Published in: Rehabilitation Robotics (ICORR), 2017 International Conference on
Recent technological developments regarding wearable soft-robotic devices extend beyond the current application of rehabilitation robotics and enable unobtrusive support of the arms and hands during daily activities. In this light, the HandinMind (HiM) system was developed, comprising a soft-robotic, grip supporting glove with an added computer gaming environment. The present study aims to gain first insight into the feasibility of clinical application of the HiM system and its potential impact. In order to do so, both the direct influence of the HiM system on hand function as assistive device and its therapeutic potential, of either assistive or therapeutic use, were explored. A pilot randomized clinical trial was combined with a cross-sectional measurement (comparing performance with and without glove) at baseline in 5 chronic stroke patients, to investigate both the direct assistive and potential therapeutic effects of the HiM system. Extended use of the soft-robotic glove as assistive device at home or with dedicated gaming exercises in a clinical setting was applicable and feasible. A positive assistive effect of the soft-robotic glove was proposed for pinch strength and functional task performance ‘lifting full cans’ in most of the five participants. A potential therapeutic impact was suggested with predominantly improved hand strength in both participants with assistive use, and faster functional task performance in both participants with therapeutic application.
Source: Applying a soft-robotic glove as assistive device and training tool with games to support hand function after stroke: Preliminary results on feasibility and potential clinical impact – IEEE Xplore Document
Surface electromyographic (sEMG) signals is one most commonly used control source of exoskeleton for hand rehabilitation. Due to the characteristics of non-invasive, convenient collection and safety, sEMG can conform to the particularity of hemiplegic patients’ physiological state and directly reflect human’s neuromuscular activity. By way of collecting, analyzing and processing, sEMG signals corresponding to identify the target movement model would be translated into robot movement control instructions and input into hand rehabilitation exoskeleton controller. Then patients’ hand can be directed to achieve the realization of the similar action finally. In this paper, the recent key technologies of sEMG-based control for hand rehabilitation robots are reviewed. Then a summarization of controlling technology principle and methods of sEMG signal processing employed by the hand rehabilitation exoskeletons is presented. Finally suitable processing methods of multi-channel sEMG signals for the controlling of hand rehabilitation exoskeleton are put forward tentatively and the practical application in hand exoskeleton control is commented also.
Source: A survey on sEMG control strategies of wearable hand exoskeleton for rehabilitation – IEEE Xplore Document
Finger recovery is much harder than other parts on the upper limbs, because finger recovery movement has several key problems need to overcome, including high precision of movement, high control resolution requirements, variable data with different person, as well as the fuzzy signal during the movement. In order to overcome the difficulties, a new scheme of finger recovery is presented in the paper based on symmetric rehabilitation. In the paralyzed hand side, a mechanical exoskeleton hand is designed and simulated to provide skeletal traction, while in the regular hand side, the curve magnitude of every joint during movement is detected. Then the hand motion is analyzed and recognized using Multi-class SVM. Many candidates were chosen to perform the experiment, and the data produced by the candidates were divided the training parts and recognition parts. Experiments shows that the Multi-class SVM is effective and practical for classification and recognition, and could be helpful in the finger recovery process.
Source: A novel scheme of finger recovery based on symmetric rehabilitation: Specially for hemiplegia – IEEE Xplore Document
This paper describes the design of a FES system automatically controlled in a closed loop using a Microsoft Kinect sensor, for assisting both cylindrical grasping and hand opening. The feasibility of the system was evaluated in real-time in stroke patients with hand function deficits. A hand function exercise was designed in which the subjects performed an arm and hand exercise in sitting position. The subject had to grasp one of two differently sized cylindrical objects and move it forward or backwards in the sagittal plane. This exercise was performed with each cylinder with and without FES support. Results showed that the stroke patients were able to perform up to 29% more successful grasps when they were assisted by FES. Moreover, the hand grasp-and-hold and hold-and-release durations were shorter for the smaller of the two cylinders. FES was appropriately timed in more than 95% of all trials indicating successful closed loop FES control. Future studies should incorporate options for assisting forward reaching in order to target a larger group of stroke patients.
Source: Design and Test of a Closed-Loop FES System for Supporting Function of the Hemiparetic Hand Based on Automatic Detection using the Microsoft Kinect sensor – IEEE Xplore Document
This paper describes the design and initial prototype of a thumb curling exoskeleton for movement therapy. This add-on device for the Finger INdividuating Grasp Exercise Robot (FINGER) guides the thumb through a single-degree-of-freedom naturalistic grasping motion. This motion complements the grasping motions of the index and middle fingers provided by FINGER. The kinematic design and mechanism synthesis described herein utilized 3D motion capture and included the determination of the principle plane of the thumb motion for the simple grasping movement. The results of the design process and the creation of a first prototype indicate that this thumb module for finger allows naturalistic thumb motion that expands the capabilities of the FINGER device.
Source: IEEE Xplore Document – Design of a thumb module for the FINGER rehabilitation robot
This paper reports on the development of a low-profile exoskeleton module to enable training of the fingers and thumb in grasp and release tasks. The design has been made as an add-on module for use with the ArmAssist arm rehabilitation system (Tecnalia, Spain). Variable-position springs and adjustable link lengths provide adaptability to fit a variety of users. Additive manufacturing has been utilized for the majority of components allowing easy modifications. A few structural components were machined from aluminum or steel to produce a functional prototype with sufficient strength for direct evaluation. The design includes independent and adjustable assistance in finger and thumb extension using various width elastic bands, and measurement of user grasp/release forces in finger flexion/extension, thumb flexion/extension, and thumb adduction/abduction using low-profile force sensitive resistors.
Source: IEEE Xplore Document – Design of a spring-assisted exoskeleton module for wrist and hand rehabilitation
Stroke patients often have inappropriate finger flexor activation and finger extensor weakness, which makes it difficult to open their affected hand for functional grasp. The goal was to develop a passive, lightweight, wearable device to enable improved hand function during performance of activities of daily living. The device, HandSOME II, assists with opening the patient’s hand using 11 elastic actuators that apply extension torques to finger and thumb joints. Device design and initial testing are described. A novel mechanical design applies forces orthogonal to the finger segments despite the fact that all of the device DOFs are not aligned with human joint DOF. In initial testing with seven stroke subjects with impaired hand function, use of HandSOME II significantly increased maximum extension angles and range of motion in all of the index finger joints (P<0.05). HandSOME II allows performance of all the grip patterns used in daily activities and can be used as part of home-based therapy programs.
Source: IEEE Xplore Document – Hand rehabilitation after stroke using a wearable, high DOF, spring powered exoskeleton
Many mechatronic devices exist to facilitate hand rehabilitation, however few directly address deficits in muscle activation patterns while also enabling functional task practice.
We developed an innovative voice and electromyography-driven actuated (VAEDA) glove, which is sufficiently flexible/portable for incorporation into hand-focused therapy post-stroke. The therapeutic benefits of this device were examined in a longitudinal intervention study. Twenty-two participants with chronic, moderate hand impairment (Chedoke-McMaster Stroke Assessment Stage of Hand (CMSA-H=4)) enrolled >8 months post-stroke for 18 one-hour training sessions (3x/week) employing a novel hand-focused occupational therapy paradigm, either with (VAEDA) or without (No-VAEDA) actuated assistance.
Outcome measures included CMSA-H, Wolf Motor Function Test (WMFT), Action Research Arm Test, Fugl-Meyer Upper Extremity Motor Assessment (FMUE), grip and pinch strength and hand kinematics. All outcomes were recorded at baseline and endpoint (immediately after and 4 weeks post-training).
Significant improvement was observed following training for some measures for the VAEDA group (n=11) but for none of the measures for the No-VAEDA group (n=11). Specifically, statistically significant gains were observed for CMSA-H (p=0.038) and WMFT (p=0.012) as well as maximum digit aperture subset (p=0.003, n=7), but not for the FMUE or grip or pinch strengths.
In conclusion, therapy effectiveness appeared to be increased by employment of the VAEDA glove, which directly targets deficits in muscle activation patterns.
Source: IEEE Xplore Abstract (Abstract) – Benefits of using a voice and EMG-driven actuated glove to support occupational therapy for stroke s…
This paper presents a soft robotic glove designed to assist individuals with functional grasp pathologies in performing activities of daily living. The glove utilizes soft fabric-regulated pneumatic actuators that are low-profile and require lower pressure than previously developed actuators. They are able to support fingers and thumb motions during hand closure. Upon pressurization, the actuators are able to generate sufficient force to assist in hand closing and grasping during different manipulation tasks. In this work, experiments were conducted to evaluate the performances of the actuators as well as the glove in terms of its kinetic and kinematic assistance on a healthy participant. Additionally, surface electromyography and radio-frequency identification techniques were adopted to detect user intent to activate or deactivate the glove. Lastly, we present preliminary results of a healthy participant performing different manipulation tasks with the soft robotic glove controlled by surface electromyography and radio-frequency identification techniques.
Source: IEEE Xplore Abstract (Abstract) – A fabric-regulated soft robotic glove with user intent detection using EMG and RFID for hand assisti…
Treatment options for stroke survivors with severe hand impairment are limited. Active task practice can be restricted by difficulty in voluntarily activating finger muscles and interference from involuntary muscle excitation.
We developed a portable, actuated glove-orthosis, which could be employed to address both issues. We hypothesized that combining passive cyclical stretching (reducing motoneuronal hyperexcitability) imposed by the device with active-assisted, task-oriented training (rehabilitating muscle activation) would improve upper extremity motor control and task performance post-stroke.
Thirteen participants who experienced a stroke 2-6 months prior to enrollment completed 15 treatment sessions over five weeks. Each session involved cyclically stretching the long finger flexors (30 min) followed by active-assisted task-oriented movement practice (60 min). Outcome measures were completed at six intervals: three before and three after treatment initiation.
Overall improvement in post-training scores was observed across all outcome measures, including the Graded Wolf Motor Function Test, Action Research Arm Test, and grip and pinch strength ( p ≤ 0.02), except finger extension force. No significant change in spasticity was observed. Improvement in upper extremity capabilities is achievable for stroke survivors even with severe hand impairment through a novel intervention combining passive cyclical stretching and active-assisted task practice, a paradigm which could be readily incorporated into the clinic.
Source: IEEE Xplore Abstract – Use of a Portable Assistive Glove to Facilitate Rehabilitation in Stroke Survivors With Severe Hand …