Posts Tagged hand rehabilitation

[ARTICLE] Peak Activation Shifts in the Sensorimotor Cortex of Chronic Stroke Patients Following Robot-assisted Rehabilitation Therapy – Full Text



Ischemic stroke is the most common cause of complex chronic disability and the third leading cause of death worldwide. In recovering stroke patients, peak activation within the ipsilesional primary motor cortex (M1) during the performance of a simple motor task has been shown to exhibit an anterior shift in many studies and a posterior shift in other studies.


We investigated this discrepancy in chronic stroke patients who completed a robot-assisted rehabilitation therapy program.


Eight chronic stroke patients with an intact M1 and 13 Healthy Control (HC) volunteers underwent 300 functional magnetic resonance imaging (fMRI) scans while performing a grip task at different force levels with a robotic device. The patients were trained with the same robotic device over a 10-week intervention period and their progress was evaluated serially with the Fugl-Meyer and Modified Ashworth scales. Repeated measure analyses were used to assess group differences in locations of peak activity in the sensorimotor cortex (SM) and the relationship of such changes with scores on the Fugl-Meyer Upper Extremity (FM UE) scale.


Patients moving their stroke-affected hand had proportionally more peak activations in the primary motor area and fewer peak activations in the somatosensory cortex than the healthy controls (P=0.009). They also showed an anterior shift of peak activity on average of 5.3-mm (P<0.001). The shift correlated negatively with FM UE scores (P=0.002).


A stroke rehabilitation grip task with a robotic device was confirmed to be feasible during fMRI scanning and thus amenable to be used to assess plastic changes in neurological motor activity. Location of peak activity in the SM is a promising clinical neuroimaging index for the evaluation and monitoring of chronic stroke patients.



Fig. (2). Spatial distributions of peak brain activation during a grip task with both hands. Dots (red, left hemisphere stroke patients; green, healthy control subjects) are overlaid on an International Consortium for Brain Mapping brain surface template (ICBM-152).

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[ARTICLE] Direct Drive Hand Exoskeleton for Robot-assisted Post Stroke Rehabilitation – Full Text PDF


This article introduces novel rehabilitation hand module development for the
physiotherapy of the hand of patients suffering from spastic hemiplegia. Spasm is basically a muscle cramp, it practically involves the sudden, unintended and painful contraction of a muscle or muscle group, which is caused by nerve damage resulting from a stroke. Stroke is the main reason for permanent disability in adulthood, and so the social- and medical care systems require a huge amount of healthcare resources due to the inactivity of the patients concerned. The robotically facilitated rehabilitation assists the physicians in providing repeated therapies of great intensity, and so the patients may enjoy the benefits of rehabilitation, while the therapists may reduce their own workload at the same time. Furthermore, the robotic devices offer an objective and reliable opportunity for tracing and accurately assessing the improvement of the patients’ motor skills. This article introduces the electrical- and mechanical design of a therapeutic device and the inverse kinematic and dynamic modules which control this device. The rehabilitation device is capable of moving the thumb, the index-, the middle- and the ring fingers, and allows the rehabilitation of the left- and right hands as well. The device is a completely new design with direct
drive approach and several benefits. It has two components: a planar module with serial kinematics of rotational joints with three degrees of freedom (3DoF RRR), and another module with two degrees of freedom (2DoF). The modules integrated load cells, which are built in between each joint to measure the reaction forces. The 3DoF finger moves the index, the middle and the ring fingers, using a load distributor placed above the fingers. The finger orthoses are connected to the load distributor via magnets. The 2DoF finger moves the thumb performing the opening/closing along the plane tilted in two angles.[…]

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[Abstract] A Portable Device for Hand Rehabilitation with Force Cognition: Design, Interaction and Experiment


Introducing interactive system into portable robots for hand rehabilitation has always been a crucial topic. Moreover, hand rehabilitation with force cognition can make patients participate actively and improve rehabilitation effect. In this paper, we design a portable robotic device with interactive system for patients to rehabilitate with force cognition. Firstly, an exoskeleton glove is designed with a compact mechanical structure which is controlled by a real-time feedback system. The portable device allows patients to rehabilitate not only in hospital. Next, an interactive system including virtual environment and force cognition is introduced to detect the hand motion and collision. At last, clinical tests of our portable device is carried out with 9 subjects after tendon injury to show the effective assistance with our device.


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[Abstract] Development of a Home-based Hand Rehabilitation Training and Compensation Feedback System


Stroke survivors often show a limited recovery in the hand function even after the recovery period (3-6 months after stroke) and at-home hand rehabilitation is common due to the long-term nature of hand rehabilitation and the limited medical resources. We designed a home-based hand rehabilitation training and compensation feedback system. A low-cost simple orthosis glove, a set of hand rehabilitation training games and a compensation detection and feedback module were designed and developed in this system. A preliminary test was carried out on the system and the results showed that the training section (the orthosis glove and the hand rehabilitation training games) of the system was friendly to the subjects and the subjects were more receptive to the system and the compensation detection and feedback module had a promising performance. This system can not only provide high intensity and incentive hand rehabilitation training, but also guide the stroke patients to correct wrong upper body postures during the training process, which can achieve better rehabilitation results. The system has the potential to become an effective home-based hand rehabilitation training and compensation feedback system.


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[Abstract] Preliminary Results of Hand Rehabilitation for Post Stroke Patient using Leap Motion-based Virtual Reality


This paper introduced a rehabilitation system for the upper limb function of the post stroke patients who involved virtual reality games. Post- stroke patient is needed to perform rehabilitation to improve their hand and finger motion, which were affected from the stroke. Thus a virtual reality hand rehabilitation using Leap Motion sensor integrated with Unity software was developed, which focuses on the hand and finger movement of the patient. There are three games created namely Space game, Cannon game and Piano games in order to evaluate the performance of the users. Data from 10 normal subjects playing each virtual game in one minute has been collected and analysed. The results show that average values of objects can be destroyed by the normal people in Space game, Cannon game and Piano game is 9,23 and 20 respectively. Feedback has been received and these virtual reality games hopefully could facilitate the recovery of motor functions in stroke patients.


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[ARTICLE] Design, analysis and experiment of finger soft actuator with nested structure for rehabilitation training – Full Text PDF


Compared with the rigid hand rehabilitation robot, the soft hand rehabilitation robot has the advantages of good flexibility, which is of great significance to its research. In order to make the soft hand rehabilitation robot have the advantagesof high stiffness and simple manufacturing process, a nested structure is proposed for finger soft actuator in this paper.
The nested structure consists of outer restraint structure and inner core structure. The inner core structure can realize deformation under the action of air pressure. The outer restraint structure can improve bending efficiency by restraining deformation in non-functional direction of inner core structure. On this basis, the processing technology of nested structure is designed, and the effect of structural parameters on performance is analyzed. In order to illustrate the advantages of nested structure, the performance of nested structure and fiber-constrained structure is compared by simulation, which includes bending angle, gripping force and expansion amount (by measuring the deformation of the cross section).
The simulation results show the advantages of the nested structure. A prototype of the soft hand rehabilitation robot is developed with nested structure as finger soft actuator, and the experimental results prove the feasibility of design. The results of this study provide a reference for the structure design of soft hand rehabilitation robot.[…]

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[Abstract] Design and Implementation of An Interactive Hand Rehabilitation Training System Based on LabVIEW


With the development of science and technology in multidisciplinary fields of automation control, rehabilitation medicine and robotics and the improvement of people’s living standards, medical rehabilitation robots are playing an increasingly important role in life. The traditional hand rehabilitation robots are exoskeleton rigid robots with complex structure and small fault tolerance. It is dangerous for the rehabilitation of human finger joints, while soft wearable hand rehabilitation robots have better safety and flexibility. For the rehabilitation needs of stroke fingers, a virtual online game of human-computer interaction is developed using LabVIEW and a soft wearable hand rehabilitation robot, in order to improve the initiative of patients in the process of active rehabilitation training and to increase the interest of patients in active rehabilitation training, which also improves the initiative of patients to participate in active rehabilitation training.


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[Abstract + References] A Virtual Reality Serious Game for Hand Rehabilitation Therapy – IEEE Conference Publication


The human hand is the body part most frequently injured in occupational accidents, accounting for one out of five emergency cases and often requiring surgery with subsequently long periods of rehabilitation. This paper proposes a Virtual Reality game to improve conventional physiotherapy in hand rehabilitation, focusing on resolving recurring limitations reported in most technological solutions to the problem, namely the limited diversity support of movements and exercises, complicated calibrations and exclusion of patients with open wounds or other disfigurements of the hand. The system was assessed by seven able-bodied participants using a semistructured interview targeting three evaluation categories: hardware usability, software usability and suggestions for improvement. A System Usability Score (SUS) of 84.3 and participants’ disposition to play the game confirm the potential of both the conceptual and technological approaches taken for the improvement of hand rehabilitation therapy.


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[Abstract + References] A New Rehabilitation Device for Finger Extension Movement – Conference paper


This paper focuses on the development of a device for hand rehabilitation that can perform the finger extension movement. Developing new rehabilitation systems and devices is necessary since the world population is ageing and spastic hand patients are increasing.

This paper presents a new rehabilitation device that will overcome the limits of most existing rehabilitation mechanisms. Simulations of a conceived system conducted by a CAD code (PTC Creo) showed that the new adopted concepts can be applicable for the finger extension movement.

The results are promising and the potential of the mechanism is believed to be significant. Nevertheless, experimentation on a real prototype will be necessary to fully validate the simulation promising results.


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[Abstract + Referrences] Interactive and Assistive Gloves for Post-stroke Hand Rehabilitation – Conference paper


The inability to fold fingers and move the wrist due to stroke, cardiovascular injuries or emotional shock is one of the most common illnesses wherein conventional rehabilitation therapies are propitious in functional recovery. However, implementation of these methods is laborious, costly and resource-intensive. The structure of the prevailing healthcare system challenges us to design innovative rehabilitation techniques. A desktop-based interactive hand rehabilitation system is, therefore, developed to ensure a more feasible and cost- effective approach. It will encourage a higher number of participation as it is designed to be interesting and interactive than the traditional physiotherapy sessions. The system uses sensor data from Arduino microcontroller and is programmed in Processing IDE allowing user interaction with a virtual environment. The data is further received in an Android application from where it is stored using ThingSpeak Cloud.


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Source: Interactive and Assistive Gloves for Post-stroke Hand Rehabilitation | SpringerLink

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