Posts Tagged hand rehabilitation

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

Highlights

  • Robotic hand training can be helpful in improving hand motor recovery.
  • Amadeo™ induces large modulations of sensorimotor rhythms and connectivity.
  • Robotic training yields improvement of hand motor performance by restoring hand motor control.

 

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.

 

via Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial – ScienceDirect

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[Abstract + References] Design of wearable hand rehabilitation glove with soft hoop-reinforced pneumatic actuator

Abstract

Traditional hand rehabilitation gloves usually use electrical motor as actuator with disadvantages of heaviness, bulkiness and less compliance. Recently, the soft pneumatic actuator is demonstrated to be more suitable for hand rehabilitation compared to motor because of its inherent compliance, flexibility and safety. In order to design a wearable glove in request of hand rehabilitation, a soft hoop-reinforced pneumatic actuator is presented. By analyzing the influence of its section shape and geometrical parameters on bending performance, the preferred structure of actuator is achieved based on finite element method. An improved hoop-reinforced actuator is designed after the fabrication and initial measurement, and its mathematical model is built in order to quickly obtain the bending angle response when pressurized. A series of experiment about bending performance are implemented to validate the agreement between the finite element, mathematical and experimental results, and the performance improvement of hoop-reinforced actuator. In addition, the designed hand rehabilitation glove is tested by measuring its output force and actual wearing experience. The output force can reach 2.5 to 3 N when the pressure is 200 kPa. The research results indicate that the designed glove with hoop-reinforced actuator can meet the requirements of hand rehabilitation and has prospective application in hand rehabilitation.

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[Abstract] Design and development of a portable exoskeleton for hand rehabilitation

Abstract:

Improvement in hand function to promote functional recovery is one of the major goals of stroke rehabilitation. This paper introduces a newly developed exoskeleton for hand rehabilitation with a user-centered design concept, which integrates the requirements of practical use, mechanical structure and control system. The paper also evaluated the function with two prototypes in a local hospital. Results of functional evaluation showed that significant improvements were found in ARAT (P=0.014), WMFT (P=0.020) and FMA_WH (P=0.021). Increase in the mean values of FMA_SE was observed but without significant difference (P=0.071). The improvement in ARAT score reflects the motor recovery in hand and finger functions. The increased FMA scores suggest there is motor improvement in the whole upper limb, and especially in the hand after the training. The product met patients’ requirements and has practical significance. It is portable, cost effective, easy to use and supports multiple control modes to adapt to different rehabilitation phases.

 

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[Abstract + References] A Novel Method for Designing and Implementing a Training Device for Hand Rehabilitation – Conference paper

 

Abstract

Improvement in hand function to promote functional recovery is an important goal of stroke rehabilitation. However, not all of the rehabilitation products are sufficiently well developed for use in daily life. This paper introduces a newly developed hand training device with a user-centred design concept, which integrates fuzzy-based quality function deployment and morphological analysis method. As a key to rehabilitation product design, the study focuses on how and to what extent certain technical attributes of products are to be met to obtain a higher level of user satisfaction. The paper also tested the function in a local hospital. Test results showed that the hand affected due to a stroke could complete the training task successfully. It also showed that the product met patients’ requirements and has practical significance. The proposed method also can be applied to the development of similar products.

References

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    Idrogenet GLOREHA supports upper limb rehabilitation. Available at http://www.gloreha.com/index.php/en/. Cited 24.06.2015
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    Festo AG, Co KG (2015) New scope for interaction between humans and machines. Available at http://www.festo.com/net/SupportPortal/Files/156734/Brosch_FC_ExoHand_EN_lo_L.pdf. Cited 24.06.2015
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[Abstract] Hand Rehabilitation via Gesture Recognition Using Leap Motion Controller – Conference Paper

I. Introduction

Nowadays, a stroke is the fourth leading cause of death in the United States. In fact, every 40 seconds, someone in the US is having a stroke. Moreover, around 50% of stroke survivors suffer damage to the upper extremity [1]–[3]. Many actions of treating and recovering from a stroke have been developed over the years, but recent studies show that combining the recovery process with the existing rehabilitation plan provides better results and a raise in the patients quality of life [4]–[6]. Part of the stroke recovery process is a rehabilitation plan [7]. The process can be difficult, intensive and long depending on how adverse the stroke and which parts of the brain were damaged. These processes usually involve working with a team of health care providers in a full extensive rehabilitation plan, which includes hospital care and home exercises.

References

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13. K. R. Anderson, M. L. Woodbury, K. Phillips, L. V. Gauthier, “Virtual reality video games to promote movement recovery in stroke rehabilitation: a guide for clinicians”, Archives of physical medicine and rehabilitation, vol. 96, no. 5, pp. 973-976, 2015.

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[Abstract] Design and Evaluation of a Soft and Wearable Robotic Glove for Hand Rehabilitation

Abstract

In the modern world, due to an increased aging population, hand disability is becoming increasingly common. The prevalence of conditions such as stroke is placing an ever-growing burden on the limited fiscal resources of health care providers and the capacity of their physical therapy staff. As a solution, this paper presents a novel design for a wearable and adaptive glove for patients so that they can practice rehabilitative activities at home, reducing the workload for therapists and increasing the patient’s independence. As an initial evaluation of the design’s feasibility the prototype was subjected to motion analysis to compare its performance with the hand in an assessment of grasping patterns of a selection of blocks and spheres. The outcomes of this paper suggest that the theory of design has validity and may lead to a system that could be successful in the treatment of stroke patients to guide them through finger flexion and extension, which could enable them to gain more control and confidence in interacting with the world around them.

I. Introduction

In the modern world an extended life expectancy coupled with a sedentary lifestyle raises concerns over long term health in the population. This is highlighted by the increasing incidence of disability stemming from multiple sources, for example medical conditions such as cancer or stroke [1]. While avoiding the lifestyle factors that have a high association with these diseases would be the preferred solutions of health services the world over, as populations get progressively older and more sedentary, this becomes increasingly more difficult [1], [2]. The treatment of these conditions is often complex; in stroke for example, the initial incident is a constriction of blood flow in the brain which in turn damages the nervous system’s ability to communicate with the rest of the body. This damage will occur in one hemisphere of the body but can impact both the upper and lower limbs, as well as impairing functional processes such as speech and cognitive thinking.

 

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[Abstract + References] Development of a hand exoskeleton system for index finger rehabilitation

Abstract

In order to overcome the drawbacks of traditional rehabilitation method, the robot-aided rehabilitation has been widely investigated for the recent years. And the hand rehabilitation robot, as one of the hot research fields, remains many challenging issues to be investigated. This paper presents a new hand exoskeleton system with some novel characteristics. Firstly, both active and passive rehabilitative motions are realized. Secondly, the device is elaborately designed and brings advantages in many aspects. For example, joint motion is accomplished by a parallelogram mechanism and high level motion control is therefore made very simple without the need of complicated kinematics. The adjustable joint limit design ensures that the actual joint angles don’t exceed the joint range of motion (ROM) and thus the patient safety is guaranteed. This design can fit to the different patients with different joint ROM as well as to the dynamically changing ROM for individual patient. The device can also accommodate to some extent variety of hand sizes. Thirdly, the proposed control strategy simultaneously realizes the position control and force control with the motor driver which only works in force control mode. Meanwhile, the system resistance compensation is preliminary realized and the resisting force is effectively reduced. Some experiments were conducted to verify the proposed system. Experimentally collected data show that the achieved ROM is close to that of a healthy hand and the range of phalange length (ROPL) covers the size of a typical hand, satisfying the size need of regular hand rehabilitation. In order to evaluate the performance when it works as a haptic device in active mode, the equivalent moment of inertia (MOI) of the device was calculated. The results prove that the device has low inertia which is critical in order to obtain good backdrivability. The experiments also show that in the active mode the virtual interactive force is successfully feedback to the finger and the resistance is reduced by one-third; for the passive control mode, the desired trajectory is realized satisfactorily.

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[Abstract] A novel exoskeleton robotic system for hand rehabilitation – Conceptualization to prototyping

Abstract

This research presents a novel hand exoskeleton rehabilitation device to facilitate tendon therapy exercises. The exoskeleton is designed to assist fingers flexion and extension motions in a natural manner. The proposed multi-Degree Of Freedom (DOF) system consists of a direct-driven, optimized and underactuated serial linkage mechanism having capability to exert extremely high force levels perpendicularly on the finger phalanges. Kinematic and dynamic models of the proposed device have been derived. The device design is based on the results of multi-objective optimization algorithm and series of experiments conducted to study capabilities of the human hand. To permit a user-friendly interaction with the device, the control is based on minimum jerk trajectory generation. Using this control system, the transient response and steady state behavior of the proposed device are analyzed after designing and fabricating a two-fingered prototype. The pilot study shows that the proposed rehabilitation system is capable of flexing and extending the fingers with accurate trajectories.

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[Abstract] Design of a Low-Cost Exoskeleton for Hand Tele-Rehabilitation After Stroke

Abstract

The impairment of finger movements after a stroke results in a significant deficit in hands everyday performances. To face this kind of problems different rehabilitation techniques have been developed, nevertheless, they require the presence of a therapist to be executed. To overcome this issue have been designed several apparatuses that allow the patient to perform the training by itself. Thus, an easy to use and effective device is needed to provide the right training and complete the rehabilitation techniques in the best way. In this paper, a review of state of the art in this field is provided, along with an introduction to the problems caused by a stroke and the consequences for the mobility of the hand. Then follows a complete review of the low cost home based exoskeleton project design. The objective is to design a device that can be used at home, with a lightweight and affordable structure and a fast mounting system. For implementing all these features, many aspects have been analysed, starting from the rehabilitation requirements and the ergonomic issues. This device should be able to reproduce the training movements on an injured hand without the need for assistance by an external tutor.

via Design of a Low-Cost Exoskeleton for Hand Tele-Rehabilitation After Stroke | SpringerLink

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