Posts Tagged thumb
[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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20. N. Arman, E. Tarakci, D. Tarakci and O. Kasapcopur, “Effects of Video Games-Based Task-Oriented Activity Training (Xbox 360 Kinect) on Activity Performance and Participation in Patients with Juvenile Idiopathic Arthritis: A Randomized Clinical Trial”, Am. J. Phys. Med. Rehabil., vol. 98, no. 3, pp. 174-181, 2019. Show Context CrossRef Google Scholar
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23. Y.-T. Wu, K.-H. Chen, S.-L. Ban, K.-Y. Tung and L.-R. Chen, “Evaluation of leap motion control for hand rehabilitation in burn patients: An experience in the dust explosion disaster in Formosa Fun Coast”, Burns, vol. 45, no. 1, pp. 157-164, Feb. 2019. Show Context CrossRef Google Scholar
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[Abstract + References] Multi-modal Intent Recognition Method for the Soft Hand Rehabilitation Exoskeleton
Stroke has become the second most disabling disease in the world. Due to the intensive demand for physical therapists and the severe dependence on hospitals, the cost for the treatment of stroke patients is huge. As the most flexible limb of the human body, the hand faces more severe challenges, which has a much lower degree of recovery than the upper and lower limbs. In the face of these challenges, a new treatment, exoskeleton-based rehabilitation, has demonstrated new vitality. This paper proposes a novel design of the soft hand exoskeleton based on bionics and anatomy and the exoskeleton could help the users bend and extend their fingers, which would greatly improve the motor ability of stroke patients. Through the control of the six drive motors, the exoskeleton could achieve most of the hand’s freedom of training. At the same time, we propose a multi-modal intent recognition method based on machine vision and machine speech. Under specific rehabilitation training scenarios, both healthy subjects and patients could complete grasping tasks in the wearing of the exoskeleton, overcoming potential security risks caused by misidentification due to using the single-modal intent understanding method.
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5. J. Yi, X. Chen and Z. Wang, “A three-dimensional- printed soft robotic glove with enhanced ergonomics and force capability”, IEEE Robotics and Automation Letters, vol. 3, no. 1, pp. 242-248, 2017. Show Context View Article Full Text: PDF (676KB) Google Scholar
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8. L. Gerez and M. Liarokapis, “An underactuated tendon-driven wearable exo-glove with a four-output differential mechanism”, 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), pp. 6224-6228, 2019. Show Context View Article Full Text: PDF (3125KB) Google Scholar
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14. J. Redmon, S. Divvala, R. Girshick and A. Farhadi, “You only look once: Unified real-time object detection”, Proceedings of the IEEE conference on computer vision and pattern recognition, pp. 779-788, 2016. Show Context View Article Full Text: PDF (1742KB) Google Scholar
[Conference Paper] HandMATE: Wearable Robotic Hand Exoskeleton and Integrated Android App for At Home Stroke Rehabilitation – Full Text
We have developed HandMATE (Hand Movement Assisting Therapy Exoskeleton); a wearable motorized hand exoskeleton for home-based movement therapy following stroke. Each finger and the thumb is powered by a linear actuator which provides flexion and extension assistance. Force sensitive resistors integrated into the design measure grasp and extension initiation force. An assistive therapy mode is based on an admittance control strategy. We evaluated our control system via subject and bench testing. Errors during a grip force tracking task while using the HandMATE were minimal (<1%) and comparable to unassisted healthy hand performance. We also outline a dedicated app we have developed for optimal use of HandMATE at home. The exoskeleton communicates wirelessly with an Android tablet which features guided exercises, therapeutic games and performance feedback. We surveyed 5 chronic stroke patients who used the HandMATE device to further evaluate our system, receiving positive feedback on the exoskeleton and integrated app.
Stroke is the leading cause of severe long-term disability in the US . The probability of regaining functional use of the impaired upper extremity is low . At 6 months post stroke, 62% of survivors failed to achieve some dexterity . Such impairments can inhibit the individual’s ability to perform activities of daily living (ADL). Subsequently, upper limb rehabilitation recovery to improve ADL is one of the main self-reported goals of stroke survivors .
Outpatient rehabilitation is recommended for survivors that have been discharged from inpatient rehabilitative services . However, outpatient rehabilitation in general is largely underutilized, with only 35.5% of stroke survivors using services . Factors inhibiting outpatient therapy include cost, lack of resources and transportation. Wearable robotics that enable home-based therapy have the potential to overcome these barriers. They provide assistive movement forces which enable task-specific training in real-life situations that patients are often unable to practice without a clinician. See  for wearable hand robots for rehabilitation review.
At home therapy is not without its limitations. The inability to motivate oneself and fatigue are the most common reported factors resulting in failure to adhere to home based exercise programs for stroke recovery . While wearable robotics can reduce fatigue during exercise, it does not directly address lack of motivation. Research has shown incorporating games into home therapy can encourage compliance . Zondervan et al. showed that use of an instrumented sensor glove, named the MusicGlove, improved self-reported use and quality of movement, greater than convention at home exercises . Other studies showed increased motivation to complete the therapeutic exercises and optimized movement when the user is given feedback of their performance via the Microsoft Kinect . Wearable robotic systems that offer feedback and gaming capability may optimize at home stroke therapy.
Such a system was presented by Nijenhuis et al. in which stroke survivors showed motor improvements after completing a 6 week self-administered training program comprised of a dynamic hand orthosis and gaming environment . However, the hand device was passive, assisting only with extension, which limits the range of stroke survivors who could utilize such a system. Research groups have proposed combining their powered take-home wearable hand devices with custom integrated gaming systems , or guided exercises ; however, they have yet to conduct clinical trials. Notably, Ghassemi et al., have developed an integrated multi-user VR system to use with their X-Glove actuated orthosis, which will allow for client-therapist sessions without the patient having to travel .
Tablets are relatively inexpensive, portable, and straight forward to use, with 47% of internet users globally already owning one . Furthermore, a recent study demonstrated the success of a tablet based at home exercise program in improving the recovery of stroke survivors . Notably, the study evaluated the accessibility of tablets, concluding every participant used the tablet successfully. Therefore a wearable powered hand robot with a dedicated tablet app which will provide functional games, task-specific guided exercises and feedback of movement, could optimize at home stroke therapy.
The goal of this project was to create a wearable robotic exoskeleton that enables repetitive practice of task-specific and goal orientated movements, which translates into improvements in ADL. Furthermore, for maximum use and successful integration into home-based rehabilitation, we aimed to create an Android application compatible with the robotic exoskeleton.
To meet these goals, the following design objectives were established: 1) Assistance with finger flex/extension. 2) Assistance with thumb carpometacarpal (CMC) add/abduction and thumb metacarpophalangeal (MCP) flex/extension. 3) Independent assistive control of each finger and thumb. 4) Portable for at home use, meaning the device has to be lightweight and wireless. 5) Relatively affordable. 6) Integrated with android tablet app. Specific design goals for the app included: 1) Easy to use. 2) Allow the user to control the exoskeletons assistance mode through the app. 3) Records the user’s data and prompts the user via notifications to complete the allocated daily or weekly recommended activity time.
In this paper we will evaluate if the proposed device and app goals have been achieved via bench and subject testing.
The HandMATE device (Fig. 1) builds upon the Hand Spring Operated Movement Enhancer (HandSOME) devices , , . The HandSOME devices are non-motorized wearable exoskeletons that assists stroke patients with finger and thumb extension movements. The HandSOME I device assists with gross whole hand opening movements, while the HandSOME II assists isolated extension movement of 15 finger and thumb degrees of freedom (DOF), allowing performance of various grip patterns used in ADL. While both devices have been shown to significantly increase range of motion (ROM) and functional ability in chronic stroke subjects ,, the HandSOME devices only assist with extension movements and require enough flexion activity to overcome the assistance of the extension springs. As many stroke patients also suffer finger and thumb flexion weakness, we decided to build upon the work of the high DOF HandSOME II and additionally utilize power actuation so we can assist with both flexion and extension movements.
[Abstract + References] Feasibility of Wearable Sensing for In-Home Finger Rehabilitation Early After Stroke
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[Abstract + References] Design and Kinematics Analysis of a Bionic Finger Hand Rehabilitation Robot Mechanism
A low-cost 1-DOF hand exoskeleton for neuromuscular rehabilitation has been designed and assembled. It consists of a base equipped with a servo motor, an index finger part, and a thumb part, connected through three gears. The index part has a tri-axial load cell and an attached ring to measure the finger force. An admittance control scheme was designed to provide intuitive control and positive force amplification to assist the user’s finger movement. To evaluate the effects of different control parameters on neuromuscular response of the fingers, we created an integrated exoskeleton-hand musculoskeletal model to virtually simulate and optimize the control loop. The exoskeleton is controlled by a proportional derivative controller that computes the motor torque to follow a desired joint angle of the index part, which is obtained from inverse kinematics of a virtual end-effector mass driven by the finger force. We conducted parametric simulations of the exoskeleton in action, driven by the user’s
closing and opening finger motion, with different proportional gains, endeffector masses, and other coefficients. We compared the interaction forces between the index finger and the ring in both passive and active modes. The best performing assistive controller can reduce the force from around 1.45N (in passive mode) to only around 0.52N, more than 64% of reduction. As a result, the muscle activations of the flexors and extensors were reduced significantly. We also noted the admittance control scheme is versatile and can also provide resistance (e.g. for strength training) by simply increasing the virtual end-effect mass.
Stroke, one of the leading causes of adult disability, affects approximately 800,000 individuals each year in the United States . Nearly 80% of stroke survivors suffer
from hemiparesis of the upper arm and thus impaired hand function, which is integral
to most activities of daily living. It is well established that highly repetitive training
can aid in the recovery of motor function of the hand however this can be labor intensive for the providing physical therapist in addition to the cost. In the past decade,
more robotic hand rehabilitation devices have been introduced to help patients recover
hand function through assistance during repetitive training of the hand [2-4].
In a comprehensive review by Heo et al. , hand exoskeleton technologies for rehabilitation and assistive engineering, from basic hand biomechanics, neurophysiology, sensors and actuators, physical human-robot interactions and ergonomics, are summarized. Different types of actuators and control schemes have been used for hand exoskeletons. In some control schemes, the robotic device will move the user passively through a preprogrammed trajectory for continuous passive movement (CPM) therapy. These devices can be beneficial for severely impaired individuals who may not have the ability to generate the forces required for specific finger or hand movement or for individuals who have abnormal muscle synergies preventing continuous movement. A few devices such as the Kinetic Maestra and Vector 1 are commercially available devices that are used for CPM [5, 6]. These devices allow for
passive movement through the range of motion for individual fingers. However, as
there is no active participation by the user, this device on its own may not promote
neurorehabilitation. These devices can be combined with other simulations or control
schemes that require active participation by the user. One commercially available
hand exoskeleton that has been used extensively by our lab to provide haptics to virtual simulations is the CyberGrasp . The CyberGrasp is a cable driven exoskeleton
that weighs 450 grams and can provide up to 12 N of force on each finger and can be
used to provide assistance for extension of the user’s fingers. In one study, this was
used in combination with a virtual reality simulation to train finger individuation as
the user played a virtual piano . The CyberGrasp was used to resist finger flexion
of the inactive fingers, promoting movement of the active independent finger. Similarly, the eXtension Glove (X-Glove) was developed to be used for cyclical stretching
in addition to active movement training [9-11]. This cable driven design is actuated
using linear servos allowing for individual finger movement in both extension and
flexion. In addition to this, each cable is integrated with a tension sensor which allows
the force of each digit to be monitored. This device has two modes that can be used
for rehabilitation, the first mode cyclically extends and flexes the fingers. The second
mode is an active training mode in which the glove provides constant extension assistance so that the user can complete flexion tasks as long as they overcome the force
required to keep the finger extended. In a further attempt to integrate user control with
the exoskeleton, an external input from the user such as force or electromyography
has been incorporated into some designs such as the Helping Hand . This soft
robotic device allows for active assistance for each finger individually, in addition to
the ability to follow control states triggered by EMG.
In this paper, we introduce a low cost 1-DOF hand exoskeleton for neuromuscular
rehabilitation of individual fingers. This exoskeleton consists of a base equipped with
a servo motor, an index finger component and a thumb component connected with
gears. The exoskeleton’s control system was designed to generate suitable actuation
torques based on the interaction force between the user’s finger and the exoskeleton’s
index component. The goal of this study is to model the exoskeleton interacting with a
neuromuscular hand model in order to evaluate the effectiveness of an intuitive admittance control algorithm on providing different levels of assistance or resistance during hand rehabilitation.
2.1 The 1-DOF Exoskeleton and Hand Model
This exoskeleton consists of a base stationed with a servo motor (Dynamixel
XM430), an index finger part and a thumb part, which are connected through 3 gears
of equal sizes as shown in Fig. 1. The motor drives the top gear which in turn rotates
the gear attached to the index part and then the gear attached the thumb part. The
index and thumb parts both have rings for the fingers, and an OptoForce tri-axial load
cell or force sensor (OnRobot, Denmark) is attached to the index ring. All parts are
3D printed with a carbon fiber reinforced nylon material called Onyx (Markforged,
USA). The total weight of this exoskeleton is 0.158kg and the mass and inertia properties of its components, which were either measured or computed based on material
and part geometry, are listed in Table 1.
[Abstract] Decoupling Finger Joint Motion in an Exoskeletal Hand: A Design for Robot-assisted Rehabilitation
In this study, a cable-driven exoskeleton device is developed for stroke patients to enable them to perform passive range of motion exercises and teleoperation rehabilitation of their impaired hands. Each exoskeleton finger is controlled by an actuator via two cables. The motions between the metacarpophalangeal and distal/proximal interphalangeal joints are decoupled, through which the movement pattern is analogous to that observed in the human hand. A dynamic model based on the Lagrange method is derived to estimate how cable tension varies with the angular position of the finger joints. Two discernable phases are observed, each of which reflects the motion of the metacarpophalangeal and distal/proximal interphalangeal joints. The tension profiles of exoskeleton fingers predicted by the Lagrange model are verified through a mechatronic integrated platform. The model can precisely estimate the tensions at different movement velocities, and it shows that the characteristics of two independent phases remain the same even for a variety of movement velocities. The feasibility for measuring resistance when manipulating a patient’s finger is demonstrated in human experiments. Specifically, the net force required to move a subject’s finger joints can be accounted for by the Lagrange model.
[Abstract] Gesture Interaction and Augmented Reality based Hand Rehabilitation Supplementary System – IEEE Conference Publication
[Abstract + References] Design of Isometric and Isotonic Soft Hand for Rehabilitation Combining with Noninvasive Brain Machine Interface
In recent years, stroke has became one of the major health problems which significantly affect the daily life of the elderly, and hand rehabilitation is introduced as an auxiliary treatment. Though various kinds of mechanical devices for hand rehabilitation have been developed, some deficiencies still exist in the current rigid rehabilitation hand, such as the degrees of freedom is not enough, complexity, unsafe status, overweight, being uncomfortable, unfitness and so on. Therefore, with the growth of aging population, it is highly needed to develop some new devices to satisfy the comprehensive rehabilitation requirements. Meanwhile, inspired by the mollusks in nature, soft robot is made of soft materials that can withstand large strains. It is a new type of continuum robot with high flexibility and environmental adaptability. The soft robot has a broad application prospects in military detection techniques, such as instance search, rescue, medical application and other fields.