Posts Tagged Hand impairments

[REVIEW] A structured overview of trends and technologies used in dynamic hand orthoses – Full Text

Abstract

The development of dynamic hand orthoses is a fast-growing field of research and has resulted in many different devices. A large and diverse solution space is formed by the various mechatronic components which are used in these devices. They are the result of making complex design choices within the constraints imposed by the application, the environment and the patient’s individual needs. Several review studies exist that cover the details of specific disciplines which play a part in the developmental cycle. However, a general collection of all endeavors around the world and a structured overview of the solution space which integrates these disciplines is missing. In this study, a total of 165 individual dynamic hand orthoses were collected and their mechatronic components were categorized into a framework with a signal, energy and mechanical domain. Its hierarchical structure allows it to reach out towards the different disciplines while connecting them with common properties. Additionally, available arguments behind design choices were collected and related to the trends in the solution space. As a result, a comprehensive overview of the used mechatronic components in dynamic hand orthoses is presented.

Background

Human hands are complex and versatile instruments. They play an essential role in the interaction between a person and the environment. Many people suffer from hand impairments like spasticity, lack of control or muscle weakness, which may be due to the consequences of stroke, paralysis, injuries or muscular diseases. Such impairments may limit an individual’s independence in performing activities of daily living (ADL) and the ability to socially interact (e.g. non-verbal communication). Devices like hand exoskeletons, rehabilitation robots and assistive devices, here collectively termed as dynamic hand orthoses, aim to overcome these limitations. Their development is a fast-growing field of research and has already resulted in a large variety of devices [1, 2, 3, 4].

Each individual has different demands for a dynamic hand orthoses. Some patients benefit from rehabilitation therapy (e.g. stroke patients [5]) while others would more likely benefit from daily assistance (e.g. Duchenne Muscular Dystrophy [6]). The resulting diversity between the different devices can be illustrated by the elaborate overviews on robotic devices [4], training modalities [3] and intention detection systems [7] they use. Clearly, there are many mechatronic components to choose from and are often the result of making particular design choices within the imposed design constraints. However, not everybody has the resources (i.e. time, accessibility) to investigate all possible design choices within these constraints. Moreover, not always are design choices reported in literature and are therefore hard to retrieve. The full potential of learning from each other’s endeavors is therefore not yet fully exploited, leaving several questions in this field of research unanswered. For example, there is the discussion whether pneumatic or electric actuation is better for some applications.

The goal of this study is to collect a high quantity of dynamic hand orthoses and extract the mechatronic components which are used. Their collective properties are analyzed by using a framework which uses a generic categorization applicable for any mechatronic system: a signal domain (e.g. controllers, sensors), energy domain (e.g. energy sources, actuators) and mechanical domain (e.g. cables, linkages). Additionally, feasible technologies from other, but similar, disciplines are included (e.g. prosthetics, haptics). Trends are then visualized using bar charts and compared to available arguments behind design choices. This not only includes arguments from often-cited success-stories, but also from small-scale projects. Referring to the case of using pneumatic or electric actuation, this approach can answer how often each method is used and what arguments are reported, which may help in scoping further research and making a well-considered choice.

This paper is structured in different sections. The “Scope” section describes the boundaries and limitations of this study and Framework introduces the basis of the framework structure that is proposed. The “Results” section describes the quantitative results which illustrate the trends. How this relates to the functionality of the components, is discussed and summarized in the “Discussion” and “Conclusion” section, respectively.

Continue —> A structured overview of trends and technologies used in dynamic hand orthoses | Journal of NeuroEngineering and Rehabilitation | Full Text

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