Sistem Rehabilitasi Hybrid FES-Exoskeleton untuk Integrasi Gerakan Sendi Bahu dan Siku Menggunakan Fuzzy Coactivation Model

Azzahra, Vira (2026) Sistem Rehabilitasi Hybrid FES-Exoskeleton untuk Integrasi Gerakan Sendi Bahu dan Siku Menggunakan Fuzzy Coactivation Model. Other thesis, Institut Teknologi Sepuluh Nopember.

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Abstract

Stroke merupakan masalah kesehatan global dengan jumlah kasus mencapai 12,2 juta pada tahun 2025. Di Indonesia, berdasarkan Survei Kesehatan Indonesia (SKI), prevalensi stroke mencapai 8,3 per 1.000 penduduk. Sekitar 85% penyintas stroke mengalami gangguan motorik pada ekstremitas atas yang menghambat aktivitas sehari-hari, sehingga diperlukan metode rehabilitasi yang efektif untuk memulihkan fungsi gerak. Teknologi rehabilitasi seperti Functional Electrical Stimulation (FES) dan exoskeleton telah banyak dikembangkan, namun umumnya masih difokuskan pada gerakan single-joint. Oleh karena itu, penelitian ini mengembangkan sistem Hybrid FES-Exoskeleton untuk rehabilitasi gerakan double-joint pada sendi bahu dan siku menggunakan Fuzzy Coactivation Model, sensor Inertial Measurement Unit (IMU), dan kontrol proporsional pada exoskeleton. Pengujian dilakukan pada lima subjek normal dan satu subjek pasca-stroke melalui tiga metode pengujian, yaitu pengujian FES berbasis IMU, Hybrid FES-Exoskeleton skema sub-threshold, dan Hybrid FES-Exoskeleton skema supra-threshold. Hasil pengujian FES berbasis IMU menunjukkan bahwa sistem mampu mengikuti trajectory referensi dengan rata-rata RMSE sebesar 6,29° ± 1,78° pada elbow, 9,57° ± 4,43° pada shoulder, serta 9,79° ± 2,10° (elbow) dan 13,20° ± 4,91° (shoulder) pada gerakan double-joint. Pada pengujian Hybrid FES-Exoskeleton skema sub-threshold, diperoleh rata-rata RMSE sebesar 1,25° ± 0,78° pada elbow dan 1,21° ± 0,74° pada shoulder dengan rata-rata torsi 1,39 ± 0,10 Nm. Sementara itu, pada skema supra-threshold, rata-rata RMSE menurun menjadi 1,11° ± 0,70° pada elbow dan 1,10° ± 0,66° pada shoulder, disertai peningkatan rata-rata torsi menjadi 1,46 ± 0,07 Nm. Hasil tersebut menunjukkan bahwa integrasi exoskeleton, sensor IMU, dan Fuzzy Coactivation Model mampu menghasilkan gerakan rehabilitasi bahu dan siku yang akurat dan sinkron terhadap trajectory yang dirancang. Selain meningkatkan akurasi tracking dibandingkan FES berbasis IMU, stimulasi supra-threshold juga memberikan kontribusi gaya otot yang lebih besar tanpa menurunkan kualitas tracking, sehingga sistem berpotensi menjadi alternatif rehabilitasi ekstremitas atas bagi penyintas stroke.
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Stroke is a major global health problem, with approximately 12.2 million new cases reported in 2025. In Indonesia, according to the Survei Kesehatan Indonesia (SKI), the prevalence of stroke reached 8.3 per 1,000 population. Approximately 85% of stroke survivors experience upper-limb motor impairment, which limits their ability to perform daily activities and highlights the need for effective rehabilitation methods. Rehabilitation technologies such as Functional Electrical Stimulation (FES) and exoskeletons have been widely developed, however, most existing systems are limited to single-joint movements. Therefore, this study developed a Hybrid FES-Exoskeleton system for double-joint rehabilitation of the shoulder and elbow using a Fuzzy Coactivation Model, an Inertial Measurement Unit (IMU), and proportional control for the exoskeleton. Experiments were conducted on five healthy subjects and one post-stroke subject under three testing scenarios: IMU-based FES, Hybrid FES-Exoskeleton with sub-threshold stimulation, and Hybrid FES-Exoskeleton with supra-threshold stimulation. The IMU-based FES results demonstrated that the proposed system was able to follow the reference trajectory with average RMSE values of 6.29° ± 1.78° for the elbow, 9.57° ± 4.43° for the shoulder, and 9.79° ± 2.10° (elbow) and 13.20° ± 4.91° (shoulder) during double-joint movements. In the Hybrid FES-Exoskeleton sub-threshold scheme, the average RMSE values were 1.25° ± 0.78° for the elbow and 1.21° ± 0.74° for the shoulder, with an average measured torque of 1.39 ± 0.10 Nm. Under the supra-threshold scheme, the average RMSE values decreased to 1.11° ± 0.70° for the elbow and 1.10° ± 0.66° for the shoulder, while the average torque increased to 1.46 ± 0.07 Nm. These results demonstrate that the integration of the exoskeleton, IMU, and Fuzzy Coactivation Model enables accurate and synchronized shoulder and elbow rehabilitation movements that closely follow the predefined trajectory, while achieving higher tracking accuracy than the IMU-based FES system, thereby demonstrating its potential as an effective upper-limb rehabilitation system for stroke survivors.

Item Type:	Thesis (Other)
Uncontrolled Keywords:	Double-joint, Fuzzy Co-activation Model, Hybrid FES-Exoskeleton, Inertial Measurement Unit, Stroke, Fuzzy Co-activation Model, Multi-joint, Hybrid FES-Exoskeleton, Inertial Measurement Unit, Stroke
Subjects:	R Medicine > R Medicine (General) > R857.M3 Biomedical materials. Biomedical materials--Testing. R Medicine > RM Therapeutics. Pharmacology > RM950 Rehabilitation technology.
Divisions:	Faculty of Intelligent Electrical and Informatics Technology (ELECTICS) > Biomedical Engineering > 11410-(S1) Undergraduate Thesis
Depositing User:	Vira Azzahra
Date Deposited:	01 Aug 2026 02:17
Last Modified:	01 Aug 2026 02:17
URI:	http://repository.its.ac.id/id/eprint/141338

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