Hand Rehabilitation Device Research Articles

A Simple Non-Powered Hand Rehabilitation Device Capable of Adjusting the Individual Finger Load: A Pilot Study

A Simple Non-Powered Hand Rehabilitation Device Capable of Adjusting the Individual Finger Load: A Pilot Study

Mechatronics System Design and Implementation of a Pneumatic Hand Rehabilitation Device

Mechatronics System Design and Implementation of a Pneumatic Hand Rehabilitation Device

4D Printing Hybrid Soft Robots Enabled by Shape-Transformable Liquid Metal Nanoparticles.

In recent years, soft robotics has emerged as a rapidly expanding frontier research field that draws inspiration from the locomotion mechanisms of soft-bodied creatures in nature to achieve smooth and complex motion for diverse applications. However, the fabrication of soft robots with hybrid structures remains challenging due to limitations in material selection and the complex, multi-step processes involved in traditional manufacturing methods. Herein, a novel direct one-step additive manufacturing (3D printing) approach is introduced for the fabrication of hybrid robots composed of soft and rigid components for sophisticated tasks. Inspired by the shape-transformable liquid metal nanoparticles (LMNPs), a functional material toolkit with tuneable mechanical properties and deformability is developed by integrating differently shaped gallium-based nanoparticles (GNPs) into the 3D printing polymers. Then the direct printing of assembled or one-piece hybrid soft-rigid robots is presented through a single recipe of GNPs-integrated inks. This fabrication method enables precise control of the mechanical properties and shape memory properties within the hybrid structures of robot body with a customized structure design. Their capabilities are further demonstrated through the design and fabrication of hybrid robots as high-precision gripper, bioinspired motor, and hand rehabilitation device.

Stroke Survivors' Interaction With Hand Rehabilitation Devices: Observational Study.

The hand is crucial for carrying out activities of daily living as well as social interaction. Functional use of the upper limb is affected in up to 55% to 75% of stroke survivors 3 to 6 months after stroke. Rehabilitation can help restore function, and several rehabilitation devices have been designed to improve hand function. However, access to these devices is compromised in people with more severe loss of function. In this study, we aimed to observe stroke survivors with poor hand function interacting with a range of commonly used hand rehabilitation devices. Participants were engaged in an 8-week rehabilitation intervention at a technology-enriched rehabilitation gym. The participants spent 50-60 minutes of the 2-hour session in the upper limb section at least twice a week. Each participant communicated their rehabilitation goals, and an Action Research Arm Test (ARAT) was used to measure and categorize hand function as poor (scores of 0-9), moderate (scores of 10-56), or good (score of 57). Participants were observed during their interactions with 3 hand-based rehabilitation devices that focused on hand rehabilitation: the GripAble, NeuroBall, and Semi-Circular Peg Board. Observations of device interactions were recorded for each session. A total of 29 participants were included in this study, of whom 10 (34%) had poor hand function, 17 (59%) had moderate hand function, and 2 (7%) had good hand function. There were no differences in the age and years after stroke among participants with poor hand function and those with moderate (P=.06 and P=.09, respectively) and good (P=.37 and P=.99, respectively) hand function. Regarding the ability of the 10 participants with poor hand function to interact with the 3 hand-based rehabilitation devices, 2 (20%) participants with an ARAT score greater than 0 were able to interact with the devices, whereas the other 8 (80%) who had an ARAT score of 0 could not. Their inability to interact with these devices was clinically examined, and the reason was determined to be a result of either the presence of (1) muscle tone or stiffness or (2) muscle weakness. Not all stroke survivors with impairments in their hands can make use of currently available rehabilitation technologies. Those with an ARAT score of 0 cannot actively interact with hand rehabilitation devices, as they cannot carry out the hand movement necessary for such interaction. The design of devices for hand rehabilitation should consider the accessibility needs of those with poor hand function.

User Needs for a Robotic Hand Rehabilitation Device in Home-based Therapy Following a Stroke: A User-centered Approach

User Needs for a Robotic Hand Rehabilitation Device in Home-based Therapy Following a Stroke: A User-centered Approach

A study on the intention of upper limb hemiplegic patients to use interactive gaming devices for hand rehabilitation

Investigating stroke patients with hemiplegia, this study explores how various pre-factors and personal characteristics influence their intention to use interactive gaming devices (IGDs) for hand rehabilitation. Key pre-factors include performance expectancy, effort expectancy, social influence, hedonic motivation, and game design, while personal characteristics cover age, gender, digital experience, and stroke severity. The research, involving 38 participants, integrates these elements into the development of IGDs, using a survey based on an extended Unified Theory of Acceptance and Use of Technology. Results indicate that hedonic motivation, affected by performance and effort expectancy as well as game design, plays a crucial role in patients’ willingness to use IGDs. Additionally, stroke severity emerges as a significant moderator in this context. These findings highlight the importance of aligning game design with patient expectations and conditions to enhance engagement and efficacy in hand rehabilitation using IGDs.

Assist-as-needed control with a soft robotic glove based on human-object contact estimation

Assist-as-needed control with a soft robotic hand glove for active rehabilitation is studied in this work. There are two resources of the grasping force, the robotic glove and the subject. Compared with traditional passive rehabilitation where the grasping force is merely provided by a robotic hand rehabilitation device (such as hand exoskeleton, robotic glove), assist-as-needed control accounts for the user contribute to performing grasping tasks collaboratively. In this control method, the human muscle strength for grasping is estimated through the myoelectrical signals of the human forearm collected by the MYO armband. A neural network is used for the recognition of human-object contact estimation. The assist-as-needed control is finally implemented to assist humans in grasping tasks. Experiment results on a soft robotic glove show the effectiveness of the proposed assistive control method.

Design, Modeling and Experiments of a Variable Stiffness Soft Robotic Glove for Stroke Patients With Clenched Fist Deformity

Soft wearable devices for hand rehabilitation can assist activities of daily living. While existing soft robotic gloves can help with finger flexion, they are less suitable for patients who cannot extend their fingers due to poststroke increased muscular tension. In this letter, we proposed a variable stiffness pneumatic actuator that effectively increases the elasticity of the actuator to facilitate finger extension. The actuator consists of a fiber-reinforced actuator and a multi-stage articulated elastomer. It bends and extends by pneumatic actuation, with multi-stage articulated elastomer providing stiffness adjustment to accommodate varying joint resistance. The variable stiffness mechanism was achieved by the multi layered discrete metal plates which can gracefully fit the unique structure of human fingers. Analysis models were established to quantify the actuator's air pressure, vacuum pressure, and bending angle, also to predict the actuator's stiffness under different vacuum pressures. Experiments and finite element simulation were carried out to evaluate the bending performance of the actuator. Meanwhile, the output force and variable stiffness characteristic of the actuator were tested. The results show that the actuator can achieve 1.54 N fingertip output force and 2.4 times stiffness change, which satisfy the requirement of stroke patient. In addition, a clenched artificial hand with similar damper forces to human hand was applied to further verify the extending effect of the variable stiffness actuator. Finally, a rehabilitation glove integrated with multiple actuators was tested to assess typical rehabilitation gestures and the ability to grasp daily objects.

4D printed origami-inspired accordion, Kresling and Yoshimura tubes.

Applying tessellated origami patterns to the design of mechanical materials can enhance properties such as strength-to-weight ratio and impact absorption ability. Another advantage is the predictability of the deformation mechanics since origami materials typically deform through the folding and unfolding of their creases. This work focuses on creating 4D printed flexible tubular origami based on three different origami patterns: the accordion, the Kresling and the Yoshimura origami patterns, fabricated with a flexible polylactic acid (PLA) filament with heat-activated shape memory effect. The shape memory characteristics of the self-unfolding structures were then harnessed at 60°C, 75°C and 90°C. Due to differences in the folding patterns of each origami design, significant differences in behaviour were observed during shape programming and actuation. Among the three patterns, the accordion proved to be the most effective for actuation as the overall structure can be compressed following the folding crease lines. In comparison, the Kresling pattern exhibited cracking at crease locations during deformation, while the Yoshimura pattern buckled and did not fold as expected at the crease lines. To demonstrate a potential application, an accordion-patterned origami 4D printed tube for use in hand rehabilitation devices was designed and tested as a proof-of-concept prototype incorporating self-unfolding origami.

Personalized and Safe Soft Glove for Rehabilitation Training

Traditional hand rehabilitation devices present a challenge in providing personalized training that can lead to finger movements exceeding the safe range, resulting in secondary injuries. To address this issue, we introduce a soft rehabilitation training glove with the function of safety and personalization, which can allow patients to select training modes based on rehabilitation and provide real-time monitoring, as well as feedback on finger movement data. The inner glove is equipped with bending sensors to access the maximum/minimum angle of finger movement and to provide data for the safety of rehabilitation training. The outer glove contains flexible drivers, which can drive fingers for different modes of rehabilitation training. As a result, the rehabilitation glove can drive five fingers to achieve maximum extension/flexion angles of 15.65°/85.97°, 15.34°/89.53°, 16.78°/94.27°, 15.59°/88.82°, and 16.73°/88.65°, from thumb to little finger, respectively, and the rehabilitation training frequency can reach six times per minute. The safety evaluation result indicated an error within ±6.5° of the target-motion threshold. The reliability assessment yielded a high-intra-class correlation coefficient value (0.7763–0.9996). Hence, the rehabilitation glove can achieve targeted improvement in hand function while ensuring safety.

Successfully Implementing a Clinically-Used Therapy Device in a Home-Therapy Setting.

Telerehabilitation has the potential to improve the outcomes of rehabilitation. To expand tele-rehabilitation, the REHA2030 project aimed to integrate medical devices in therapy. To use medical devices in an unsupervised setting within a telerehabilitation system, requirements, processes and control mechanisms need to be defined. In a field trail with four patients and seven therapists, the REHA2030 system with an integrated hand rehabilitation device was evaluated. The aim of including the hand rehabilitation device in combination with a serious game was to increase hand strength and sensor-motor function and to test the feasibility in a home setting. From the four included patients two used the hand rehabilitation device within the field test and trained with it in average 5,8 respectively 5,2 times per week over a period of 10 respectively 5 weeks. The statements of the participants indicate an increase in exercise intensity and frequency and an increase in motivation to practice independently. Easy handling of the system by therapists and patients could also be demonstrated. Further results with more study participants over a longer period of time are needed to validate the results.

Soft Robotic Glove with Sensing and Force Feedback for Rehabilitation in Virtual Reality.

Many diseases, such as stroke, arthritis, and spinal cord injury, can cause severe hand impairment. Treatment options for these patients are limited by expensive hand rehabilitation devices and dull treatment procedures. In this study, we present an inexpensive soft robotic glove for hand rehabilitation in virtual reality (VR). Fifteen inertial measurement units are placed on the glove for finger motion tracking, and a motor-tendon actuation system is mounted onto the arm and exerts forces on fingertips via finger-anchoring points, providing force feedback to fingers so that the users can feel the force of a virtual object. A static threshold correction and complementary filter are used to calculate the finger attitude angles, hence computing the postures of five fingers simultaneously. Both static and dynamic tests are performed to validate the accuracy of the finger-motion-tracking algorithm. A field-oriented-control-based angular closed-loop torque control algorithm is adopted to control the force applied to the fingers. It is found that each motor can provide a maximum force of 3.14 N within the tested current limit. Finally, we present an application of the haptic glove in a Unity-based VR interface to provide the operator with haptic feedback while squeezing a soft virtual ball.

Interactive device for the treatment of pediatric neuromotor deficiencies using personalized recovery programs

Abstract: Modern rehabilitation procedures use devices that provide physical therapists with various types of information to improve assessment of patient progress during reha-bilitation plans. The new trend of these technologies is the development of safe, portable and comfortable wearable devices with extensive applications in various environments (medical clinics or at the patient's home). The present work presents a portable and safe device for hand rehabilitation, consisting of five finger force sensors and a palmar sensor arranged in the ball, capable of capturing pressure signals during the execution of move-ments guided by the physiotherapist or by a video game/virtual reality. A 3-axis accel-erometer was used to spatially monitor the patient's movements. A series of games with different levels of difficulty were created, through which the degree of mobility of the pa-tient can be monitored depending on the game he chooses and at the same time reflected by the score obtained at the end of the game. Also, to be more interactive, the interface was chosen to play with 2 players simultaneously. So that they can choose to play in the team or as competitors. The system allows users to show different routines to guide them in their use and also evaluates pressure signals and response time. Keywords: microcontroller, games interactive, physiokinetotherapist, rehabilitation, health im-provement.

Understanding the Technology Acceptance and Usability of a New Device for Hand Therapy: Qualitative Descriptive Study.

Upper extremity function plays a critical role in completing activities of daily living, employment, and participating in recreational activities. The FEPSim device is a medical device for hand and wrist rehabilitation that can be adjusted according to the patient's requirements in rehabilitation. Furthermore, the FEPSim can be used to assess the patient's strength and range of motion of the forearm, wrist, and hand. At present, the acceptance and usability of the FEPSim have not been tested in a clinical setting, with limited perspectives from rehabilitation-providing clinicians. This study aims to understand the factors related to the acceptance and usability of the FEPSim device. Upper limb disorders are prevalent across populations. The impact of upper limb disorders, both acute and chronic, puts a significant burden on the Canadian health care system. A qualitative descriptive study was conducted that involved face-to-face semistructured interviews with hand therapists from hand therapy services who used the FEPSim device. We used purposive sampling to recruit 10 participants over a period of 14 months. Semistructured interview questions (topic-guided) examined the technology acceptance and usability of the FEPSim device. We found 6 factors to be critical aspects of the acceptance and usability of the FEPSim device. These factors were (1) useful for therapy, (2) effortlessness, (3) environmental conditions, (4) internal encouragement, (5) technological aesthetics, and (6) use. The FEPSim device was widely accepted by the therapists. The use of the FEPSim device is a feasible alternative for supporting hand therapy. ISRCTN Registry ISRCTN13656014; https://www.isrctn.com/ISRCTN13656014.

Vibrotactile enhancement in hand rehabilitation has a reinforcing effect on sensorimotor brain activities.

ObjectiveStroke patients often suffer from hand dysfunction or loss of tactile perception, which in turn interferes with hand rehabilitation. Tactile-enhanced multi-sensory feedback rehabilitation is an approach worth considering, but its effectiveness has not been well studied. By using functional near-infrared spectroscopy (fNIRS) to analyze the causal activity patterns in the sensorimotor cortex, the present study aims to investigate the cortical hemodynamic effects of hand rehabilitation training when tactile stimulation is applied, and to provide a basis for rehabilitation program development.MethodsA vibrotactile enhanced pneumatically actuated hand rehabilitation device was tested on the less-preferred hand of 14 healthy right-handed subjects. The training tasks consisted of move hand and observe video (MO), move hand and vibration stimulation (MV), move hand, observe video, and vibration stimulation (MOV), and a contrast resting task. Region of interest (ROI), a laterality index (LI), and causal brain network analysis methods were used to explore the brain’s cortical blood flow response to a multi-sensory feedback rehabilitation task from multiple perspectives.Results(1) A more pronounced contralateral activation in the right-brain region occurred under the MOV stimulation. Rehabilitation tasks containing vibrotactile enhancement (MV and MOV) had significantly more oxyhemoglobin than the MO task at 5 s after the task starts, indicating faster contralateral activation in sensorimotor brain regions. (2) Five significant lateralized channel connections were generated under the MV and MOV tasks (p < 0.05), one significant lateralized channel connection was generated by the MO task, and the Rest were not, showing that MV and MOV caused stronger lateralization activation. (3) We investigated all thresholds of granger causality (GC) resulting in consistent relative numbers of effect connections. MV elicited stronger causal interactions between the left and right cerebral hemispheres, and at the GC threshold of 0.4, there were 13 causal network connection pairs for MV, 7 for MO, and 9 for MOV.ConclusionVibrotactile cutaneous stimulation as a tactile enhancement can produce a stronger stimulation of the brain’s sensorimotor brain areas, promoting the establishment of neural pathways, and causing a richer effect between the left and right cerebral hemispheres. The combination of kinesthetic, vibrotactile, and visual stimulation can achieve a more prominent training efficiency from the perspective of functional cerebral hemodynamics.

Novel Planar Strain Sensor Design for Capturing 3-Dimensional Fingertip Forces from Patients Affected by Hand Paralysis.

Assessment and therapy for individuals who have hand paresis requires force sensing approaches that can measure a wide range of finger forces in multiple dimensions. Here we present a novel strain-gauge force sensor with 3 degrees of freedom (DOF) designed for use in a hand assessment and rehabilitation device. The sensor features a fiberglass printed circuit board substrate to which eight strain gauges are bonded. All circuity for the sensor is routed directly through the board, which is secured to a larger rehabilitative device via an aluminum frame. After design, the sensing package was characterized for weight, capacity, and resolution requirements. Furthermore, a test sensor was calibrated in a three-axis configuration and validated in the larger spherical workspace to understand how accurate and precise the sensor is, while the sensor has slight shortcomings with validation error, it does satisfy the precision, calibration accuracy, and fine sensing requirements in orthogonal loading, and all structural specifications are met. The sensor is therefore a great candidate for sensing technology in rehabilitation devices that assess dexterity in patients with impaired hand function.

Generation and evaluation of product concepts by integrating extended axiomatic design, quality function deployment and design structure matrix

Existing product concept generation and evaluation methods are mainly based on designers' experience to determine design schemes in the process of product development, which is time-consuming and ineffective. This paper proposes an approach to generate and evaluate design concepts by integrating the extended axiomatic design, quality function deployment and design structure matrix. Different design domains are mapped for matrix operations to generate feasible concepts based on design criteria. A domain mapping matrix is built to determine technical measures, functional requirements and design parameters based on customer requirements. The proposed approach provides a structured method to quantify, validate and qualify design concepts. A case study of the design of a hand rehabilitation device demonstrates the effectiveness of the proposed method.

Towards Unsupervised Rehabilitation: Development of a Portable Compliant Device for Sensorimotor Hand Rehabilitation.

Sensorimotor impairments of the hand after stroke can drastically reduce the ability to perform activities of daily living. Recently, there has been an increased interest in minimally supervised and unsupervised rehabilitation to increase therapy dosage and to complement conventional therapy. Several devices have been developed that are simple to use and portable. Yet, they do not incorporate diversified somatosensory feedback, which has been suggested to promote sensorimotor recovery. Here we present the prototype of a portable one-degree-of-freedom hand trainer based on a novel compliant shell mechanism. Our solution is safe, intuitive, and can be used for various hand sizes. Importantly, it also provides rich sensory feedback through haptic rendering. We complement our device with a rehabilitation game, where we leverage interactive tangible game elements with diverse haptic characteristics to provide somatosensory training and foster recovery.

Automatic and Personalized Adaptation of Therapy Parameters for Unsupervised Robot-Assisted Rehabilitation: a Pilot Evaluation.

Growing evidence shows that increasing the dose of upper limb therapy after stroke might improve functional outcomes and unsupervised robot-assisted therapy may be a solution to achieve such an increase without adding workload on therapists. However, most of existing robotic devices still need frequent supervision by trained personnel and are currently not designed or ready for unsupervised use. One reason for this is that most rehabilitation devices are not capable of delivering and adapting personalized therapy without external intervention. Here we present a set of clinically-inspired algorithms that automatically adapt therapy parameters in a personalized way and guide the course of robot-assisted therapy sessions. We implemented these algorithms on a robotic device for hand rehabilitation and tested them in a pilot study with 5 subacute stroke subjects over 10 robot-assisted therapy sessions, some of which unsupervised. Results show that our algorithms could adapt the therapy difficulty throughout the whole study without requiring external intervention, maintaining performance around a predefined 70% target value (mean performance for all the subjects over all the sessions: 64.5%). Moreover, the algorithms could guide patients through the therapy sessions, minimizing the number of actions that subjects had to learn and perform. These results open the door to the use of robotic devices in an unsupervised setting to increase therapy dose after stroke.

Design and Analysis of Fiber-Reinforced Soft Actuators for Wearable Hand Rehabilitation Device

Fiber-reinforced soft actuators have great potential for the development of wearable technology. However, its complex structural design, nonlinear soft material body, fluid-driven dynamics and high manufacturing costs have brought huge challenges to system modeling, control and application. To improve this situation, a novel fiber-reinforced soft actuator is designed and analyzed. First, a wearable hand rehabilitation device based on fiber-reinforced soft actuators with three-air-chamber structure is designed. Next, using Yeoh model and principle of virtual work, we establish a bending mathematical model of the soft actuator, whose input parameters are air pressure <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$P$</tex-math></inline-formula> and winding number <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$N$</tex-math></inline-formula> , and output parameter is bending angle <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$\beta$</tex-math></inline-formula> . Finally, through the finite element analysis, the optimal <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$N$</tex-math></inline-formula> is obtained, and the correctness of the model is verified. Additionally, the rehabilitation device is fabricated by using Kevlar fiber, silicone rubber and 3D printing. To verify the above research, an experimental platform is constructed. The results show that the relative error of the modelw is in an acceptable state. The device can imitate common gestures, produce a maximum fingertip force of 0.61 N, easily grasp objects with a volume of 1.6 <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$dm^{3}$</tex-math></inline-formula> and mass of 335.7 g, which can realize the hand rehabilitation training.