Posts Tagged finger

[Abstract] A Randomized Controlled Study: Effectiveness of Functional Electrical Stimulation on Wrist and Finger Flexor Spasticity in Hemiplegia


The objective of this study was to investigate the effectiveness of functional electrical stimulation (FES) applied to the wrist and finger extensors for wrist flexor spasticity in hemiplegic patients.


Thirty stroke patients treated as inpatients were included in the study. Patients were randomly divided into study and control groups. FES was applied to the study group. Wrist range of movement, the Modified Ashworth Scale (MAS), Rivermead Motor Assessment (RMA), Brunnstrom (BS) hand neurophysiological staging, Barthel Index (BI), and Upper Extremity Function Test (UEFT) are outcome measures.


There was no significant difference regarding range of motion (ROM) and BI values on admission between the groups. A significant difference was found in favor of the study group for these values at discharge. In the assessment within groups, there was no significant difference between admission and discharge RMA, BS hand, and UEFT scores in the control group, but there was a significant difference between the admission and discharge values for these parameters in the study group. Both groups showed improvement in MAS values on internal assessment.


It was determined that FES application is an effective method to reduce spasticity and to improve ROM, motor, and functional outcomes in hemiplegic wrist flexor spasticity.


Source: A Randomized Controlled Study: Effectiveness of Functional Electrical Stimulation on Wrist and Finger Flexor Spasticity in Hemiplegia – Journal of Stroke and Cerebrovascular Diseases

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[WEB SITE] MusicGlove for Stroke Therapy – Flint Rehab

MusicGlove: Hand Therapy with a Beat

What Is MusicGlove?

MusicGloveMusicGlove is a hand therapy device that is clinically proven to improve hand function in 2 weeks.

The device is a sensorized “glove” that allows users to perform hundreds of hand and finger exercises while playing a therapy-based musical game.

How does it work?

To use the device, you simply put the MusicGlove on your hand, plug it into your personal laptop or Flint tablet, and press play.

Then, follow along and make the appropriate pinching movements when each musical note floats down the screen.

What’s the Research Behind It?

ForTherapistsImage_croppedExercise with MusicGlove has been clinically proven to:

  • Improve hand function in 2 weeks
  • Lead to functional gains such as opening a door, washing dishes, typing, and using the restroom independently
  • Motivate safe, high-intensity movements that initiate neuroplasticity in the brain

How is it different?

Most assistive hand devices help open your hand but fail to retrain your brain how to use your hand again.

MusicGlove is unique because it’s designed to initiate neuroplasticity, the process that your brain uses to rewire itself after injury. The more you play the game, the better your brain becomes at controlling your hand!

Who Is MusicGlove For?

To use MusicGlove hand therapy actively without assistance, you need the ability to touch your thumb to at least one of your fingertips or side of your index finger.


If you cannot make this movement, then you can try using the device passively. Read this article to learn more.

MusicGlove is intended to treat:

  • Stroke
  • Spinal Cord Injury
  • Cerebral Palsy
  • Traumatic Brain Injury
  • Neurologic and muscular injury
  • Developmental disability

If you have received hand therapy in clinic and want to continue at home, MusicGlove is for you!

Are You a Clinician?

If so, please visit our MusicGlove for Clinic Use page!


Visit Site —> MusicGlove for Stroke Therapy – Flint Rehab

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[ARTICLE] Development of Device and Serious Game Contents for the Multi-finger Rehabilitation – Full Text

In modern society, with the increasing use of such compact devices as smart phones and computers, finger and hand mobility is very important for daily living. Generally, in the case where there is impaired motor function of the hands or fingers, rehabilitation involves boring repetitive exercises. In this study, serious games were implemented using a dynamometer which made it possible to measure grip width and finger grip strength according to the size of the hand. The game was developed based on rhythm games, and, by selectively training the fingers that need rehabilitation, it is possible to improve a variety of functions such as finger agility, power and endurance. In addition, by analyzing data changes during the training process, the intensity of the rehabilitation can be quantitatively assessed. Furthermore, it provided users with an active and fun rehabilitation environment because they could choose and use their own desired music files during their rehabilitation.

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[Abstract] Technical validation of an integrated robotic hand rehabilitation device: Finger independent movement, EMG control, and EEG-based biofeedback


The objective of this work was to design and experiment a robotic hand rehabilitation device integrated with a wireless EEG system, going towards patient active participation maximization during the exercise. This has been done through i) hand movement actively triggered by patients muscular activity as revealed by electromyographic signals (i.e., a target hand movement for the rehabilitation session is defined, the patient is required to start the movement and only when the muscular activity overcomes a predefined threshold, the patient-initiated movement is supported); ii) an EEG-based biofeedback implemented to make the user aware of his/her level of engagement (i.e., brain rhythms power ratio Beta/Alpha). The designed system is composed by the Gloreha hand rehabilitation glove, a device for electromyographic signals recording, and a wireless EEG headset. A strong multidisciplinary approach was the base to reach this goal, which is the fruitful background of the Think and Go project. Within this project, research institutes (Politecnico di Milano), clinical centers (INRCA-IRCCS), and companies (ab medica s.p.a., Idrogent, SXT) have worked together throughout the development of the integrated robotic hand rehabilitation device. The integrated device has been tested on a small pilot group of healthy volunteers. All the users were able to calibrate and correctly use the system, and they reported that the system was more challenging to be used with respect to the standard passive hand mobilization session, and required more attention and involvement. The results obtained during the preliminary tests are encouraging, and demonstrate the feasibility of the proposed approach.

Source: Technical validation of an integrated robotic hand rehabilitation device: Finger independent movement, EMG control, and EEG-based biofeedback – IEEE Xplore Document

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[Abstract] Design of a thumb module for the FINGER rehabilitation robot


This paper describes the design and initial prototype of a thumb curling exoskeleton for movement therapy. This add-on device for the Finger INdividuating Grasp Exercise Robot (FINGER) guides the thumb through a single-degree-of-freedom naturalistic grasping motion. This motion complements the grasping motions of the index and middle fingers provided by FINGER. The kinematic design and mechanism synthesis described herein utilized 3D motion capture and included the determination of the principle plane of the thumb motion for the simple grasping movement. The results of the design process and the creation of a first prototype indicate that this thumb module for finger allows naturalistic thumb motion that expands the capabilities of the FINGER device.

Source: IEEE Xplore Document – Design of a thumb module for the FINGER rehabilitation robot

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[ARTICLE] The Robotic Sixth Finger: a Wearable Compensatory Tool to Regain Grasping Capabilities in Paretic Hands – Full Text PDF


Among the most promising field of applications of wearable robotics there are the rehabilitation and the support in activities of daily living (ADL) of impaired people. In this paper, we propose two possible designs of a robotic extra-finger, the Robotic Sixth Finger, for grasping compensation in patients with reduced hand mobility, such as post-stroke patients. The idea is to let the patients be able to grasp an object by taking advantage of the wearable device worn on the paretic limb by means of an elastic band. The Robotic Sixth Finger and the paretic hand work jointly to hold an object. Adding a robotic opposing finger is a promising approach that can significantly improve the grasping functional compensation in different typologies of patients during everyday life activities.

1 Introduction

Wearable robots are expected to work very closely, to interact and collaborate with people in an intelligent environment [1]. Traditionally, wearable robotic structures have been mainly used in substitution of lost limbs (e.g., prosthetic limbs) or for human limb rehabilitation (e.g., exoskeletons). However, the progress in miniaturization and efficiency of the technological components is allowing more light and compact solutions, enhancing user’s safety and comfort, while opening new opportunities for wearable robot use [2]. Together with exoskeleton and prosthesis, a very promising research direction seems to be that of adding robotic limbs to human, rather than substituting or enhancing them [3]. This addition could let the humans augment their abilities and could give support in everyday tasks to impaired people. This paper investigates how to compensate the capabilities of the human hand, instead of developing additional robotic extra-arms, as discussed for instance in [4]. The idea of using an extra-finger to support the human hand in grasping functions was initially proposed in [5]. Then, independently both in [6] and [7, 8], the authors proposed the use of extra fingers to support the human hand to grasp objects whose size does not fit a hand or in executing bimanual tasks with one hand. The main difference is that in [7, 8], the goal was to minimize the size and the weight of the unique extra limb, while in [6], two extra fingers were used so to hold objects. While in [9] the authors developed a control strategy to grasp and manipulate objects, in [10] the authors mainly focused on the use of extra fingers for post-stroke patients.

Focusing on the hand, many wearable devices have been proposed in the last decade, especially for hand rehabilitation and function recovery. A review on robotassisted approaches to motor neurorehabilitation can be found in [11]. In [12] the authors presented a comprehensive review of hand exoskeleton technologies for rehabilitation and assistive engineering, from basic hand biomechanics to actuator technologies.

However, most of the devices proposed in literature are designed either to increase the functional recovery in the first months of the rehabilitation therapy, when biological restoring and reorganization of the central nervous system take place, or are designed to augment human hand capabilities of healthy subjects by coordinating the device motion to that of the hand.

To the best of our knowledge, only few works target on the robotic compensation of hand function in the latter phase of rehabilitation. This means that patients usually after 6–9 months of rehabilitation must rely only on compensatory strategies by improving adaptations that increase the functional disparity between the impaired and the unaffected upper limb [13].

This work focuses on the compensation of hand function in patients with paretic limbs, e.g. chronic stroke patients. The final aim is to provide the patient with an additional robotic finger worn on the wrist. The Robotic Sixth Finger is used together with the paretic hand to seize an object, as shown in Fig. 1. The systems acts like a two-finger gripper, where one finger is represented by the Robotic Sixth Finger, while the other by the patient paretic limb. The proposed device goes beyond exoskeletons: it adds only what is needed to grasp, i.e. an extra thumb. We presented in [7] a preliminary version of a robotic extra-finger showing how this wearable device is able to enhance grasping capabilities and hand dexterity in healthy subjects. In [8], we also presented an object-based mapping algorithm to control robotic extra-limbs without requiring explicit commands by the user. The main idea of the mapping was to track human hand by means of dataglove and reproduce the main motions on the extra-finger. This kind of approach is not suitable for patients with a paretic limb due to the reduced mobility of the hand. Therefore, we developed a wearable interface embedded in a ring to activate and use the finger [14].

In this work, we propose two possible designs of devices. The first model is a modular fully actuated finger. The other design consists of an underactuated finger which is compliant and consequently able to adapt to the different shapes of the objects.

For validation purposes, pilot experiments with two chronic stroke patients were performed. The experiments consisted in wearing the Robotic Sixth Finger and performing a rehabilitation test referred to as Frenchay Arm Test [15, 10]. Finally, we present preliminary results on the use of the extra-fingers for grasping objects for Activities of Daily Living (ADL).

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 [WEB SITE] HB Hands: Upper Extremity Home Exercise Program

HB Hands

Source: HB Hands

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[ARTICLE] Usability evaluation of low-cost virtual reality hand and arm rehabilitation games – Full Text PDF


The emergence of lower-cost motion tracking devices enables home-based virtual reality rehabilitation activities and increased accessibility to patients. Currently, little documentation on patients’ expectations for virtual reality rehabilitation is available.

This study surveyed 10 people with stroke for their expectations of virtual reality rehabilitation games. This study also evaluated the usability of three lowercost virtual reality rehabilitation games using a survey and House of Quality analysis. The games (kitchen, archery, and puzzle) were developed in the laboratory to encourage coordinated finger and arm movements.

Lower-cost motion tracking devices, the P5 Glove and Microsoft Kinect, were used to record the movements. People with stroke were found to desire motivating and easy-to-use games with clinical insights and encouragement from therapists. The House of Quality analysis revealed that the games should be improved by obtaining evidence for clinical effectiveness, including clinical feedback regarding improving functional abilities, adapting the games to the user’s changing functional ability, and improving usability of the motion-tracking devices.

This study reports the expectations of people with stroke for rehabilitation games and usability analysis that can help guide development of future games.

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[ARTICLE] SCRIPT passive orthosis: design of interactive hand and wrist exoskeleton for rehabilitation at home after stroke – Full Text PDF


Recovery of functional hand movements after stroke is directly linked to rehabilitation duration and intensity. Continued therapy at home has the potential to increase both. For many patients this requires a device that helps them overcome the hyperflexion of wrist and fingers that is limiting their ability to open and use their hand. We developed an interactive hand and wrist orthosis for post-stroke rehabilitation that provides compliant and adaptable extension assistance at the wrist and fingers, interfaces with motivational games based on activities of daily living, is integrated with an off-the-shelf mobile arm support and includes novel wrist and finger actuation mechanisms. During the iterative development, multiple prototypes have been evaluated by therapists in clinical settings and used intensively and independently by 33 patients at home. This paper details the final design of the SCRIPT passive orthosis resulting from these efforts.

Source: SCRIPT passive orthosis: design of interactive hand and wrist exoskeleton for rehabilitation at home after stroke | SpringerLink

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[Abstract] The effect of a finger training application using a tablet PC in chronic hemiparetic stroke patients.


Twenty-one consecutive patients were randomly assigned to either the intervention group (10 patients) or the control group (11 patients). The application consisted of three sections (registration, evaluation, and training) and the training section consisted of five programs (stretching, flexion, extension, opposition, and thumb abduction). Application training consisted of 1 session (31 min)/day, 6 days/week for 4 weeks. We found that our application training was effective in terms of the motor function of the affected hand: Manual Muscle Test of the wrist and finger extensors, the Manual Function Test (subtest of manipulative activity), and the Purdue Pegboard Test.


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Source: The effect of a finger training application using a tablet PC in chronic hemiparetic stroke patients – Somatosensory & Motor Research –

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