,000 and a prevalence
of ~ 6/100,000.
Amyotrophic lateral sclerosis (ALS) is pathologically
characterized by progressive loss of upper and lower motor
neurons. The onset is usually from middle age to elderly,
with a large variation in the presence of symptoms and
evolution of the disease. The disease is often sporadic and its
exact cause is not known, though an increasing number of
genetic markers have been noticed recently. Even the

Some tests were already conducted with patients: they


were able to control domestic robotic devices and drive

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17th IEEE Mediterranean Electrotechnical Conference, Beirut, Lebanon, 13-16 April 2014.

In the context of the project BRAINHURO, Braincontrol


transforms thoughts into action using the electrical activity
generated by ensembles of cortical neurons. This has been
made possible due to advances in methods of
electroencephalography (EEG) analysis and in information
technology, associated with a better understanding of the
functional significance of certain EEG parameters. This
system is particularly suitable for patients who have lost all
motor function because is driven purely by thoughts and
does not require sight, facial movements or any other
stimuli.

disease duration is variable with a large spectrum of


possibilities ranging from forms with mild conditions and a
slower evolution to more severe forms with survival no
more than 2.5 years and finally to very rapid forms with
survival of less than 6 months.
Clinically the ALS is characterized by rapidly progressive
weakness, muscle atrophy and fasciculations, muscle
spasticity, difficulty of speaking (dysarthria), difficulty of
swallowing (dysphagia), and difficulty of breathing
(dyspnea). Sensory nerves and autonomic nervous system
are generally unaffected, meaning the majority of people
with ALS will maintain hearing, sight, touch, smell, and
taste.

III.

This progressive neurodegenerative disease, usually leads


to complete immobilization of patients who need of a
complete and continuous assistive support for living. In the
majority of these patients, however, the cognitive functions
are longer preserved making indispensable to find solutions
that may help patients to contact caregivers and other people
and to interact with the environment. The disease evolves
toward a respiratory and cardiac failure, though death occurs
after 35 years from the onset.

The main task of a BCI is the capability to distinguish


different patterns of brain activity, each being associated
with a specific intention or mental task. Most BCIs rely on
non-invasive electroencephalogram (EEG) signals, where
the electrical brain activity is recorded from electrodes
placed on the scalp, that is a practical way to bring BCI
technology to a large population.
Despite progress in Assistive Technologies (AT), there is
still a large number of people with severe motor disabilities
who cannot fully benefit from AT due to their limited access
to current assistive products. For example, independent
mobility is central to being able to perform activities of daily
living by oneself. However, power wheelchairs are not an
option for many people who, due to severe motor
disabilities, are unable to use conventional controls. For
some of these people, non-invasive brain-computer
interfaces (BCIs) offer a promising solution to this
interaction problem.

Since the time of Charcots first description of ALS


between 1860-70, key discoveries in neurobiology have led
to steady advances in our understanding of the pathogenesis
of the disease and there has been modest progress in the
management and reliable medical treatment of ALS. At the
same time, the number of newly affected individuals has
increased in the past few years as well as the identification
of new familial forms. As no effective treatment is so far
available for ALS, most medical interventions aim to
improve the quality of life of patients.
Indeed, there are many opportunities for interventions that
may improve quality of life for the patient and caregiver.
Although the majority of the efforts are directed toward the
individuation of tools that may maintain the capacity of
communicating with family members and other people,
other assistive aspect cannot be underestimated. In particular
those aspects related to depression, hopelessness, anxiety,
and other mental health issues that should be aggressively
addressed and treated. Additionally many symptoms such as
pseudobulbar palsy, scialorrhea, constipation, spasticity, and
cramps can be treated effectively with medications. In
contrast to the discouraging view that "there is nothing we
can do," a broad approach to management, through
collaboration with a multidisciplinary team, will permit the
ALS physician to make a meaningful difference in the lives
of individuals living with ALS.

Over the past 20 years, research in the field of braincomputer interface has been increasing almost
exponentially, driven by advances in understanding of brain
function and the evolution of computers and sensors.
BCI is an effective way to augment human capabilities by
providing a new interaction link with the outside world and
is particularly relevant as an aid for disabled people.
In recent years, BCI research is exploring many
applications in different fields related to AT, including
communication [29], environmental control [30], and
robotics and mobility [31-35].
However, no sufficiently usable and robust BCI solution
addresses the needs of people with severe physical
disabilities. BrainControl (see Figure 1) is the worlds first
commercial available BCI that is usable by people who
cannot move any muscles or communicate, but who are
consciously aware, a state called locked-in or apparent
coma. It is a BCI platform that allows people suffering
from pathologies such as Amyotrophic Lateral Sclerosis
(ALS), Multiple Sclerosis, tetraplegia and various kinds of
muscular dystrophies, to overcome severe physical and
communicative disabilities (3.7 million people worldwide).
In particular, BrainControl can help patients suffering from
diseases that paralyze the whole body or parts of the body,
but who retain their intellectual abilities.

Table 1. Amyotrophic Lateral Sclerosis: Clinical Presentation and


Prognostic Aspects
limb onset 75%

limb weakness

slower
evolution

bulbar onset 25%

Problem of speaking and


swallowing

rapid
progression

Respiratory onset

Intercostals muscle
weakness

rapid
progression

fronto-temporal
dementia onset

mood and cognitive


changes

mild/rapid
progression

BCI TECHNOLOGIES AND HUMAN-ROBOT


INTERACTION

The first version of BrainControl, the Basic


Communicator, fills a technological void for patients in

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17th IEEE Mediterranean Electrotechnical Conference, Beirut, Lebanon, 13-16 April 2014.

locked-in state, and meets many of the unmet needs for


patients in less advanced states who are currently using or
cannot use eye-tracking systems.

SABIAN body [26].


Two different gaits (knee-stretched and knee-bended)
were performed on SABIAN with the aim of measuring the
power consumption of every single joint in different
configurations, also in comparison with data related to
human movements, in order to give the bases for the
realization of an energy recovering system.

Future versions of BrainControl, which are currently


under development, will include advanced communication
and entertainment (virtual keyboard, text-to-speech, web
browsing, interaction via SMS, social networks, email, webradio), home automation (lights, alarms, temperature, etc.)
and the control of a wheelchair.

From the analysis of the shown graphs (see Figures 2, 3,


4, 5 and 6), obtained by the driver interface of the robot and
by neuroscience literature, some considerations can be
derived:

The aim of this work is to apply the BrainControl


technology to the control of a humanoid robot for domestic
assistance developed by the innovative Italian start-up
Humanots.r.l. [36].

1.
The main percentage of the power is necessary to
move the right and left knee pitches.
2.
As well, the others legs pitches related to the ankle
and the hip can play an important role in an energy
recovering system.
3.

Other joints are almost not used in this gait.

Considering the mechanical power in absolute value (see


Figure 2), we can have an idea of the total amount of power
necessary to perform a 4 steps knee-stretched gait [27].
It can be immediately noticed that the total amount of
power during a simple walk is quite low, with peaks of 400
W (P_tot graph in the Figure 2). A big amount of power
(30% - 50%) is thermally dissipated (electronic drivers,
motor resistance); and it can hardly be recovered, although it
can be reduced with measures in the design phase (P_th
graph in the Figure 2). Some of the mechanical power can
instead be recovered by using alternators instead of fixed
bearings for belt tensioning (P_mecc graph in the Figure 2).

Figure 1. BrainControl.

IV.

ENERGY EFFICIENCY: HUMAN-ROBOT COMPARISON

A humanoid robot that interacts with the human


environment such as a home, a hospital, a public place, etc.,
should have enormous dexterity to avoid obstacles such as
chairs, beds, tables, people, etc.. The dexterity is related to
the degrees of freedom (DoFs) of the robot and to the joints
motion controllers of the biped structure. Higher dexterity
usually implies that many joints should be controlled and a
big amount of energy is necessary. Optimising a robot
structure, high dexterity with low energy consumption could
be obtained. In the assistive application proposed with the
BrainHuro project, the robot will be constantly at the ready,
making energy efficiency a focal point of its
implementation. In order to measure the power consumption
and to compare data with the human gait and investigate the
best suited regions of the body for energy recovering, a
series of experiments were performed with the humanoid
robot SABIAN (SantAnna BIped humANoid) [26], a biped
humanoid robot developed by the Robot-An Laboratory, at
Scuola Superiore SantAnna. It is a copy of WABIAN 2-R
(Waseda BIped humANoid) [27], [28]. Compared to most
bipedal humanoid robots, which walk with bent knees,
WABIAN 2-R is able to perform a human-like walking,
with stretched knees, and to get the pelvis motion, raising
the hip. WABIAN 2-R is approximately the size of the
average adult Japanese women. The robot has 7 DOFs in
each leg, 2 DOFs in the waist, which help the robot perform
stretched knee walking, 2 DOFs in the trunk. Every degree
of freedom has a bioinspired range of motion, defined in
reference to human motion measurements.

From an accurate analysis of the gait, we can mark


different joint power regions (see Figure 3): stance flexion,
stance extension, pressing, swing flexion, swing extension.
During stance flexion, the motors that act to extend the knee
are active, producing an extensor moment. The knee is
flexing as the leg accepts the weight of the rest of the body,
resulting in negative joint power. A negative joint power is
also produced during the swing flexion phase, due to
extensor knee moment.

Figure 2. Total amount of power dissipated during a knee-stretched


forward gait by SABIAN robot.

Regions of high joint power are best viewed as potential


regions for energy recovering. As we can see, the swing

As it will be in the final version of the robot that will be


used in this context, the iCub head was mounted on the

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17th IEEE Mediterranean Electrotechnical Conference, Beirut, Lebanon, 13-16 April 2014.

extension phase is the region in which the largest amount of


joint power is performed by the knee pitch motor, while also
in stance flexion and in pre-swing phases a huge amount of
power is required. For the other pitch joints, instead, stance
flexion and stance extension are the movement phases in
which we can focus in order to recover energy.

Figure 4. Comparison between knee data in humans and in SABIAN in a


knee-stretched forward gait. Data related to the human gait are from
[37].

In figure 5, we can see high spikes of thermic power


related to knee joint, due to a high amount of torque
necessary for a very small period (this can be due to a not
perfect behavior of the related harmonic drive). Again, this
problem will be taken into account in the design phase.
Considering the mechanical power in absolute value, we can
have an idea of the total amount of power necessary to
perform the 4 steps knee bended gait.

An interesting comparison can be done with the human


walking, showing that the SABIAN platform [26-28] walks
in a way that is very close to the human one. Figure 4 shows
the behavior of the human knee hip joint during a strechedknee walk and the behavior of the same joint in the SABIAN
robot: since the pattern show a very good similarity,
strategies close to the one designed to implement energy
recovering systems during a human walk can be here applied
to the robotic platform.

Finally, from the analysis of the gait of Figure 6, we can


select here similar joint power regions in order to implement
energy recovering systems.

Almost the same considerations made for the kneestretched mode can be repeated of a knee-bended walking
motion. The data are related to a gait of 4 steps with the
knee bended with a degree of -50 degrees (where 0 degree is
the stretched position).

Figure 5. Total amount of power dissipated during a knee-bended forward


gait.

Figure 3. Graphs related to the ankle (left), knee (center) and hip (right)
pitch joints of the right leg during a knee-stretched forward gait.

Figure 6. Energy consumption data during a knee-bended forward gait for


the ankle (left), knee (center) and hip (right) pitch joints.

Anyway, as it can be easily seen, both in case of bentknee or stretched-knee walking, the energy consumption is
quite reduced, with pattern similar to the human one and
some region of high joint power, on the pitch joints of both
legs, that can be easily used for some strategy of energy
recovering, increasing the autonomy of these robotic
artifacts.

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17th IEEE Mediterranean Electrotechnical Conference, Beirut, Lebanon, 13-16 April 2014.

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CONCLUSION AND FUTURE WORKS


This paper analyses the adoption of humanoid robotics
and BCI technologies to help people suffering from
amyotrophic lateral sclerosis (ALS). The improvement of
their quality of life is a fundamental aspect and it was shown
that the possibility to interact with robotic artifacts could be
very useful at this aim. This possibility is currently being
investigated in the context of the project BRAINHURO, in
which the techniques of BCI systems are integrated with a
humanoid robot in order to assist ALS patients. First data
related to the energy consumption of the humanoid platform
that will be used in this context are shown in the paper. Next
work will be oriented to show the results of the integration
of BCI technologies here addressed, both considering
engineering and a psychological point of view.
ACKNOWLEDGMENTS
This joint research was partly supported by the
BrainHuRo Italian Project (cofounded by the POR-CREO
Fesr 2007-2013 Le ali alle tue idee) and partly supported
by University of Siena, Liquidweb s.r.l. and Humanot s.r.l.
as active partners in the BrainHuRo project.

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