Archive for category Rehabilitation robotics

[Abstract + References] Preliminary Design of Soft Exo-Suit for Arm Rehabilitation – Conference paper

Abstract

Every year, millions of people experience a stroke but only a few of them fully recover. Recovery requires a working staff, which is time consuming and inefficient. Therefore, over the past few years rehabilitation robots like Exoskeletons have been used in the recuperation process for patients. In this paper we have designed an Exosuit which takes into considerations of the rigid Exo-Skeleton and its limitations for patients suffering from loss of function of the arm. This paper concentrates on enabling a stroke affected person to perform flexion-extension at elbow joint. Validation of the developed model on general population is still needed.

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[Abstract] Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial.

Abstract

OBJECTIVE:

The objective of this study was the evaluation of the clinical and neurophysiological effects of intensive robot-assisted hand therapy compared to intensive occupational therapy in the chronic recovery phase after stroke.

METHODS:

50 patients with a first-ever stroke occurred at least six months before, were enrolled and randomised into two groups. The experimental group was provided with the Amadeo™ hand training (AHT), whereas the control group underwent occupational therapist-guided conventional hand training (CHT). Both of the groups received 40 hand training sessions (robotic and conventional, respectively) of 45 min each, 5 times a week, for 8 consecutive weeks. All of the participants underwent a clinical and electrophysiological assessment (task-related coherence, TRCoh, and short-latency afferent inhibition, SAI) at baseline and after the completion of the training.

RESULTS:

The AHT group presented improvements in both of the primary outcomes (Fugl-Meyer Assessment for of Upper Extremity and the Nine-Hole Peg Test) greater than CHT (both p < 0.001). These results were paralleled by a larger increase in the frontoparietal TRCoh in the AHT than in the CHT group (p < 0.001) and a greater rebalance between the SAI of both the hemispheres (p < 0.001).

CONCLUSIONS:

These data suggest a wider remodelling of sensorimotor plasticity and interhemispheric inhibition between sensorimotor cortices in the AHT compared to the CHT group.

SIGNIFICANCE:

These results provide neurophysiological support for the therapeutic impact of intensive robot-assisted treatment on hand function recovery in individuals with chronic stroke.

 

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[ARTICLE] Mechanical Design of Exoskeleton for Hand Therapeutic Rehabilitation – Full Text PDF

ABSTRACT 

In this study an exoskeleton is designed for hand in therapeutic rehabilitation. The mechanical design is manufactured in consideration of anthropometrical measurements of the hand studied from literature. Kinematic model of the hand exoskeleton was obtained by results of position, velocity and torque-moment analysis.
The exoskeleton has a single degree of freedom (DOF) for the PIP and MCP joints. Basic four-bar linkage mechanisms are used in the exoskeleton. With this design, while movements (flexion and extension) occurs in both joints at the same time, angular displacement come out as in healthy hands. Linkage lengths aroptimized to achieve the targeted angular dynamics. The manipulation of the exoskeleton is actuated by a linear
servo motor.

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Fig 2 Hand Rehabilitation System

 

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[Abstract + References] A personalized flexible exoskeleton for finger rehabilitation: a conceptual design – Conference paper

Abstract

Several robotic rehabilitation systems have already been developed for the hand requiring the biological joints to be aligned with those of the exoskeleton making the standardization of this devices for different anthropomorphic sizes almost impossible. This problem together with the usage of rigid components can affect the natural movement of the hand and injure the user. Moreover, these systems are also typically expensive and are designed for in-clinic use as they are generally not portable.

Biomimetic and bioinspired inspiration using soft robotics can solve these issues. This paper aims to introduce the conceptual design of a personalized flexible exoskeleton for finger rehabilitation modelled around one specific user’s finger with the help of a 3D scanning procedure presenting a dynamic FEM analysis and a preliminary prototype obtaining a low-cost and easy to use and wear device.

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[Abstract + References] An Exoskeleton Design Robotic Assisted Rehabilitation: Wrist & Forearm – Conference paper

Abstract

Robotic systems are being used in physiotherapy for medical purposes. Providing physical training (therapy) is one of the main applications of fields of rehabilitation robotics. Upper-extremity rehabilitation involves shoulder, elbow, wrist and fingers’ actions that stimulate patients’ independence and quality of life. An exoskeleton for human wrist and forearm rehabilitation is designed and manufactured. It has three degrees of freedom which must be fitted to real human wrist and forearm. Anatomical motion range of human limbs is taken into account during design. A six DOF Denso robot is adapted. An exoskeleton driven by a serial robot has not been come across in the literature. It is feasible to apply torques to specific joints of the wrist by this way. Studies are still continuing in the subject.

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Image result for An Exoskeleton Design Robotic Assisted Rehabilitation: Wrist & Forearm

Fig. 1. Wrist and forearm motions [17]

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[Abstract + References] Development of a Hand Rehabilitation Therapy System with Soft Robotic Glove – Conference paper

Abstract

The major cause of problems with hand motility in adults is due to work accidents, strokes, injuries and work accidents. The emergence of robotic gloves for hand rehabilitation therapy has been developed to assist with rehabilitation treatment. In this scientific paper, a robotic glove prosthesis is designed and developed for use in hand rehabilitation in patients with grip pathologies. There is talk of mechanical design and operation, and the glove is controlled by a mobile application that allows the physiotherapist to enter the settings for the patient or allow an expert system based on 15 rules to do so. The system is capable of generating reports for the patient, the physiotherapist or the caregiver to review. The developed system is portable, lightweight and easy to transport. The validation of the prototype was carried out with adult patients suffering from hemiparesis.

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    Jones, C., Wang, F., Morrison, R., Sarkar, N., Kamper, D.G.: Design and development of the cable actuated finger exoskeleton for hand rehabilitation following stroke (2014). ieeexplore.ieee.orgCrossRefGoogle Scholar
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    Polygerinos, P., Wang, Z., Galloway, K., Wood, R.J., Walsh, C.J.: Soft robotic glove for combined assistance and at-home rehabilitation. Elsevier (2015)Google Scholar
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    Maciejasz, P., Eschweiler, J., Gerlach-Hahn, K., Jansen-Troy, A., Leonhardt, S.: A survey on robotic devices for upper limb rehabilitation. J. Neuroeng. Rehabil. 11(1), 3 (2014)CrossRefGoogle Scholar
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    Avila Chaurand, R., Prado León, L.R., González Muñoz, E.L., and Universidad de Guadalajara: Centro de Investigaciones en Ergonomía., Dimensiones antropométricas de población latinoamericana. Universidad de Guadalajara, Centro Universitario de Arte, Arquitectura y Diseño, División de Tecnología y Procesos, Departamento de Producción y Desarrollo, Centro de Investigaciones en Ergonomía (2001)Google Scholar

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[Conference paper] Wrist Rehabilitation Equipment Based on the Fin-Ray® Effect – Abstract + References

Abstract

A swift post-traumatic recovery of upper limbs can be achieved best by means of dedicated rehabilitation equipment. A speedy recovery process ensures the early reintegration of patients into society. The rehabilitation equipment proposed in this paper is conceived for the simultaneous passive mobilization of the radiocarpal, metacarpophalangeal and interphalangeal joints. The paper presents and discusses the construction and actuation system of the equipment. The elements of novelty put forward by this equipment refer to the Fin-Ray® effect underlying the design of the hand support and to its operation by means of a pneumatic muscle – an actuator with inherently compliant behavior. The discussion includes the occurring of hysteresis, and concludes that it does not affect the efficiency of the rehabilitation exercises..

References

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    Bulbul, M.K.: Study on Carpal Tunnel syndrome incidence, a tardy complication of distal meta- and physeal fractures of the forearm in correlation with their treatment. Ph.D. thesis, Oradea University (2015). (in Romanian)Google Scholar
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    Skirven, T.M.: Rehabilitation of the Hand and Upper Extremity, vol. 1. Elsevier Mosby, Philadelphia (2011)Google Scholar
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    W2 Wrist CPM. http://qalmedical.com/w2-wrist-cpm-device/. Accessed 10 Sept 2018
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    WaveFlex Hand. http://www.remingtonmedical.com/product/detail/A1. Accessed 20 Sept 2018
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    Deaconescu, T., Deaconescu, A.: Pneumatic muscle-actuated adjustable compliant gripper system for assembly operations. Strojniški vestnik J. Mech. Eng. 63(4), 225–234 (2017)CrossRefGoogle Scholar
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    Van Ham, R., Sugar, T.G., Vanderborght, B., Hollander, K.W., Lefeber, D.: Compliant actuator designs. IEEE Robot. Autom. Mag. 16, 81–94 (2009)CrossRefGoogle Scholar
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    Andrikopoulos, G., Nikolakopoulos, G., Manesis, S.: Motion control of a novel robotic wrist exoskeleton via pneumatic muscle actuators. In: 2015 IEEE 20th Conference on Emerging Technologies & Factory Automation (ETFA), pp. 1–8 (2015)Google Scholar
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    Petre, I., Deaconescu, A., Sârbu, F., Deaconescu, T.: Pneumatic muscle actuated wrist rehabilitation equipment based on the fin ray principle. Strojniški vestnik J. Mech. Eng. 64(6), 383–392 (2018)Google Scholar
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    Kniese, L.: Load carrying element with flexible outer skin. EP1040999A2. Patent (1999)Google Scholar
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    Filip, O., Deaconescu, T.: Mathematical modelling of a Fin Ray type mechanism, used in the case of the wrist rehabilitation equipment. In: 4th International Conference on Computing and Solutions in Manufacturing Engineering, Brasov, vol. 94 (2017).  https://doi.org/10.1051/matecconf/20179401006CrossRefGoogle Scholar

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[WEB SITE] RATULS Trial Using BIONIK InMotion Researches Robot-Assisted Stroke Therapy

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A landmark Robot Assisted Training for the Upper Limb after Stroke (RATULS) trial utilizing BIONIK Laboratories Corp’s InMotion Robotic Therapy Systems was completed recently, the Toronto-based company announces.

The RATULS trial, which began in 2014 and was completed at the end of 2018, compared the clinical effectiveness of robot-assisted training, enhanced upper limb therapy, and usual care for patients with moderate or severe upper limb functional limitation.

Results were presented recently at the European Stroke Organisation Conference (ESOC) in Milan, Italy, and published in The Lancet.

“We are pleased that the RATULS trial confirmed the finding of previous research studies which demonstrated that robot-assisted therapy improved upper limb impairment when compared with conventional care methods for stroke victims.

“The trial’s finding that robotic therapy is the only therapy to statistically maintain a significant impairment advantage at six months after treatment is a strong signal that robotic therapy is critical for achieving positive patient outcomes,” says Dr Eric Dusseux, CEO, BIONIK Laboratories, in a media release.

For the RATULS trial, the primary outcome for upper limb success was determined by Action Research Arm Test (ARAT), with four distinct success criteria that varied according to baseline severity, not used previously and developed by the RATULS trial team.

Although the findings demonstrated that robot-assisted therapy improved upper limb impairment, using this ARAT measurement, the trial was unable to conclude that robot-assisted therapy or enhanced upper limb therapy resulted in improved upper limb functionality after stroke compared with usual care provided to patients with stroke-related upper limb functional limitation. The attrition rate was also drastically reduced in patient population following either robotic therapy or enhanced upper limb therapy versus usual care only, and most of the withdrawals before 3 months in usual care were due to disappointment with treatment allocation, the release explains.

“The combination of evidenced-based medicine and real-world clinical feedback have led to the release of substantially improved versions of the InMotion ARM Robotic Therapy System announced in early 2018, and the InMotion ARM/HAND Robotic Therapy System announced beginning of 2019. These versions of our products include enhanced software applications with patient-centric configurable protocols to assist the therapist in providing specialized treatment of stroke and traumatic brain injury.”

[Source(s): BIONIK Laboratories Corp, Business Wire]

 

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[Abstract] Control and Dynamic Manipulability of a Dual-Arm/Hand Robotic Exoskeleton System (EXO-UL8) for Rehabilitation Training in Virtual Reality

Author & Article Info

Every year there are about 800,000 new stroke patients in the US, and many of them suffer from upper limb neuromuscular disabilities including but not limited to: weakness, spasticity and abnormal synergy. Patients usually have the potential to rehabilitate (to some extent) based on neuroplasticity, and physical therapy intervention helps accelerate the recovery. However, many patients could not afford the expensive physical therapy after the onset of stroke, and miss the opportunity to get recovered. Robot-assisted rehabilitation thus might be the solution, with the following unparalleled advantages:

  1. 24/7 capability of human arm gravity compensation;
  2. multi-joint movement coordination/correction, which could not be easily done by human physical therapists;
  3. dual-arm training, either coupled in joint space or task space;
  4. quantitative platform for giving instructions, providing assistance, exerting resistance, and collecting real-time data in kinematics, dynamics and biomechanics;
  5. potential training protocol personalization; etc.

However, in the rehabilitation robotics field, there are still many open problems. I am especially interested in:

  1. compliant control, in high-dimensional multi-joint coordination condition;
  2. assist-as-needed (AAN) control, in quantitative model-based approach and model-free approach;
  3. dual-arm training, in both symmetric and asymmetric modes;
  4. system integration, e.g., virtual reality (VR) serious games and graphical user interfaces (GUIs) design and development.

Our dual-arm/hand robotic exoskeleton system, EXO-UL8, is in its 4th generation, with seven (7) arm degrees-of-freedom (DOFs) and one (1) DOF hand gripper enabling hand opening and closing on each side. While developing features on this research platform, I contributed to the robotics research field in the following aspects:

(1) I designed and developed a series of eighteen (18) serious VR games and GUIs that could be used for interactive post-stroke rehabilitation training. The VR environment, together with the exoskeleton robot, provides patients and physical therapists a quantitative rehabilitation training platform with capability in real-time human performance data collection and analysis.

(2) To provide better compliant control, my colleagues and I proposed and implemented two new admittance controllers, based on the work done by previous research group alumni. Both the hyper parameter-based and Kalman Filter-based admittance controllers have satisfactory heuristic performance, and the latter is more promising in future adaptation. Unlike many other upper-limb exoskeletons, our current system utilizes force and torque (F/T) sensors and position encoders only, no surface electromyography (sEMG) signals are used. It brings convenience to practical use, as well as technical challenges.

(3) To provide better AAN control, which is still not well understood in the academia, I worked out a redundant version of modified dynamic manipulability ellipsoid (DME) model to propose an Arm Postural Stability Index (APSI) to quantify the difficulty heterogeneity of the 3D Cartesian workspace. The theoretical framework could be used to teach the exoskeleton where and when to provide assistance, and to guide the virtual reality where to add new minimal challenges to stroke patients. To the best of my knowledge, it is also for the first time that human arm redundancy resolution was investigated when arm gravity is considered.

(4) For the first time, my colleagues and I have done a pilot study on asymmetric dual-arm training using the exoskeleton system on one (1) post-stroke patient. The exoskeleton on the healthy side could trigger assistance for that on the affected side, and validates that the current mechanism/control is eligible for asymmetric dual-arm training.

(5) Other works of mine include: activities of daily living (ADLs) data visualization for VR game difficulty design; human arm synergy modeling; dual-arm manipulation taxonomy classification (on-going work).

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[ARTICLE] Robotics for rehabilitation of hand movement in stroke survivors – Full Text

This article aims to give an overall review of research status in hand rehabilitation robotic technology, evaluating a number of devices. The main scope is to explore the current state of art to help and support designers and clinicians make better choices among varied devices and components. The review also focuses on both mechanical design, usability and training paradigms since these parts are interconnected for an effective hand recovery. In order to study the rehabilitation robotic technology status, the devices have been divided in two categories: end-effector robots and exoskeleton devices. The end-effector robots are more flexible than exoskeleton devices in fitting the different size of hands, reducing the setup time and increasing the usability for new patients. They suffer from the control of distal joints and haptic aspects of object manipulation. In this way, exoskeleton devices may represent a new opportunity. Nevertheless their design is complex and a deep investigation of hand biomechanics and physical human–robot interaction is required. The main hand exoskeletons have been developed in the last decade and the results are promising demonstrated by the growth of the commercialized devices. Finally, a discussion on the complexity to define which design is better and more effective than the other one is summarized for future investigations.

Over the past years, rehabilitation engineering has played a crucial role in improving the hand and finger function after stroke. The applications of robotics and mechatronic devices have rapidly expanded from the industrial environment to human assistance in rehabilitation and functional improvements. Rehabilitation engineering has increased the quality lives of individuals with disabilities, offering dedicated training that performs better than conventional methods.

In this way, there are many challenges and opportunities to integrate engineering concepts into hand rehabilitation, and increasing population wellbeing and wealth as well as reducing healthcare costs. This motivates researchers to study, design, and develop novel rehabilitative and assistive technologies and devices to help people to motor functions. Specifically, the current challenge is to transfer the research results and new knowledge to stakeholders creating a general awareness of the importance of rehabilitation engineering.

This review aims to present and discuss the main robotic technologies for hand recovery rehabilitation in stroke survivors, evaluating and comparing previous and current works and researches. This study explores the current state of art to help and support designers and clinicians make better choices among varied devices and components. The review also focuses on both mechanical design (e.g. concept), usability (e.g. setup, lightness, portability) and training paradigms (e.g. hand, hand/wrist or entire arm) since these parts are interconnected for an effective hand recovery. An overview of the main advantages and drawbacks in applying robotics to hand motor impairments is provided in order to give a general view of the relationship between hand rehabilitation devices, rehabilitation theories and results. The challenge is to restore the hand movements such as opening, closing, grasping and releasing movements. Second, a discussion on the application and new challenges of rehabilitation robotic devices is summarized for future investigations. In particular, the main challenges are to develop safe devices with less complex designs, increasing potential for portability and efficacy. In fact, future development for patient treatment should include the device portability to increase the potential applications. The preliminary results have highlighted the robot-assisted therapy currently works hand in hand rather than a replacement of traditional therapy. Therapies and rehabilitation strategies should be not only more effective but also more cost-efficient.

Stroke is one of the leading causes of long-term disability, affecting approximately 14% of world’s population.1,2 33% of survivors reports very limited or no functional use of the upper limb.3 Rehabilitation activities based on repeated exercises have been identified suitable in recovering some degree of motion, in particular, a simple flexion and extension of fingers has demonstrated improvements in hand functionality.4,5 In this way, medical devices and robot-assisted strategies may provide a number of advantages guaranteeing the range of motion (ROM) and avoiding inappropriate movements. Nevertheless, only a limited part of the proposed devices by the literature has been clinically tested, highlighting as the design complexity and development costs may negatively impact the system implementation. The previous and current robots and devices are often too complex to be used by patients limiting any testing on the real users.

Note that the hand functional improvement may be the result of a set of compensatory strategies based on an initial support assisted by the physiotherapist. Usually, these approaches may be suggested during the first months after stroke, when the impairment reduction may be preferred to extensive functional training. In this phase of impairment, the patients show a loss of control and a decreased tactile sensation and proprioception, reducing the physical independence and social integration. The patient’s motivation associated with verbal encouragement may significantly impact the therapy efficacy.

Over the last decades, a set of studies has evaluated the influence of the robot-assisted therapies on arm motor improvement and impairment reduction using randomized clinical controlled trials.612 The obtained results have not shown a complete consensus; nevertheless, the therapy assisted by robotics seems to obtain results beyond what is done by conventional methods.1317 In particular, researchers have been slow to investigate the hand function due to the complexity of this limb.11,12,1820

In any case, a number of studies observed that the rehabilitation training can improve the hand motor in terms of pull, push, and grip strengths, confirming that robotic training is at least as effective as conventional training.13,2124 A significant part of the obtained outcomes have been also proved by Fugl-Meyer Assessment (FMA) and Functional Independence Measure (FIM) tests, performed after the robot treatment.2527

Despite these promising results, the literature review shows also researches that did not observed significant difference between conventional and robotic training groups, highlighting as the conventional therapies are more effective in decreasing levels of impairment and disability.2,8,28,29 Mazzoleni et al.29 and Colombo et al.30 have underlined that there are other significant factors that may impact the efficacy of the training outcome, such as recovery stage, intensity, or duration of the rehabilitation therapy. This point needs to be considered to evaluate and compare different therapy treatments. In the light of these considerations, there are not evident conclusions that sustain the robot-therapy efficacy, suggesting further investigations.31,32

 

Robot-based methods may be used independently by patients in different levels of impairment. Robots permit to obtain a quantifiable measure of subjective performance, repeating treatment protocols without the need of continuous involvement of therapists saving a significant amount of the human labor that may lead to high cost.8,10 In fact, traditional therapist–based methods require several sessions of rehabilitation training, inducing impractical and unaffordable therapies for many patients. Robotic therapy techniques guarantee a safe, intensive, and task-oriented rehabilitation at relatively moderate costs.14,1533 They may apply forces with precision, improving accuracy and reducing variance. These actions are potentially effective to strengthen muscle, ROM, and motor coordination. Advanced robots provide also tactile feedback that may correct the impaired movements. In addition, robot-assisted therapies may be quantified easily and collect a number of parameters useful to track the patient’s status (e.g. spasticity or level of voluntary control).34

A further advantage of robotic rehabilitation consists of the possibility to be combined with other technologies (e.g. virtual reality (VR), brain computer interface (BCI) technology or haptic stimuli).3537 This combination allows to motivate the patients to perform the rehabilitation tasks without the constant supervision, guaranteeing repetitive movements and informative feedback. On the other hand, robot-assisted therapy permits the therapist to conduct rehabilitation tasks for two or more patients at the same time, improving the service efficiency.

Finally, it has been noted that robotics may improve the accessibility to rehabilitation. In fact, a patient prefers to use the unaffected limb in daily activities, damaging the recovery of the impaired limb.38 The possibility to perform rehabilitation in remote locations (e.g. home) using robotics devices may involve better the patient in the recovery process.

Despite these noted advantages, a number of limits and constraints of rehabilitation robot-based cannot be ignored. First, there is a significant gap between the outcomes of rehabilitation robots and people’s expectations. This element may negatively impact patient’s motivations during the therapy. In particular, the personalization is still difficult due to the design complexity of devices. Another further issue is the determination of the most efficient dosage of rehabilitation training.

Although the literature has demonstrated the main advantages and benefits of robot applications, more studies involving a large participant size are required to confirm whether robotic-assisted therapy performs better than conventional methods, evaluating and comparing the treatment dosage. In particular, a lack of robust methods to evaluate the efficacy of the robot-assisted therapy making difficult to define which design is better and more effective than the other one. A deep investigation is needed to explore whether the obtained results on the patient can be maintained in the long term and how the potential improvements can be transformed into the motor skills in performing the activities of daily living (ADL). The user’s safety needs to be guaranteed during the training, avoiding the nonlinear movement of the patient. Further limits are noted on the current robotic devices regarding their design, often complex and unconvinced for the user, or the high costs for the treatment access.3941 The ratio between the price and performance is rather dissatisfactory due to the high cost of development combined with a relatively benefit for patients and clinics.4244 These drawbacks need to be considered in the overall evaluation of robotic application. They represent an open challenge to improve the integration of engineering concepts into hand rehabilitation, increasing population wealth, as well as reducing healthcare costs. These issues justify the low penetration of robotics in the market and the requirements of new investigations. Only a limited number of stroke patients (5%–15%) who requires assistive devices and technologies may access to this service. On the other hand, the studies and researches on rehabilitation robots are becoming strategic for the society due to the fact that the costs of excluding people with disabilities are high and borne by community.45

A primary categorization of rehabilitation robotic technologies is based on the design concepts of the device: end-effector or exoskeleton.

An end-effector device (also called endpoint control) recreates dynamic environments corresponding to ADL, determining the movements at the joint level. Usually, the patient’s joint rotation is distally executed using a support (e.g. a table or a tripod) to facilitate the training and avoiding muscle fatigue. It means that the more proximal joints are not directly controlled by the robot. End-effector devices may be dedicated to hand rehabilitation or to be integrated in more complex structures for the arm recovery.

The second main logic to design a rehabilitation robotic device is the exoskeleton. An exoskeleton, from Greek “exo” = outer and “skeletos” = skeleton, is a wearable robot attached to the user’s limbs, in order to enhance their movements. It focuses on the anatomy of the subject’s hand following the limb segments, each degree of freedom is aligned with the corresponding human joint. Figure 1 illustrates a number of examples. An exoskeleton should be compliant with the user’s movements and delivers at least part of the power required by the movements. In order to guarantee the natural motor of the hand joints, their design is more complex than end-effector devices. For example, a set of components (e.g. rings, hinges, external linkages, or structures) is embedded to accomplish the alignment between the forearm axial rotation of the forearm located along an axis between the ulna and the radius50,51 to support in forearm pronation and supination.

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Figure 1. Examples of rehabilitation robotic devices: (a) Gloreha,46 (b) CyberGrasp,47 (c) Hand of Hope,48 and (d) Reha-Digit.49

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Continue —> Robotics for rehabilitation of hand movement in stroke survivors – Francesco Aggogeri, Tadeusz Mikolajczyk, James O’Kane, 2019

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