Posts Tagged Hand

[Abstract] Modeling and analysis of hydraulic piston actuation of McKibben fluidic artificial muscles for hand rehabilitation

Soft robotic actuators are well-suited for interactions with the human body, particularly in rehabilitation applications. The fluidic artificial muscle (FAM), specifically the McKibben FAM, is a type of soft robotic actuator that can be driven either pneumatically or hydraulically, and has potential for use in rehabilitation devices. The force applied by a FAM is well-described by a variety of models, the most common of which is based on the virtual work principle. However, the use of a piston assembly as a hydraulic power source for activation of FAMs has not previously been modeled in detail. This article presents a FAM designed to address the specific needs of a hand rehabilitation device. A syringe pump test bed is used to find and validate a novel volume–strain relationship. The volume–strain relationship remains constant with the coupled piston–FAM system, regardless of load. This confirms a bivariate approach to FAM control which is particularly beneficial in the exoskeleton application as the load varies throughout use. A novel, fixed-end cylindrical model is found to predict the strain of the FAM, given a volume input, regardless of load. For the FAMs tested in this work, the fixed-end cylindrical model improves strain prediction seven-fold when compared with traditional models.

via Modeling and analysis of hydraulic piston actuation of McKibben fluidic artificial muscles for hand rehabilitation – Anderson S Camp, Edward M Chapman, Paola Jaramillo Cienfuegos,

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[WEB SITE] When it Comes to Stroke Recovery, Who You See Matters

(a) Top view of the experiment. A tablet monitor was placed over the participant’s right forearms on the desk in front of them. (b) Diagrammatic view of the experiment from the left. There is a space to open the hand, which made it easier to imagine the opening-clench hand movement. (Photo courtesy of Toshihisa Tanaka, TUAT)

For stroke patients, observing their own hand movements in a video-assisted therapy – as opposed to someone else’s hand – could enhance brain activity and speed up rehabilitation, according to researchers.

The scientists, from Tokyo University of Agriculture and Technology (TUAT), published their findings in IEEE Transactions on Neural Systems and Rehabilitation Engineering.

Brain plasticity, where a healthy region of the brain fulfills the function of a damaged region of the brain, is a key factor in the recovery of motor functions caused by stroke. Studies have shown that sensory stimulation of the neural pathways that control the sense of touch can promote brain plasticity, essentially rewiring the brain to regain movement and senses.

To promote brain plasticity, stroke patients may incorporate a technique called motor imagery in their therapy. Motor imagery allows a participant to mentally simulate a given action by imagining themselves going through the motions of performing that activity. This therapy may be enhanced by a brain-computer interface technology, which detects and records the patients’ motor intention while they observe the action of their own hand or the hand of another person, a media release from Tokyo University of Agriculture and Technology explains.

“We set out to determine whether it makes a difference if the participant is observing their own hand or that of another person while they’re imagining themselves performing the task,” says co-author Toshihisa Tanaka, a professor in the Department of Electrical and Electrical Engineering at TUAT in Japan and a researcher at the RIKEN Center for Brain Science and the RIKEN Center for Advanced Intelligent Project.

The researchers monitored brain activity of 15 healthy right-handed male participants under three different scenarios. In the first scenario, participants were asked to imagine their hand moving in synchrony with hand movements being displayed in a video clip showing their own hand performing the task, together with corresponding voice cues.

In the second scenario, they were asked to imagine their hand moving in synchrony with hand movements being displayed on a video clip showing another person’s hand performing the task, together with voice cues. In the third scenario, the participants were asked to open and close their hands in response to voice cues only.

Using electroencephalography (EEG), brain activity of the participants was observed as they performed each task.

The team found meaningful differences in EEG measurements when participants were observing their own hand movement and that of another person. The findings suggest that, in order for motor imagery-based therapy to be most effective, video footage of a patient’s own hand should be used.

“Visual tasks where a patient observes their own hand movement can be incorporated into brain-computer interface technology used for stroke rehabilitation that estimates a patient’s motor intention from variations in brain activity, as it can give the patient both visual and sense of movement feedback,” Tanaka explains.

[Source(s): Tokyo University of Agriculture and Technology, EurekAlert]

via When it Comes to Stroke Recovery, Who You See Matters – Rehab Managment

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[VIDEO] Stroke Rehabilitation: Use of electrical stimulation to help arm and hand recovery

This video demonstrates how to use FES, Functional Electrical Stimulation, to engage the muscles of the arm to extend the fingers.

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[Abstract + References] Design and Kinematics Analysis of a Bionic Finger Hand Rehabilitation Robot Mechanism


The rehabilitation process of human fingers is a coupling movement of wearable hand rehabilitation equipment and human fingers, and its design must be based on the kinematics of human fingers. In this paper, the forward kinematics and inverse kinematics models are established for the index finger. Kinematics analysis is carried out. Then a bionic finger rehabilitation robot is designed according to the movement characteristics of the finger, A parallelogram linkage mechanism is proposed to make the joint independent drive, realize the flexion/extension movement, and perform positive kinematics and inverse kinematics analysis on the mechanism. The results show that it conforms to the kinematics of the index finger and can be used as the mechanism model of the finger rehabilitation robot.
1. Ibrahim Yildiz, “A Low-Cost and Lightweight Alternative to Rehabilitation Robots: Omnidirectional Interactive Mobile Robot for Arm Rehabilitation” in Arabian Journal for Science & Engineering, Springer Science & Business Media B.V., vol. 43, no. 3, pp. 1053-1059, 2018.

2. Bai Shaoping, Gurvinder S. Virk, Thomas G. Sugar, Wearable Exoskeleton Systems: Design control and applications[M], Institution of Engineering and Technology Control, pp. 1-406, 2018.

3. Kai Zhang, Xiaofeng Chen et al., “System Framework of Robotics in Upper Limb Rehabilitation on Poststroke Motor Recovery”, Behavioural Neurology, vol. 12, pp. 1-14, 2018.

4. Yang Haile, Zhu Huiying, Lin Xingyu, “Review of Exoskeleton Wearable Rehabilitation System[J]”, Metrology and testing technology, vol. 46, no. 03, pp. 40-44, 2019.

5. Xiang Shichuan, Meng Qiaoling, Yu Hongliu, Meng Qingyun, “Research status of compliant exoskeleton rehabilitation manipulator [J]”, Chinese Journal of Rehabilitation Medicine, vol. 33, no. 04, pp. 461-465+474, 2018.

6. Wu Hongjian, Li Lina, Li Long, Liu Tian, Jue Wang, “Review of comprehensive intervention by hand rehabilitation robot after stroke [J]”, Journal of biomedical engineering, vol. 36, no. 01, pp. 151-156, 2019.

7. Yu Junwei, Xu Hongbin, Xu Taojin, Zhang Chengjie, Lu Shiqing, “Structure Design and Finite Element Analysis of a Rope Traction Upper Limb Rehabilitation Robot [J]”, Mechanical transmission, vol. 42, no. 12, pp. 93-97, 2018.

8. Chang Ying, Meng Qingyun, Yu Hongliu, “Research progress on the development of hand rehabilitation robot [J]”, Beijing Biomedical Engineering, vol. 37, no. 06, pp. 650-656, 2018.

9. N A I M Rosli, M A A Rahman, S A Mazlan et al., “Electrocardiographic (ECG) and Electromyographic (EMG) signals fusion for physiological device in rehab application[C]”, IEEE Student Conference on Research and Development, pp. 1-5, 2015.

10. K O Thielbar, K M Triandafilou, H C Fischer et al., “Benefits of using a voice and EMG- Driven actuated glove to support occupational therapy for stroke survivors”, IEEE Trans Neural Syst Rehabil Eng, vol. 25, no. 3, pp. 297-305, 2017.


via Design and Kinematics Analysis of a Bionic Finger Hand Rehabilitation Robot Mechanism – IEEE Conference Publication

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[ARTICLE] Home rehabilitation supported by a wearable soft-robotic device for improving hand function in older adults: A pilot randomized controlled trial – Full Text



New developments, based on the concept of wearable soft-robotic devices, make it possible to support impaired hand function during the performance of daily activities and intensive task-specific training. The wearable soft-robotic ironHand glove is such a system that supports grip strength during the performance of daily activities and hand training exercises at home.


This pilot randomized controlled clinical study explored the effect of prolonged use of the assistive ironHand glove during daily activities at home, in comparison to its use as a trainings tool at home, on functional performance of the hand.


In total, 91 older adults with self-perceived decline of hand function participated in this study. They were randomly assigned to a 4-weeks intervention of either assistive or therapeutic ironHand use, or control group (received no additional exercise or treatment). All participants performed a maximal pinch grip test, Box and Blocks test (BBT), Jebsen-Taylor Hand Function Test (JTHFT) at baseline and after 4-weeks of intervention. Only participants of the assistive and therapeutic group completed the System Usability Scale (SUS) after the intervention period.


Participants of the assistive and therapeutic group reported high scores on the SUS (mean = 73, SEM = 2). The therapeutic group showed improvements in unsupported handgrip strength (mean Δ = 3) and pinch strength (mean Δ = 0.5) after 4 weeks of ironHand use (p≤0.039). Scores on the BBT and JTHFT improved not only after 4 weeks of ironHand use (assistive and therapeutic), but also in the control group. Only handgrip strength improved more in the therapeutic group compared to the assistive and control group. No significant correlations were found between changes in performance and assistive or therapeutic ironHand use (p≥0.062).


This study showed that support of the wearable soft-robotic ironHand system either as assistive device or as training tool may be a promising way to counter functional hand function decline associated with ageing.



Hand function predominantly determines the quality of performance in activities of daily living (ADL) and work-related functioning. Older adults with age-related loss of muscle mass (i.e. sarcopenia) [1] and/or age-related diseases (e.g. stroke, arthritis) [23] suffer from loss of hand function. As a consequence, they experience functional limitations, which affects independence in performing ADL [35].

An effective intervention for improving hand function of (stroke) patients should consist of several key aspects of motor learning, such as high-intensity and task-specificity in repetitive and functional exercises that are actively initiated by the patient him/herself [67]. In a traditional rehabilitation setting, those kinds of interventions are performed with one-on-one attention from the healthcare professional for each patient. This might become problematic in the near future when the population of older adults with age-related diseases (e.g. stroke, rheumatoid arthritis) with hand function decline will rise, resulting in an increased need for healthcare professionals and a rise of healthcare costs [8]. Therefore, new alternatives to provide intensive therapy for all patients are needed in the future.

New technological developments, such as robot-assisted hand training, have the potential to provide such intensive, repetitive and task-specific therapy. Several reviews [911] already showed positive results on motor function after robot-assisted training of the upper extremity. However, limiting factors of robot-assisted therapy are the need for supervision of a healthcare professional, the high costs of the devices and the limited availability of wearable devices for training at home [12]. Furthermore, it is often not efficient in transferring the trained movements into daily situations [6]. Therefore, the next generation robotic training approaches should pay substantial attention towards home-based rehabilitation and the functional nature of the exercise involved.

A new way of providing functional, intensive and task-specific hand training would involve using new technological innovations that enable support of the affected hand directly during the performance of ADL, based on the concept of a wearable robotic glove [1318]. In this way, the affected hand can be used repeatedly and for prolonged periods of time during functional daily activities. These robotic gloves can use different human-robot interfaces to provide assistance for the affected hand, such as an EMG-controlled glove, a tendon driven glove, a glove controlled by force sensors etc. [1314161819]. All these robotic gloves use soft and flexible materials to make such devices more lightweight and easy to use, accommodating wearable applications. This concept of a wearable soft-robotic glove allows persons with reduced hand function to use their hand(s) during a large variety of functional activities and may even turn performing daily activities into extensive training, independent from the availability of healthcare professionals. This is thought to improve hand function and patient’s independence in performing ADL.

Therefore, an easy to use and wearable soft-robotic glove (ironHand system), supporting grip strength and hand training exercises at home, was developed within the ironHand project [20]. Previous studies have examined feasibility [20] and the orthotic effect of the ironHand system [21]. In a first randomized controlled clinical study, the effect of prolonged use of such an assisting glove during ADL at home on functional performance of the hand was explored, in comparison to its use as a training tool at home.[…]


Continue —> Home rehabilitation supported by a wearable soft-robotic device for improving hand function in older adults: A pilot randomized controlled trial

Fig 2.
Overview of the ironHand system with assistive functionality (left panel) and therapeutic functionality (right panel). * Reprinted from Bioservo Technologies under a CC BY license, with permission from Bioservo Technologies, original copyright 2017.


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[ARTICLE] Hand rehabilitation – a gaming experience – Full Text PDF


This research is made to aim bettering the current hand rehabilitation methodology. It is developed expressly to motivate the patients to play, as their hand is getting healthier. The system consists of a hand motion capturing device, and the game control system, that is using dedicated processing algorithms and aims to register hand movement, and also the progress that the user can make over a period of time. The game it uses is a fairly simple one that does in fact motivate the user to play longer rounds, all the more reason to attend which will always result in positive feedback from the patient.

via Hand rehabilitation – a gaming experience – IOPscience

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[ARTICLE] A Wearable Rehabilitation System to Assist Partially Hand Paralyzed Patients in Repetitive Exercises – Full Text PDF

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The main purpose of the paper is development, implementation, and testing of a low cost portable system to assist partially paralyzed patients in their hand rehabilitation after strokes or some injures. Rehabilitation includes time consuming and repetitive exercises which are costly and demotivating as well as the requirements of clinic attending and direct supervision of physiotherapist. In this work, the system consists of a graphical user interface (GUI) on a smartphone screen to instruct and motivate the patients to do their exercises by themselves. Through the GUI, the patients are instructed to do a sequence of exercises step by step, and the system measures the electrical activities (electromyographic signals EMG) of the user’s forearm muscles by Myo armband. Depending on database, the system can tell whether the patients have done correct movements or not. If a correct movement is detected, the system will inform the user through the GUI and move to the next exercise. For preliminary results, the system was extensively tested on a healthy person.


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Fig.1. shows a Myo gestures control armband and a smartphone.

Fig. 3. The main parts of the Myo armband, adapted from [14].

via A Wearable Rehabilitation System to Assist Partially Hand Paralyzed Patients in Repetitive Exercises* – IOPscience

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[Abstract + References] A Soft Robotic Glove for Hand Rehabilitation Using Pneumatic Actuators with Variable Stiffness – Conference paper


Traditional rigid robots exist many problems in rehabilitation training. Soft robotics is conducive to breaking the limitations of rigid robots. This paper presents a soft Rehabilitation training, Soft robot, Pneumatic actuator device for the rehabilitation of hands, including soft pneumatic actuators that are embedded in the device for motion assistance. The key feature of this design is the stiffness of each actuator at different positions is different, which results in the bending posture of the actuator is more accordant with the bending figure of human hand. In addition, another key point is the use of a fabric sleeves allow actuators to gain greater bending force when pressurized, which gives the hand greater bending force. We verified the feasibility of actuator through simulation, the performance of soft actuator and the device also are evaluated through experiments. Finally, the results show that this device can finish some of the hand rehabilitation tasks.


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via A Soft Robotic Glove for Hand Rehabilitation Using Pneumatic Actuators with Variable Stiffness | SpringerLink

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[ARTICLE] Development of low-cost portable hand exoskeleton for assistive and rehabilitation purposes – Full Text PDF


The design of an aid for the hand function based on exoskeleton technologies for patients who have lost or injured hand skills, e.g. because of neuromuscular or aging diseases, is one of the most influential challenge in modern robotics to assure them an independent and healthy life. This research activity is focused on the design and development of a low-cost Hand Exoskeleton System (HES) for supporting patients affected by hand disabilities during the Activities of Daily Living (ADLs). The device can be also used during the rehabilitative sessions to better recovery the dexterity of the user’s hand. This paper presents a compact design concept for a portable hand exoskeleton. This prototype has been developed thanks to the collaboration between the Department of Industrial Engineering (DIEF) of the University of Florence, and the Rehabilitation Engineering Laboratory of the ETH, Z¨ urich, during the eNTERFACE16 Workshop, hosted by the University of Twente.
Testing sequence

Testing sequence

via Development of low-cost portable hand exoskeleton for assistive and rehabilitation purposes

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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.



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.


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.


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).


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


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 … – PubMed – NCBI

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