Abstract
BackgroundSpinal cord injury is a devastating condition that can dramatically impact hand motor function. Passive and active assistive devices are becoming more commonly used to enhance lost hand strength and dexterity. Soft robotics is an emerging discipline that combines the classical principles of robotics with soft materials and could provide a new class of active assistive devices. Soft robotic assistive devices enable a human-robot interaction facilitated by compliant and light-weight structures. The scope of this work was to demonstrate that a fabric-based soft robotic glove can effectively assist participants affected by spinal cord injury in manipulating objects encountered in daily living.MethodsThe Toronto Rehabilitation Institute Hand Function Test was administered to 9 participants with C4-C7 spinal cord injuries to assess the functionality of the soft robotic glove. The test included object manipulation tasks commonly encountered during activities of daily living (ADL) and lift force measurements. The test was administered to each participant twice; once without the assistive glove to provide baseline data and once while wearing the assistive glove. The object manipulation subtests were evaluated using a linear mixed model, including interaction effects of variables such as time since injury. The lift force measures were separately evaluated using the Wilcoxon signed-rank test.ResultsThe soft robotic glove improved object manipulation in ADL tasks. The difference in mean scores between baseline and assisted conditions was significant across all participants and for all manipulated objects. An improvement of 33.42 ± 15.43% relative to the maximal test score indicates that the glove sufficiently enhances hand function during ADL tasks. Moreover, lift force also increased when using the assistive soft robotic glove, further demonstrating the effectiveness of the device in assisting hand function.ConclusionsThe results gathered in this study validate our fabric-based soft robotic glove as an effective device to assist hand function in individuals who have suffered upper limb paralysis following a spinal cord injury.
Highlights
Spinal cord injury is a devastating condition that can dramatically impact hand motor function
Many individuals with hand paralysis who retain wrist motor function can generate a type of passive grasp called tenodesis grasp
As for the secondary outcome of the Toronto Rehabilitation Institute Hand Function Test (TRI-HFT), we focused on the overall improvement across all dynamometric measures of lift force rather than analyzing each test method and individual participant
Summary
Spinal cord injury is a devastating condition that can dramatically impact hand motor function. Many individuals with hand paralysis who retain wrist motor function can generate a type of passive grasp called tenodesis grasp. This passive grasp relies on the weak elasticity of the hand muscle fibers and of the connective tissue elements composing the muscle-tendon-bone unit. Tenodesis grasp functions by contracting extensor muscles in the wrist and forearm through wrist extension This action pulls the finger tendons towards the wrist, forcing a bending moment, which can be employed to produce a grasping posture in the paralyzed hand. The passive forces produced by a tenodesis grasp are weak and generally only sufficient to lift lightweight objects when the forearm is supinated and gravity is assisting [5]. An active grasp would benefit SCI patients by allowing them to lift heavier objects and manipulate them in free space
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