Abstract:Robotic devices hold promise for aiding patients in orthopedic rehabilitation. However, current robotic-assisted physiotherapy methods struggle including biomechanical metrics in their control algorithms, crucial for safe and effective therapy. This paper introduces BATON, a Biomechanics-Aware Trajectory Optimization approach to robotic Navigation of human musculoskeletal loads. The method integrates a high-fidelity musculoskeletal model of the human shoulder into real-time control of robot-patient interaction during rotator cuff tendon rehabilitation. We extract skeletal dynamics and tendon loading information from an OpenSim shoulder model to solve an optimal control problem, generating strain-minimizing trajectories. Trajectories were realized on a healthy subject by an impedance-controlled robot while estimating the state of the subject's shoulder. Target poses were prescribed to design personalized rehabilitation across a wide range of shoulder motion avoiding high-strain areas. BATON was designed with real-time capabilities, enabling continuous trajectory replanning to address unforeseen variations in tendon strain, such as those from changing muscle activation of the subject.