DRBA: Dynamic Robotic Balance Assistant -- An assist-as-needed gait and balance rehabilitation robot for versatile training

The decline of human balance control due to aging and pathological conditions increases fall risk, a major concern in geriatric care and rehabilitation. Gait training is essential for balance recovery, enhancing walking ability and postural control. However, existing overground robotic gait trainers have limitations: body weight support systems are bulky and impractical for daily use, while end-effector-based systems often compromise transparency, altering natural gait dynamics. This paper presents the Dynamic Robotic Balance Assistant (DRBA), a novel gait trainer providing assist-as-needed body weight and balance support for various training scenarios. DRBA integrates a 3-degree-of-freedom (3-DoF) robotic arm for pelvic support with flexible motion, a compact sit-to-stand assistance module, and user-following and fall detection algorithms to ensure minimal interference and responsive support. Experimental results demonstrated high transparency, with minimal impact on natural gait dynamics. A patient trial with nine elderly patients with varying medical conditions and balance impairments (ranging from severe to mild) further validated DRBA's effectiveness. The results showed that DRBA-assisted training increased step length and walking speed compared to therapist-assisted gait training. Additionally, DRBA enabled users to perform tasks beyond their unaided ability, expanding rehabilitation possibilities. These findings highlight DRBA's potential to enhance rehabilitation outcomes by facilitating higher training intensity and enabling task-oriented exercises.