Design and Experimental Validation of a Unidirectional Cable-Driven Exoskeleton for Upper Limb Rehabilitation

Upper limb disabilities resulting from stroke affect millions worldwide, yet current rehabilitation systems face limitations in portability, cost-effectiveness, and multi-joint integration. This study presents a cable-driven parallel exoskeleton integrating elbow, wrist, and finger assistance into a single portable device. The design strategically separates actuation components, housing all motors in a backpack unit, while limb-mounted modules serve as cable routing guides, achieving seven degrees of freedom within practical constraints of portability (1.2–1.5 kg) and cost-effectiveness (3D-printed components). The device incorporates seven servo motors controlled via Arduino with IMU feedback and PID algorithms. Kinematic and dynamic analyses informed mechanical design, while ARMAX system identification enabled controller optimization achieving 87.96% model fit. Experimental validation with eight healthy participants performing four upper limb exercises demonstrated consistent trends toward reduced activation in four monitored agonist muscles with exoskeleton assistance (21.3% average reduction, p = 0.087), with moderate effect sizes for proximal muscles (Cohen’s d = 0.70–0.79) and significant reductions in brachioradialis during radial/ulnar deviation (23.4%, p = 0.045). These findings provide preliminary evidence of the device’s potential to reduce muscular effort during assisted movements, warranting further clinical validation with patient populations.