Abstract
Introduction
Loss of hand function causes severe limitations in activity in daily living. The hand-soft robot is one of the methods that has recently been growing to increase the patient’s independence. The purpose of the present systematic review was to provide a classification, a comparison, and a design overview of mechanisms and the efficacy of the soft hand robots to help researchers approach this field.
Methods
The literature research regarding such tools was conducted in PubMed, Google Scholar, Science Direct, and Cochrane Central Register for Controlled Trials. We included peer-reviewed studies that considered a soft robot glove as an assistive device to provide function. The two investigators screened the titles and abstracts, then independently reviewed the full-text articles. Disagreements about inclusion were resolved by consensus or a third reviewer.
Results
A total of 15 articles were identified, describing 210 participants (23 healthy subjects). The tools were in three categories according to their actuation type (pneumatic system, cable-driven, another design). The most critical outcomes in studies included functional tasks (fourteen studies), grip strength (four studies), range of motion (ROM) (five studies), and user satisfaction (five studies).
Discussion
Function and grip parameters are the most common critical parameters for tests of hand robots. Cable-driven transmission and soft pneumatic actuators are the most common choices for the actuation unit. Radder et al. study had the highest grade from other studies. That was the only RCT among studies.
Conclusion
Although few soft robotic gloves can be considered ready to reach the market, it seems these tools have the potential to be practical for people with a disability. But, we lack consistent evidence of comparing two or more soft robot gloves on the hand functions. Future research needs to assess the effect of soft robotic gloves on people with hand disorders with more populations.
Introduction
Over sixty million people suffer from hand disabilities globally (Lawrence et al., 2001; Organization and Society, 2013). Hand function recovery is crucial for the independence of people with disability (Almenara et al., 2017). Hand robots are one of the methods that are growing recently because of increasing the patient’s independence (Gopura et al., 2011). Soft robots and exoskeletons are two available benches for rehabilitation robots. High weight, bulky, complex, and limited interaction with an environment are some of the limitations of the exoskeletons (Gopura et al., 2016; Jiryaei et al., 2021). The exoskeletons are expensive and non-portable, which restricts the rehabilitation process at home. Hence, they need to develop lightweight and wearable robots (Cappello et al., 2018; Trivedi et al., 2008).
Soft robots are one of the newest and most innovative technological devices. These tools allow interaction between the execution of motions and the intentions of the tool and the users (Kazerooni, 2005; Pons et al., 2008). Clinical studies showed that users who used soft robotics during rehabilitation programs significantly improved hand motor functionality compared to patients without soft robots (Ueki et al., 2010).
Recently, many research groups have begun to develop and evaluate robotic gloves with soft and flexible materials (e.g., cable-driven, fluidic soft actuators, and soft pneumatic actuators) (Bardi et al., 2022; Trivedi et al., 2008). Soft robots provide more degrees of freedom, more safety, less weight, and less complexity than exoskeletons. In addition, the soft robots are suitable for delicate and sensitive movements and improve activities of daily living (ADL) with the hand (Diftler et al., 2014; Heo et al., 2012; Kadowaki et al., 2011; Polygerinos et al., 2015; Trivedi et al., 2008).
Using soft materials enables a structure without joints, which resolves the problem of aligning human finger joints with a rigid exoskeleton (Sarakoglou et al., 2016). This concept of a wearable soft-robotic glove allows low-performance users to employ their hands in ADL. It may even reduce the need for healthcare professionals and is thought to improve hand-function users’ independence in performing ADL (Radder et al., 2019).
In a systematic review, Bardi et al., assessed sixty-nine soft robots for the upper limb (105 articles) (Bardi et al., 2022). Although this review included a wide of soft robots for upper limbs, the researchers reviewed the studies related to technical points and did not consider clinical tests. In a narrative review, the clinical outcomes of the soft robots were reviewed, but only papers with SCI participants were selected (Cardoso et al., 2022). To the best of our knowledge, a comprehensive review of the topic with a clinical view needs to be included. Thus, this systematic review provides a classification, a comparison, and a design overview of mechanisms and the efficacy of the soft glove robots to help researchers approach this field. We reviewed these outcomes outcome measures functional tasks, grip and pinch strength, ROM, and user satisfaction, in the present study.
Section snippets
Search strategy
This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement (Mark Vrabel, 2015) and registered with the PROSPERO database. The search strategy was based on the Population Intervention Comparison Outcome (PICO) method and included all relevant articles published from January 2005 to April 2022. Do studies of hand robots could be benefit for researchers and clinicians? To answer this question a
Description of the studies
The present study restricted the research to papers written in English and published from January 2005 to April 2022 (see Fig. 1). The search strategy yielded 874 articles. After a full review of the articles, 15 met the inclusion criteria. This review summarizes the results of studies that evaluated soft robotic gloves on patients with hand impairment. The researchers modified the Downs and Black scale to 15 items. Four papers received a maximum score (a score of 12), and the six papers
Discussion
The present study demonstrates soft robots will have a very high potential in the near future. However, this area needs more strong evidence and clinical tests. This review’s results amplify the effect of clinical tests of soft robot gloves. The main applications for which these tools have been developed are related to the assistance of disabled people. Function and grip parameters are the most common critical parameters for tests of hand robots. From a technical view, cable-driven transmission
Conclusion
In conclusion, this study confirms that soft robots might show very high potential, but they have yet to reach the market. This review could infer no reports with long effects of using soft devices on ADL and the quality of life of disabled people. Thus, clinical trials are needed to assess the effectiveness of soft hand robots and identify the needs of disabled people who can benefit the most from these types of tools. Overall, soft robots can be a window of hope for them. Hopefully, soon
Clinical relevance
- •Soft robots may improve grip, reduce limitations and increase function.
- •Soft robots may benefit by increasing the quality of life for people with disability in hand.
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