Abstract
Recovery of functional hand movements after stroke is directly linked to rehabilitation duration and intensity. Continued therapy at home has the potential to increase both. For many patients this requires a device that helps them overcome the hyperflexion of wrist and fingers that is limiting their ability to open and use their hand. We developed an interactive hand and wrist orthosis for post-stroke rehabilitation that provides compliant and adaptable extension assistance at the wrist and fingers, interfaces with motivational games based on activities of daily living, is integrated with an off-the-shelf mobile arm support and includes novel wrist and finger actuation mechanisms. During the iterative development, multiple prototypes have been evaluated by therapists in clinical settings and used intensively and independently by 33 patients at home. This paper details the final design of the SCRIPT passive orthosis resulting from these efforts.
Highlights
Stroke is the primary cause of movement disabilities in the developed world (Dipietro et al 2007; Poungvarin 1998)
In this paper we present the final design of this orthosis, called the SCRIPT passive orthosis (SPO)-F
Based on the lessons we learned from this development process, we decided that passive but dynamic interaction was the best approach for the final design presented here, called the SPO-F
Summary
Stroke is the primary cause of movement disabilities in the developed world (Dipietro et al 2007; Poungvarin 1998). Hypertonia, spasticity, abnormal synergies, and extension weakness lead to hyperflexion of the wrist and fingers that limit their ability to voluntarily open and use their hand. This has a severe detrimental effect on ADL such as drinking, eating or getting dressed, and thereby reduces the quality of life of the affected individual. Patients perform multiple but repetitive movements, such as flexing and extending the wrist and fingers, in order to regain motor function. These sessions are scheduled at times fitting to the schedule of the physiotherapists and are expensive and often tedious
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