Posts Tagged ironHand

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

Abstract

Background

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.

Design

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.

Methods

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.

Results

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).

Conclusion

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.

 

Introduction

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.
https://doi.org/10.1371/journal.pone.0220544.g002

 

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[Abstract] The wearable hand robot: supporting impaired hand function in activities of daily living and rehabilitation

Abstract

Our hands are very important in our daily life. They are used for non-verbal communication and sensory feedback, but are also important to perform both fine (e.g. picking up paperclips) and gross (e.g. lifting heavy boxes) motor tasks. Decline of hand function in older adults as a result of age-related loss of muscle mass (i.e. sarcopenia) and/or age-related diseases such as stroke, rheumatoid arthritis or osteoarthritis, is a common problem worldwide. The decline in hand function, in particular grip strength, often results in increased difficulties in performing activities of daily living (ADL), such as carrying heavy objects, doing housework, (un)dressing, preparing food and eating.
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 ironHand and HandinMind systems are examples of such novel wearable soft-robotic systems that have been developed in the ironHand and HandinMind projects. Both systems are developed to provide grip support during a wide range of daily activities. The ironHand system consists of a 3-finger wearable soft-robotic glove, tailored to older adults with a variety of physical age-related hand function limitations. The HandinMind system consists of a 5-finger wearable soft-robotic glove, dedicated towards application in stroke. In both cases, the wearable soft-robotic system could be connected to a computer with custom software to train specific aspects of hand function in a motivating game-like environment with multiple levels of difficulty. By adding the game environment, an assistive device is transformed into a dedicated training device.
The aim of the current thesis is to define user requirements, to investigate feasibility and to evaluate the direct and clinical effects of a wearable soft-robotic system that is developed to support impaired hand function of older adults and stroke patients in a wide range of daily activities and in exercise training at home.

via The wearable hand robot: supporting impaired hand function in activities of daily living and rehabilitation — University of Twente Research Information

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