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for basic ADL. The literature comprises of findings from trials employing a range of robotic
systems, training protocols and patient characteristics. This presents a challenge when
assessing the outcomes robotic therapy. However, what is clear is the potential that such
systems offer and the need for more high quality trials.
Some of the most prominent systems developed for upper limb rehabilitation are
briefly described next.

MIT-MANUS
MIT began developing the MIT-MANUS in 1989 for the rehabilitation of the shoulder and
elbow of stroke patients (Hogan et al., 1992). This was the first robot employed in clinical
trials for delivering rehabilitation therapy. This end-effector-based system incorporated a
2 DOFs robot that used a direct-drive, five-bar linkage, selective compliant assembly robot
arm configuration.
The commercial version of MIT-MANUS is called InMotion (Fig. 11-1), and is avail-
able through Bionik Laboratories. The system employs video games to engage patients to
1
carry out defined exercise routines. For patients who are able to initiate arm movement,
the robot provides adjustable levels of assistance to facilitate the movement.
Additional modules for the system have been developed allowing 3 DOFs wrist motion
(allowing abduction/adduction, flexion/extension and pronation/supination), vertical
movements (via an antigravity module) and hand grasp (Lo et al., 2010). The device pro-
vides assistive or resistive forces as well as a passive mode (Krebs et al., 1999).
MIRROR IMAGE MOTION ENABLER
The Mirror Image Motion Enabler (MIME) is an end-effector-based system developed at
Palo Alto Rehabilitation R&D Center. The system has 6 DOFs and performs both unilateral

FIGURE 11-1 InMotion arm, Bionik Laboratories: http://bionikusa�com/healthcarereform/upper-extremity-
rehabilitiation/inmotion2-arm/�

1 https://www.bioniklabs.com/.