Rehabilitasi Hybrid FES-Exoskeleton Untuk Restorasi Fungsi Lengan Bawah Menggunakan Mekanisme Koaktivasi

Farhat, Ahmad (2026) Rehabilitasi Hybrid FES-Exoskeleton Untuk Restorasi Fungsi Lengan Bawah Menggunakan Mekanisme Koaktivasi. Other thesis, Institut Teknologi Sepuluh Nopember.

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Abstract

Stroke menyebabkan defisit motorik pada ekstremitas atas yang mengakibatkan hilangnya koordinasi otot di sendi siku dan pergelangan tangan. Penggunaan Functional Electrical Stimulation (FES) secara mandiri terbukti rentan terhadap kelelahan otot (muscle fatigue) dini akibat rekrutmen serabut motorik yang tidak optimal, sementara exoskeleton robotik tanpa FES membuat pasien cenderung pasif secara neuromuskular. Penelitian ini mengusulkan sistem rehabilitasi hybrid exoskeleton-FES multi-joint yang dikendalikan oleh Fuzzy Coactivation Model bertipe MISO untuk memodulasi intensitas stimulasi sepasang otot agonis-antagonis pada sendi siku (biceps-triceps brachii) dan pergelangan tangan (FCU-ECU) secara adaptif dan closed-loop. Pengujian melibatkan 4 subjek (3 normal, 1 pasca-stroke) pada lintasan sinusoidal 0,02 Hz. Pada sistem FES-Only (IMU-FES), sendi siku subjek pasca-stroke mencatat RMSE sebesar ±34,67 derajat akibat spastisitas yang tinggi. Integrasi sistem hybrid supra-threshold berhasil mereduksi RMSE gabungan subjek pasca-stroke menjadi ±28,90 derajat, dibandingkan ±43,58 derajat tanpa exoskeleton. Untuk subjek normal, RMSE gabungan sistem hybrid mencapai rata-rata ±3,55 derajat, jauh lebih baik dibandingkan FES-Only ±9,96 derajat dengan catatan bahwa nilai RMSE tersebut merupakan hasil kontribusi gabungan antara aktuasi mekanik exoskeleton yang telah disesuaikan parameternya dan stimulasi FES pada level intensitas tertentu sehingga peningkatan level stimulasi turut menggeser proporsi load sharing dan memengaruhi akurasi tracking. Seluruh subjek pada kedua level pengujian tidak melaporkan indikasi kelelahan otot setelah pengujian, mengindikasikan bahwa skema koaktivasi hybrid mampu mendistribusikan beban kerja neuromuskular secara efektif, sehingga memvalidasi kelayakan arsitektur kontrol koaktivasi hybrid sebagai modalitas rehabilitasi yang fisiologis dan klinis.
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Stroke causes motor deficits in the upper extremities, resulting in a loss of muscular coordination at the elbow and wrist joints. The standalone use of Functional Electrical Stimulation (FES) has been shown to be prone to early muscle fatigue due to suboptimal motor unit recruitment, while robotic exoskeletons without FES tend to render patients neuromuscularly passive. This study proposes a multi-joint hybrid exoskeleton-FES rehabilitation system controlled by a Multiple-Input Single-Output (MISO) Fuzzy Coactivation Model to adaptively and in closed-loop modulate the stimulation intensity of agonist-antagonist muscle pairs at the elbow joint (biceps-triceps brachii) and wrist joint (FCU-ECU). Testing involved 4 subjects (3 healthy, 1 post-stroke) following a 0.02 Hz sinusoidal trajectory. Under the FES-Only (IMU-FES) system, the post-stroke subject's elbow joint recorded an RMSE of ±34.67 degrees due to high spasticity. Integration of the hybrid system at supra-threshold intensity successfully reduced the post-stroke subject's combined RMSE to ±28.90 degrees, compared to ±43.58 degrees without the exoskeleton. For healthy subjects, the hybrid system's combined RMSE averaged ±3.55 degrees, considerably better than the ±9.96 degrees achieved with FES-Only, considering that these RMSE values represent the combined contribution of the exoskeleton's mechanically tuned actuation and FES stimulation at a given intensity level, such that increasing the stimulation level correspondingly shifts the load-sharing proportion and influences tracking accuracy. No subjects across either testing level reported signs of muscle fatigue following the trials, indicating that the hybrid coactivation scheme effectively distributes neuromuscular workload, thereby validating the feasibility of this hybrid coactivation control architecture as a physiologically and clinically viable rehabilitation modality.

Item Type:	Thesis (Other)
Uncontrolled Keywords:	Exoskeleton, Functional Electrical Stimulation (FES), Fuzzy-Koaktivasi, Rehabilitasi Hybrid, Multi-Joint, Exoskeleton, Functional Electrical Stimulation (FES), Fuzzy Co-activation, Hybrid Rehabilitation, Multi-Joint
Subjects:	R Medicine > RM Therapeutics. Pharmacology > RM871 Electric stimulation. 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:	Ahmad Farhat
Date Deposited:	01 Aug 2026 03:43
Last Modified:	01 Aug 2026 03:43
URI:	http://repository.its.ac.id/id/eprint/141593

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