Wrist Rehabilitation Device Research Articles

Design and development of a wrist rehabilitation device with an interactive game

In this paper, a wrist rehabilitation device integrated with an interactive game is developed. The device is designed for flexion/extension and ulnar/radial motions. The motion of the wrist joint is measured by an optical encoder. A hall sensor is also used to measure the force emitted from the DC motor. These data are fed back to the interactive gaming environment to create the movement of goals in the video game. There are two types of interactive games designed. The first requires the practitioner to move their wrist to achieve a specific goal. The second exercise requires the practitioner to move their wrist joint continuously to reach moving targets. In the game interface, therapists can easily adjust training intensity, training time, and change training limits depending on the recovery status of the patients. At the same time, it also records the patient's training efforts and monitors visual graphs of performance during exercise. The experiments were conducted to tune the games and to get a preliminary evaluation of the device. The feedback from the patients and therapists are recorded to improve the device and game interfaces. Game parameters are adjusted during the patient's exercise process under the supervision of a physiotherapist. The values of rotation angle and torque are collected and then presented in graphs so that physiotherapists can assess the patient's recovery status. The results show that the patients enjoy the games. The therapist is satisfied with the game interface and says that the games are intuitive and easy to play.

Design and Development of Portable Wrist Rehabilitation Device for Post-Stroke Subjects: A Pilot Study

Wrist mobility is vital for post-stroke patients to carry out their daily activities. The use of robotic devices in hand rehabilitation has increased significantly in recent years, allowing patients to get training at home and effectively compensating for the therapist-to-patient ratio. Nevertheless, rehabilitation devices are expensive, cumbersome, immobile, and difficult to wear and operate. This work proposes a new method for designing a wrist rehabilitation device that uses airbag technology to minimize device weight and size. A triangular prism-shaped Neoprene (synthetic rubber) airbag is utilized in the experiment; which is inflated and deflated using a DC motorized air pump. An accelerometer sensor serves as the control input for the wrist rehabilitation exercise device. The proposed device trains the impaired hand of ten hemiplegic post-stroke patients. A goniometer and Fugl-Meyer Assessment (FMA) are used to measure wrist motion before and after the training regimen to evaluate the results. The mean angle (in degree) of wrist flexion increases from 8.6 ± 2.59 to 18.4 ± 5.19 (p = 0.005). Likewise, an increase in the wrist extension angle from 12.3 ± 3.62 to 17.7 ± 6.2 (p = 0.008) is noted. The wrist rehabilitation device is lightweight, portable, and simple to use, producing good results for hemiplegic individuals with hand disability. The suggested invention enables the user to extend their wrist’s range of motion.

Design and hybrid impedance control of a new compliant wrist rehabilitation device

Over a decade, wrist rehabilitation robots have been proved to be efficient in the rehabilitation of patients with stroke or wrist injuries. Wrist rehabilitation devices compensate for deficiencies in manual rehabilitation training and reduce the workload of physiotherapists with their repetitive and gradual training necessary to rehabilitate patients with wrist impairments properly. Two design approaches have been reported in literature for wrist rehabilitation robotic devices. In one design approach, the strategy of placing the actuators, either linear or rotary, on the forearm to minimise the weight and inertia has been proposed. This necessitates a use of sophisticated transmission systems. In the other design approach, rotary motors have been proposed to be placed directly on the wrist joints, which results in a high weight and inertia. In this paper, a new 2-DOF compliant wrist rehabilitation device that can achieve the flexion-extension and radial-ulnar rehabilitation movements compliantly is proposed. In the proposed design, two series elastic actuators (SEAs), each consists of a servomotor and a custom-designed series elastic unit, are proposed to be placed directly on the wrist joints. In order to minimise the inertia and the required torques, the device is counterweight balanced by optimising the centre of mass of the device in the SolidWorks model. Based on the device dynamics modelled by ADAMS software, hybrid position and force tracking impedance control with the incorporation of a disturbance observer controller for the rotary SEA is developed for position and force tracking through the different therapeutic exercises. The disturbance observer controller is incorporated for high precision force control and robustness against exogenous disturbances. Simulation results demonstrate high performance of the proposed wrist rehabilitation device in terms of precise position and force trajectories tracking and robustness against exogenous disturbance as well as patient safety during all therapeutic exercises.

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.

Robot-assisted assessment of the effects of self-aligning mechanism on the wrist passive range of motion

Axis alignment between human and robot has been a research hotspot in wearable rehabilitation robots and has a significant effects on full natural ranges of motion (ROM) during robot-assisted training exercises. Self-alignment mechanism (SAM) has been extensively applied on the rehabilitation robots to adaptively compensate the axis misalignment between human anatomic and robot mechanical joints. However, the effects of the SAM on the wrist ROM have not been definitely assessed. In this study, we implemented a SAM on a wrist rehabilitation device (WReD II), and the SAM was specially designed to be locked or unlocked to achieve self-alignment function or not according to demands. To assess the effects of SAM on the wrist passive ROM of extension/flexion (E/F), passive training experiments involving 8 healthy participants were conducted by locking or unlocking the SAM respectively. Surface Electromyography (sEMG) was applied to monitor muscle activity during experiments. During the experiments, the wrist passive ROM were measured by applying the robot-assisted assessment technique. Preliminary results show that the means of the passive ROM have a maximum increase of 19.78° in the case with SAM unlocked when compared to the case with SAM locked. Statistical results indicated high test-retest reliability of the passive ROM measurements with intraclass correlation coefficient ICC (2,1) more than 0.82, and standard error of measurement (SEM) less than 3.2°. These findings suggest that the implement of SAM on the rehabilitation robots has great potentials due to its feasibility and reliability to obtain larger natural passive ROM.

Development of Wrist Rehabilitation Device Using Extension Type Flexible Pneumatic Actuators with Simple 3D Coordinate Measuring System

Rehabilitation devices have been developed to assist patients recover from physical disabilities by using specific devices to do an exercise, training and therapy. The purpose of this study is to develop a home-based rehabilitation device which is safe to use and without requirement of person-in-charge. In this study, a simple home-based wrist rehabilitation device which can give passive exercise on spherical orbit while patients hold its handles is proposed and tested. The device has two moving handling stage driven by 6 extension type flexible pneumatic actuators (“EFPA” for short) on two hemispherical acrylic domes. The device can give passive exercise for the upper limb by changing the relative position of the patient’s hands. In this paper, the construction and operating principle of the tested device are described. A low-cost 3-dimentional coordinate measuring system using two wire-type linear potentiometers to control the position of the holding stages is also described. In addition, the tracking position control of the holding handles on sphere is carried out. As a result, it can be found that the handling stage of the tested device can trace the desired orbit based on the coordinates measured from 3-dimentional coordinate measuring system. It can be confirmed that the tested wrist rehabilitation device has a possibility to apply passive movements to the wrist along desired orbit while patients hold its handles.

Determining the Effectiveness of a New Device for Hand Therapy (The FEPSim Device): Feasibility Protocol for a Randomized Controlled Trial Study.

BackgroundImpairments of the forearm, wrist, and hand affect a sizable proportion of individuals and impose a significant economic burden on health care systems. FEPSim is a medical device for hand and wrist rehabilitation. The FEPSim device could be part of the standard of care for upper extremity rehabilitation during therapeutic activities to increase range of motion, dexterity, and strength. FEPSim has not yet been tested in a health care setting; therefore, a trial of the effectiveness of FEPSim in upper extremity rehabilitation is warranted.ObjectiveThis study aims to assess the feasibility of conducting a definitive trial in terms of recruitment, eligibility criteria, the type and number of diagnoses included, the length and dosage of the intervention, and data collection methods. This study also aims to gather clinical and statistical information as well as information related to the cost and usability, which allows for an economic evaluation of the device.MethodsThe trial will use a randomized controlled design comprising 47 intervention participants and 47 control group participants. Participants will be adults (age≥18 years) attending outpatient rehabilitation with limitations in their forearm, wrist, or hand function due to distal radial or ulnar fractures, stroke, or osteoarthritis. This study’s primary outcome variables are related to patients’ range of motion and strength, specifically active and passive wrist flexion and extension range of motion; active and passive forearm pronation and supination range of motion; grip strength; and pinch strength. The secondary outcome variables are related to patients’ perceived wrist pain and disability in activities of daily living. The patients’ perceived wrist pain and disability in activities of daily living will be measured using the patient-rated wrist evaluation questionnaire. The control group will receive the standard of care at each of the 2 hospital facilities (Glenrose Rehabilitation and Royal Alexandra Hospitals). The intervention group will receive the same standard of care as the control group at each facility and will use the FEPSim device for therapeutic activities to increase strength, range of motion, resistance, and dexterity. All the participants will be assessed at baseline (week 0); weeks 2, 4, and 8; and postintervention (week 10).ResultsThe FEPSim study was launched in April 2020. This study is currently on hold because of the global COVID-19 pandemic. The recruitment process is expected to resume by September 2020, and the primary impact analysis is expected to be conducted by December 2020.ConclusionsThis study will provide valuable information on the measurement of comparative intervention effects, technology acceptance by hand therapists, and how associated treatment and product costs will contribute to the evidence planning process, which will be crucial for the future adoption of FEPSim.Trial RegistrationInternational Standard Randomized Controlled Trial Number Registry ISRCTN13656014; https://www.isrctn.com/ISRCTN13656014International Registered Report Identifier (IRRID)PRR1-10.2196/22145

In-hospital professional production of patient-specific 3D-printed devices for hand and wrist rehabilitation

The reported use of 3D printing in hand and wrist rehabilitation has been mostly limited to feasibility studies and case series so far. Some of the reasons are the lack of purpose-built scanning applications, complicated digital design software, and lengthy and error-prone printing processes. We propose a multidisciplinary workflow for in-hospital mass production of patient-specific 3D-printed devices for hand and wrist rehabilitation.

Development of a Tetrahedral-Shaped Soft Robot Arm as a Wrist Rehabilitation Device Using Extension Type Flexible Pneumatic Actuators

Based on aging Japanese society, there has been a strong desire for development of rehabilitation devices that patients can use at home. The purpose of this study is to develop a home-based compact, lightweight, flexible, and safe rehabilitation device. In this study, a flexible robot arm for wrist rehabilitation that can be used, while patients hold the top of the robot arm, is proposed and tested. The proposed robot arm consists of three extension type flexible pneumatic actuators (EFPAs) restrained by 22 PET sheets. To achieve suitable bending stiffness of the robot arm, three EFPAs are restrained so as to form a tetrahedral shape. The robot arm can bend toward each radial direction. In this paper, the construction and operational principles of the tested robot arm are described. Additionally, the analytical model of the robot arm for attitude control is also described. In addition, the tracking control using the robot arm for the desired orbit is performed. As a result, the tested robot arm can trace the desired orbit based on the model. It is confirmed that the robot arm has the possibility for application as a wrist rehabilitation device for patients.

Design of a Patient Wrist Rehabilitation Device with Servo Motor Drive

Stroke represents a condition that occurs when the blood supply to the brain is interrupted or reduced due to a blockage (ischemic stroke) or rupture of a blood vessel (hemorrhagic stroke). A person who suffers a stroke will have a brain disorder that causes him/her unable to carry out activities like other healthy people. In general, stroke sufferers have paralysis in several parts of the body, like the hands, feet, and even the face. With technological developments in this era, stroke can be healed in various ways that have been developed by health experts. Healing can be referred to the treatment result for blocked or damaged blood vessels. However, the sufferer’s paralysis cannot return to the normal condition immediately, so it requires therapy or exercises to stimulate the muscles in the hands, feet, or face. This study focuses on developing a therapeutic device on the wrist that has a swivel joint. To design the wrist rehabilitation device with servo motor drive, some researches about existing products need to be reviewed. From that, a list of requirements is compiled, which is used for designing the concept of a wrist rehabilitation device. It is expected that an automatic wrist rehabilitation device can help post-stroke patients undergo the rehabilitation process.

Development of a Wrist Rehabilitation Device with Android-based Game Application

Traditional methods of rehabilitation that lacking excitement can contribute to demotivate patients in completing rehabilitation. Thus, interactive and interesting rehabilitation methods are essential to ensure stroke patients continue rehabilitation activity. This project proposes a wireless home based wrist rehabilitation device with an android-based game application (app). The patients will be able to do wrist therapy at home or anywhere with the rehabilitation device. The device is consists of an accelerometer that can measure acceleration in three dimensional space. It is developed in free wrist movement such as roll, pitch and yaw. The accelerometer data is processed by an Arduino Micro, and converted into mouse cursor movement that can be used in an android-based game app for rehabilitation. The game app called “BallGame” is being developed using the MIT App Inventor software. In this work, the hardware development of the rehabilitation device is presented. Furthermore, early development stages of the game app is described where the data from the rehabilitation device is successfully transmitted to the app via Bluetooth communication.

State-of-the-Art Robotic Devices for Wrist Rehabilitation: Design and Control Aspects

Robot-assisted physical therapy of the upper limb is becoming popular among the rehabilitation community. The wrist is the second most complicated joint in the upper limb after shoulder in terms of degrees of freedom. Several robotic devices have been developed during the past three decades for wrist joint rehabilitation. Intensive physical therapy and repetitive self-practice, with objective measurement of performance, could be provided by using these wrist rehabilitation robots at a low cost. There has been an increasing trend in the development of wrist rehabilitation robots to provide safe and customized therapy according to the disability level of patients. The mechanical design and control paradigms are two active fields of research undergoing rapid developments in the field of robot-assisted wrist rehabilitation. The mechanical design of these robots could be divided into the categories of end-effector based robots and wearable robotic orthoses. The control for these wrist rehabilitation robots could also be divided into the conventional trajectory tracking control mode and the assist-as-needed control mode for providing customized robotic assistance. This article presents a review of the mechanical design and control aspects of wrist rehabilitation robots. Experimental evaluations of these robots with healthy and neurologically impaired are also discussed along with the future directions of research in the design and control domains of wrist rehabilitation robots.

Development of Wearable Wrist Rehabilitation Device using Twisted Wire Type Potentiometer and Built-In Controller with Disturbance Observer

Development of Wearable Wrist Rehabilitation Device using Twisted Wire Type Potentiometer and Built-In Controller with Disturbance Observer

Performance evaluation of Wearable Wrist Rehabilitation Device Using Parallel Link Mechanism

Performance evaluation of Wearable Wrist Rehabilitation Device Using Parallel Link Mechanism

Development of Simplified Wearable Wrist Rehabilitation Device Using Low-Friction Type Flexible Pneumatic Cylinders

Development of Simplified Wearable Wrist Rehabilitation Device Using Low-Friction Type Flexible Pneumatic Cylinders

Improvement of Wearable Wrist Rehabilitation Device Using Flexible Pneumatic Cylinders

In the condition of the insufficient number of PT, the novel wearable rehabilitation devices using a soft pneumatic actuator for the elderly are actively proposed and developed. In the previous study, a wearable wrist rehabilitation device based on a flexible robot arm using three flexible pneumatic cylinders was proposed and tested. In this study, the improvement of the device is carried out so as to use it without limitation of attitude of patient’s arm. The attitude control of the improved device based on the analytical model is also carried out. As a result, it is confirmed that the device can give the motion to patients with any attitude of their arm according to the desired position.

Development of Wearable Wrist Rehabilitation Device Using Flexible Pneumatic Cylinders

In the condition of the insufficient number of PT, the novel wearable rehabilitation devices using a soft pneumatic actuator for the elderly are actively proposed and developed. In the previous study, a wearable wrist rehabilitation device based on a flexible robot arm using three flexible pneumatic cylinders was proposed and tested. In this study, the improvement of the device is carried out so as to use it without limitation of attitude of patient’s arm. The attitude control of the improved device based on the analytical model is also carried out. As a result, it is confirmed that the device can give the motion to patients with any attitude of their arm according to the desired position.

Design of Wrist Rehabilitation Device for Hemiplegic Patients

There have been some devices for rehabilitations of upper limb such as electronic device and mechanical device which is well-known as the passive one. These devices make the motion of upper limbs and stimulate the wrist, elbow, shoulder joints with muscles. This motion does by using the patient’s normal hand (left or right hand) and rotating the wounded hand’s wrist to be recovered by the clockwise or counterclockwise with some angles. Electronic devices for upper limb rehabilitation have the advantage that the electronic ones can supply various rehabilitation exercises to the patients. However these electronic devices include relatively expensive components such as various kinds of sensors, controllers, and display device. Therefore, the prices of implementation are too expensive. On the other hand, in conventional passive upper limb rehabilitation, the patients grasp the both handles without any mechanical links. It does not supply proper rehabilitation motion because the normal hand does not supply the rehabilitation motion to hand to be recovered. So to speak, this is not proper to patients with the one hands trouble such as hemiplegic patients, by himself without the aids of any other persons. In this paper, we describe the mechanical device for rehabilitations of wrist and the proposed handles to be attached in this mechanical device. This proposed handles can generate the three angle motion of wrist such as the roll, pitch and yaw. This proposed device has some features that this device can be implemented with lower costs than electronic devices and can be used whatever the wounded hand is right or left by selecting the lever. Further, when the patient has the rehabilitation exercise intent, the patients can easily use the proposed upper limb rehabilitation devices without the aid of the rehabilitation therapist the energy source is the normal hands of the patients.

Investigation of Polymer Thick-film Piezoresistors for Medical Wrist Rehabilitation and Artificial Knee Load Sensors

Readily-available and low-cost commercial polymer-based composite materials, such as standard epoxy-fibreglass printed circuit board (PCB) substrates and resin-carbon thick-film piezoresistors, were evaluated as a solution for medical force sensors, such as a wrist rehabilitation device and an implantable wireless artificial knee force sensor. We show that such materials have high sensitivity, and sufficient short-term stability – provided careful mechanical design and materials selection are made - to allow fabrication of low-cost, robust sensors, with low processing temperatures compatible with electronics integration. Example load-sensing applications are a multi-axis wrist rehabilitation device and a knee prosthesis.

The Development of Wrist Rehabilitation Assistive Devices Using a Shape Memory Alloy

For the purpose of wrist rehabilitation, a new type of SMA (Shape memory alloy) wrist rehabilitation device is developed. The palm will be actuated/lifted by the SMA’s driving force when the shape memory alloy is heated up. Four wires of the shape memory alloy (SMA-Ti50Ni45Cu5 with 1.0mm in ψ) are bundled and passed through a fixed plastic block. The whole set of the SMA wrist rehabilitation devices can give support to the palm’s bending mechanism. A 500(g) adult palm is presented in the experimental work. In order to actuate/lift the palm at a sufficient rehabilitation angle, an electrical circuit of 10(A) is adopted. Consequently, the issue, here, is to present a new type of SMA wrist splint that is used to provide a specified rehabilitation angle for the wrist.