Rehabilitation Of Hand Function Research Articles

Conformal, stretchable, breathable, wireless epidermal surface electromyography sensor system for hand gesture recognition and rehabilitation of stroke hand function

Surface electromyography (sEMG) plays a significant role in the everyday practice of clinic hand function rehabilitation. The materials and design of current typical clinic sEMG electrodes are rigid Ag/AgCl or flexible polyimide (PI) film, which cannot provide a stable interface between electrodes and skin for adequate long-term high-quality data. Thus, conformal, soft, breathable, wireless epidermal sEMG sensor systems have broad potential relevance to clinic rehabilitation settings. Herein, we demonstrate a stretchable epidermal sEMG sensor array system with optimized materials and structure strategies for hand gesture recognition and hand function rehabilitation. The optimized serpentine structures with marvelous stretchability and improved fill ratio, provide lower impedance and high-quality sEMG signals. Moreover, the easy-to-use airhole method further ensures stable and long-term contact with the skin for recording. In addition, integrated with a customized flexible wireless data acquisition system, the capability for real-time 8-channel sEMG monitoring is developed, and taking together with the CNN-based algorithm, the system can automatically and reliably realize the 7 kinds of hand gestures with an accuracy of 81.02%. Moreover, the low-cost yet high-performance epidermal sEMG sensor system demonstrated its conceptual feasibility in quantitatively evaluation of stroke patient’s hand and facilitating human-robot collaboration in hand rehabilitation by proof-of-the-concept clinical testing.

Understanding Forearm Muscle Activity during Everyday Common Grasps: Insights for Rehabilitation, Prosthetic Control, and Human–Machine Interaction

The specific role of forearm muscles in the development of activities of daily living (ADL) remains unknown. Consequently, studying forearm muscle activity during the most commonly used grasps in ADL would yield valuable insights for hand function evaluation, rehabilitation, and advancements in prosthetic control. In this study, forearm muscle activity was analyzed in 22 healthy subjects, examining seven representative forearm areas during the performance of seven types of grasps at 50% of maximum effort. A Scheirer–Ray–Hare test revealed significant differences for grasp, spot, and their interaction (α < 0.05), but not for repetition (and its interactions). Specific significant differences between grasps were found in specific spots by means of Bonferroni post hoc analyses, ensuring the possibility to discriminate between grasps, which is key to identifying the person’s intention to perform a particular grasp. The median values ranged from 4.4% to 32.8%, depending on the spot and grasp, with small 95% confidence intervals (0.5% to 5.5%). Cylindrical grasp requires the highest muscle activity among all spots, while lateral pinch demands the least. The findings elucidate the contribution, coordination, and function of each muscle in relation to each grasp, with implications for rehabilitation, prosthetics, and telerobotic and teleoperation systems.

Stretchable, Flexible, Breathable, Self-Adhesive Epidermal Hand sEMG Sensor System.

Hand function rehabilitation training typically requires monitoring the activation status of muscles directly related to hand function. However, due to factors such as the small surface area for hand-back electrode placement and significant skin deformation, the continuous real-time monitoring of high-quality surface electromyographic (sEMG) signals on the hand-back skin still poses significant challenges. We report a stretchable, flexible, breathable, and self-adhesive epidermal sEMG sensor system. The optimized serpentine structure exhibits a sufficient stretchability and filling ratio, enabling the high-quality monitoring of signals. The carving design minimizes the distribution of connecting wires, providing more space for electrode reservation. The low-cost fabrication design, combined with the cauterization design, facilitates large-scale production. Integrated with customized wireless data acquisition hardware, it demonstrates the real-time multi-channel sEMG monitoring capability for muscle activation during hand function rehabilitation actions. The sensor provides a new tool for monitoring hand function rehabilitation treatments, assessing rehabilitation outcomes, and researching areas such as prosthetic control.

Hand Function Rehabilitation Training Robot Based on Ycbcr and CNN

Hand Function Rehabilitation Training Robot Based on Ycbcr and CNN

Effectiveness of Passive Movement Training in Patients with Cerebral Palsy: A Comparative Analysis of Robot-Assisted Therapy and Electrical Stimulation in Hand Rehabilitation

Background: Cerebral palsy is a non-progressive neurodevelopmental condition that re-sults in varied degrees of disability, with upper limb functioning affected in over 80% of cases. The objective of this study was to investigate the impact of passive movement train-ing of the hand (PMT) with robot-assisted therapy (RAT) compared to PMT with function-al electrical stimulation (FES). Methods: Fifty-eight patients diagnosed with CP, aged be-tween 7 and 14 years, participated in a two-week rehabilitation program involving physi-cal therapy (PT) combined with either RAT or FES. Post-rehabilitation, we assessed the evolution of cylinder grip, finger extension, pinch grips, lateral grip, and three-point grip in each therapy group to determine the more effective passive movement training. Results: Both the RAT group (p < 0.001) and the FES group (p < 0.01) demonstrated a statistically significant improvement in all parameters. Patients who received PT and FES exhibited more significant improvement in each movement, except for the pinch index grip, where the RAT group showed superior results. Conclusions: Our findings indicate the positive effects of both PMTs on hand function rehabilitation. We recommend incorporating both therapies into rehabilitation programs for enhanced outcomes.

A Virtual Reality Serious Game for the Rehabilitation of Hand and Finger Function: Iterative Development and Suitability Study (Preprint)

A Virtual Reality Serious Game for the Rehabilitation of Hand and Finger Function: Iterative Development and Suitability Study (Preprint)

Cortico-cortical paired associative stimulation conditioning superficial ventral premotor cortex-primary motor cortex connectivity influences motor cortical activity during precision grip.

The ventral premotor cortex (PMv) and primary motor cortex (M1) represent critical nodes of a parietofrontal network involved in grasping actions, such as power and precision grip. Here, we investigated how the functional PMv-M1 connectivity drives the dissociation between these two actions. We applied a PMv-M1 cortico-cortical paired associative stimulation (cc-PAS) protocol, stimulating M1 in both postero-anterior (PA) and antero-posterior (AP) directions, in order to induce long-term changes in the activity of different neuronal populations within M1. We evaluated the motor-evoked potential (MEP) amplitude, MEP latency and cortical silent period, in both PA and AP, during the isometric execution of precision and power grip, before and after the PMv-M1 cc-PAS. The repeated activation of the PMv-M1 cortico-cortical network with PA orientation over M1 did not change MEP amplitude or cortical silent period duration during both actions. In contrast, the PMv-M1 cc-PAS stimulation of M1 with an AP direction led to a specific modulation of precision grip motor drive. In particular, MEPs tested with AP stimulation showed a selective increase of corticospinal excitability during precision grip. These findings suggest that the more superficial M1 neuronal populations recruited by the PMv input are involved preferentially in the execution of precision grip actions. KEY POINTS: Ventral premotor cortex (PMv)-primary motor cortex (M1) cortico-cortical paired associative stimulation (cc-PAS) with different coil orientation targets dissociable neural populations. PMv-M1 cc-PAS with M1 antero-posterior coil orientation specifically modulates corticospinal excitability during precision grip. Superficial M1 populations are involved preferentially in the execution of precision grip. A plasticity induction protocol targeting the specific PMv-M1subpopulation might have important translational value for the rehabilitation of hand function.

A Brain-Myoelectric Signal-Based Approach to Hand Rehabilitation in Stroke

The existing hand function rehabilitation training model for stroke patients has problems such as single mode, low patient participation, poor rehabilitation effect and long rehabilitation period. In this paper, we propose an active stroke hand rehabilitation training method based on brain EMG signals, including the use of EEG signals to help stroke patients achieve brain neural remodelling and EMG signals to achieve real-time hand function rehabilitation training to assist patients to complete hand rehabilitation. Firstly, a multimodal guided motor imagery experimental paradigm with a mixture of pictures and Chinese characters was designed to improve the stability of the spontaneous motor imagery EEG signals. Then, a gesture acquisition paradigm based on surface EMG signals was designed to exercise the flexibility of stroke patients' arm muscles and fingers. The experimental results showed that the stroke hand rehabilitation training method based on brain-myoelectric signals could achieve better rehabilitation results.

Fabrication and assessment of partial finger prostheses made using 3D-printed molds: A case study.

3D printing for custom prosthetic finger fabrication can have better fit and comfort than non-custom off-the-shelf ones while reducing fabrication labor time. The purpose of this case study was (1) to design and fabricate custom prosthetic fingers using 3D-printed molds for the treatment of partial finger amputation; (2) to evaluate patient satisfaction of the custom prosthetic fingers fabricated using 3D-printed molds and compare them to the custom prosthetic fingers fabricated through a conventional method of molding using plaster casts. The method to develop the custom prosthetic finger are as follows: (1) The shapes of the residual digits and contralateral fingers were acquired using a high-resolution 3D optical scanner. (2) Prosthetic fingers were designed by modifying the model of the residual digits and the contralateral fingers. (3) Molds of the prosthetic fingers were designed using computer-aided design software and fabricated by 3D printing. The study compared hand function tests and rehabilitation outcome surveys to evaluate the performance of the prosthetic fingers fabricated using 3D-printed molds and plaster casts. This case suggests that the prosthetic fingers fabricated using 3D-printed molds had comparable performance to the prosthetic fingers fabricated using plaster casts. The aesthetics and transparency of the prosthetic fingers contributed highly to the low satisfaction of the prosthetic fingers fabricated using 3D-printed molds.

A neuroergonomic approach to assessing motor performance in stroke patients using fNIRS and behavioral data

Stroke is characterized by high morbidity and disability, and proposing effective methods for assessing and designing rehabilitation products is an attractive topic in current research. In this study, a hand function rehabilitation aid was developed for stroke patients. Ten stroke patients and 20 healthy older people as a control group were recruited to perform a 600 s task after a 600 s resting by gripping a stick while clicking on a flashing light in an electronic insert in sequence according to a pattern. The functional near-infrared spectroscopy (fNIRS) and behavioral data were collected during their rehabilitation training. Brain function was analyzed using three indicators, namely brain area activation, functional connectivity and effective connectivity, while behavioral performance was analyzed using ten indicators, such as velocity and acceleration, and correlations were made between both. Followed by proposing a quantitative assessment method based on the fusion of multiple data sources. The results showed that the developed rehabilitation tool could effectively stimulate the patient's brain and help recover their cognitive and behavioral capacities. The scientific validity of the proposed assessment approach was further confirmed by contrasting the data results of the stroke group with those of the healthy elderly group. This study has integrated brain function and behavioral data, providing a practical quantitative evaluation method of product ergonomics and data-driven product design concepts for stroke patients.

Effectiveness of early rehabilitation in hand burns.

Hand burn trauma occurs quite commonly and the outcome of hand burns can significantly impact self-care daily function, work and employment, leisure activities, and overall health-related quality of life. The overall goal of the management of hand burn trauma is to optimize hand function. Rehabilitation and restoration of hand function are critical for the patient's independence and re-integration into society and work. The purpose of this study is to present our experience with 105 hand burn trauma patients admitted and treated in our burn center and to show the efficacy of early rehabilitation on their ability to return to their prior social life and work. In our study, we included that 105 patients with acute severe hand burn trauma were hospitalized in Gulhane burn center between 2017 and 2021. They underwent rehabilitation program daily sessions. Patients with hand burns are evaluated by ranges of motions (ROM), grip strength, Cochin Hand Function Scale (CHFS), and Michigan Hand Questionnaire (MHQ) 12 months after the injury. Overall, mean digital total active motion were >180°. The mean values for grip strength of dominant hand for men were 27.2±9.3 kg, for women were 22.0±8.8 kg and non-dominant hand for men were 24.05±13.8 kg, for women were 17.8±10.3 kg. Total score of 5 items was 19.0 in CHFS. The mean overall score on the MHQ was 62.3±27.4. All obtained data were within normal or accepted functional ranges. Spearman correlation coefficient indicates a negative correlation between MHQ and CHFS (p≤0.01). A comprehensive rehabilitation program is essential in helping patients to regain optimal function after hand burn trauma. Physiotherapy and occupational therapy is most beneficial when started at the time of admission.

Effectiveness of rehabilitation with virtual reality and biofeedback in recovery of hand function after stroke

To evaluate the effectiveness and safety of the rehabilitation glove (RG) with virtual reality (VR) and biofeedback (BFB) on recovery of the hand function in patients during the late recovery period after first hemispheric ischemic stroke (IS). The study was randomized and controlled. One hundred and six patients (age 58.8±4.3 years, time after stroke onset - 8.7±2.1 months) were included in the final analysis. The intervention group (n=56) received rehabilitation with RG and VR. The control group (n=50) received individualized physical therapy. The primary end points were a change in the Fugl-Meyer scale score (FMA-UE), in the Action Research Arm Test (ARAT), and in the nine holes peg test (NHPT). Secondary end points included changes in MRCS, MAS, MoCA, HADS, modified Barthel index (MBI) and quality of life (EQ-5D-5L). Improvement of the motor function in the intervention group on FMA-UE scale (an increase of ≥7 points in sections A-D) was observed in 46.4% of patients, on ARAT (an increase of ≥5 points) in 53.6% of patients. There was a significant decrease in time from 36.8±6.3 sec. to 22.0±3.9 sec. on NHPT. A negative correlation was observed between the average ARAT score and anxiety (r=-0.7; p<0.05) and depression (r=-0.67; p<0.05). There was also a significant increase in EQ-5D-5L (VAS) by the end of rehabilitation in both groups with better scores in the intervention group (p=0.03). Rehabilitation based on VR, RG, and BFB is effective in the rehabilitation of dexterous hand function in patients with first hemispheric IS.

A review on the application of intelligent control strategies for post-stroke hand rehabilitation machines

Among the approaches to functional hand rehabilitation after stroke, the use of hand rehabilitation robots can provide functional training of the hand or assist the paralyzed hand in activities of daily living, and in particular, intelligent control strategies play a very important role in rehabilitation robotics. The purpose of this review is to summarize the current status of commercially available intelligently controlled hand rehabilitation robots developed in recent years. Firstly, we summarize the theoretical basis of post-stroke hand rehabilitation in the reviewed literature, and the intelligent control strategies of hand rehabilitation robots. Then, representative intelligently controlled hand rehabilitation robots are listed. Finally, we discuss the future directions of the intelligently controlled hand rehabilitation robots. The results show that the development trend in recent years is more inclined to: combining the theoretical basis of stroke hand rehabilitation and studying intelligent control methods of hand function rehabilitation robots that combine human bioelectrical signals to achieve prediction of patients’ motor intentions and also induced stimulation of neuroplasticity in the brain. As well as fusing different bioelectrical signals as a way to improve the applicability of the assistive device in real life. This paper will help researchers to understand the current state of the art regarding intelligently controlled hand rehabilitation robotics after stroke in recent years.

Application of Multi-Dimensional Intelligent Visual Quantitative Assessment System to Evaluate Hand Function Rehabilitation in Stroke Patients.

Hand dysfunction is one of the main symptoms of stroke patients, but there is still a lack of accurate hand function assessment systems. This study focused on the application of the multi-dimensional intelligent visual quantitative assessment system (MDIVQAS) in the rehabilitation assessment of hand function in stroke patients and evaluate hand function rehabilitation in stroke patients. Eighty-two patients with stroke and unilateral hand dysfunction were evaluated by MDIVQAS. Cronbach's Alpha coefficient was used to assess the internal consistency of MDIVQAS; the F-test is used to assess the differences in MDIVQAS for multiple repeated measures. Spearman's analysis was used to identify correlations of MDIVQAS with other assessment systems. t-tests were used to identify differences in outcomes assessed with MDIVQAS in patients before and after treatment. p &lt; 0.05 were considered significant. (1) Cronbach's Alpha coefficient of MDIVQAS in evaluating hand's function &gt; 0.9. (2) There was no significant difference between the other repeated measurements, except for thumb rotation in MDIVQAS. (3) MDIVQAS had a significant correlation with other assessment systems (r &gt; 0.5, p &lt; 0.01). (4) There were significant differences in the evaluation of hand function in patients before and after treatment using MDIVQAS. The MDIVQAS system has good reliability and validity in the evaluation of stroke hand function, and it can also better evaluate the treatment effect.

Design of Guided Bending Bellows Actuators for Soft Hand Function Rehabilitation Gloves

This study developed a soft pneumatic glove actuated by elliptical cross-sectional guided bending bellows to augment finger-knuckle rehabilitation for patients with hand dysfunction. The guided bending bellows actuators (GBBAs) are made of thermoplastic elastomer (TPE) materials, demonstrating the necessary air tightness as a pneumatic actuator. The GBBAs could produce different moments of inertia when increasing internal air pressure drives the GBBAs bending along distinct symmetry planes and exhibits anisotropic kinematic bending performance. Actuated by GBBAs, wearable soft rehabilitation gloves can be used for daily rehabilitation training of hand dysfunction to enhance the range of motion of the finger joint. To control each finger of the gloves independently to achieve the function of manipulating gestures, a multi-channel pneumatic control system is designed, and each air circuit is equipped with an air-pressure sensor to make adjustments based on feedback. Compared with general soft robotic exoskeleton gloves currently used for hand dysfunction, the GBBAs actuated soft gloves have the advantage of enhancing the rehabilitation strength, finger movement range, and multi-action coordination applied with guided bending bellows actuators.

RESEARCH ON ROPE-DRIVEN FLEXIBLE ROBOT FOR HAND REHABILITATION AND EXPERIMENTAL STUDY BASED ON EEG SIGNALS

Dysfunction of hand after stroke can affect patients’ ability to perform daily activities and social ability. This paper developed a flexible hand function rehabilitation robot based on sensory input. First, we designed a flexible external finger muscle based on rope drive, then we designed a special two-way output linear actuator to drive fingers for rehabilitation training. At the same time, we performed vibration stimulation on each finger of the patient and low-frequency electrical stimulation on the patient’s wrist. Sensory stimulation mobilizes the active participation of the brain in rehabilitation training, thereby effectively promoting the rehabilitation effect of fine functions of fingers after stroke. We have completed the hardware design of the flexible hand robot and developed the control software of the flexible hand, thus completing the development of the hand function robot. Finally, experiments were carried out on the use of equipment by using EEG. Experiments show that when the flexible hand robot developed in this paper is used for training, it mobilizes the active participation of the brain in rehabilitation training.

PREFACE

PREFACE

Validity and Reliability of a Depth Camera–Based Quantitative Measurement for Joint Motion of the Hand

Quantitative measurement of hand motion is essential in evaluating hand function. This study aimed to investigate the validity and reliability of a novel depth camera-based contactless automatic measurement system to assess hand range of motion and its potential benefits in clinical applications. Five hand gestures were designed to evaluate the hand range of motion using a depth camera-based measurement system. Seventy-one volunteers were enrolled in performing the designed hand gestures. Then, the hand range of motion was measured with the depth camera and manual procedures. System validity was evaluated based on 3 dimensions: repeatability, within-laboratory precision, and reproducibility. For system reliability, linear evaluation, the intraclass correlation coefficient, paired t -test and bias were employed to test the consistency and difference between the depth camera and manual procedures. When measuring phalangeal length, repeatability, within-laboratory precision, and reproducibility were 2.63%, 12.87%, and 27.15%, respectively. When measuring angles of hand motion, the mean repeatability and within-laboratory precision were 1.2° and 3.3° for extension of 5 digits, 2.7° and 10.2° for flexion of 4 fingers, and 3.1° and 5.3° for abduction of 4 metacarpophalangeal joints, respectively. For system reliability, the results showed excellent consistency (intraclass correlation coefficient= 0.823; P < .05) and good linearity with the manual procedures (r= 0.909-0.982, approximately; P < .001). Besides, 78.3% of the measurements were clinically acceptable. Our depth camera-based evaluation system provides acceptable validity and reliability in measuring hand range of motion and offers potential benefits for clinical care and research in hand surgery. However, further studies are required before clinical application. This study suggests a depth camera-based contactless automatic measurement system holds promise for assessing hand range of motion in hand function evaluation, diagnosis, and rehabilitation for medical staff. However, it is currently not adequate for all clinical applications.

To Observe the Promotion Effect of PDF Technology on Hand Function Rehabilitation of Stroke Hemiplegic Patients

To Observe the Promotion Effect of PDF Technology on Hand Function Rehabilitation of Stroke Hemiplegic Patients

A Review of Hand Function Rehabilitation Systems Based on Hand Motion Recognition Devices and Artificial Intelligence.

The incidence of stroke and the burden on health care and society are expected to increase significantly in the coming years, due to the increasing aging of the population. Various sensory, motor, cognitive and psychological disorders may remain in the patient after survival from a stroke. In hemiplegic patients with movement disorders, the impairment of upper limb function, especially hand function, dramatically limits the ability of patients to perform activities of daily living (ADL). Therefore, one of the essential goals of post-stroke rehabilitation is to restore hand function. The recovery of motor function is achieved chiefly through compensatory strategies, such as hand rehabilitation robots, which have been available since the end of the last century. This paper reviews the current research status of hand function rehabilitation devices based on various types of hand motion recognition technologies and analyzes their advantages and disadvantages, reviews the application of artificial intelligence in hand rehabilitation robots, and summarizes the current research limitations and discusses future research directions.