Impaired Hand Research Articles

Brain-Controlled Hand Exoskeleton Based on Augmented Reality-Fused Stimulus Paradigm.

Advancements in brain-machine interfaces (BMIs) have led to the development of novel rehabilitation training methods for people with impaired hand function. However, contemporary hand exoskeleton systems predominantly adopt passive control methods, leading to low system performance. In this work, an active brain-controlled hand exoskeleton system is proposed that uses a novel augmented reality-fused stimulus (AR-FS) paradigm as a human-machine interface, which enables users to actively control their fingers to move. Considering that the proposed AR-FS paradigm generates movement artifacts during hand movements, an enhanced decoding algorithm is designed to improve the decoding accuracy and robustness of the system. In online experiments, participants performed online control tasks using the proposed system, with an average task time cost of 16.27 s, an average output latency of 1.54 s, and an average correlation instantaneous rate (CIR) of 0.0321. The proposed system shows 35.37% better efficiency, 8.03% reduced system delay, and 35.28% better stability than the traditional system. This study not only provides an efficient rehabilitation solution for people with impaired hand function but also expands the application prospects of brain-control technology in areas such as human augmentation, patient monitoring, and remote robotic interaction. The video in Graphical Abstract Video demonstrates the user's process of operating the proposed brain-controlled hand exoskeleton system.

Novel Digital Biomarkers for Fine Motor Skills Assessment in Psoriatic Arthritis: The DaktylAct Touch-based Serious Game Approach.

Psoriatic Arthritis (PsA) is a chronic, inflammatory disease affecting joints, substantially impacting patients' quality of life, with European guidelines for managing PsA emphasizing the importance of assessing hand function. Here, we present a set of novel digital biomarkers (dBMs) derived from a touchscreen-based serious game approach, DaktylAct, intended as a proxy, gamified, objective assessment of hand impairment, with emphasis on fine motor skills, caused by PsA. This is achieved by its design, where the user controls a cannon to aim at and hit targets using two finger pinch-in/out and wrist rotation gestures. In-game metrics (targets hit and score) and statistical features (mean, standard deviation) of gameplay actions (duration of gestures, applied pressure, and wrist rotation angle) produced during gameplay serve as informative dBMs. DaktylAct was tested on a cohort comprising 16 clinically verified PsA patients and nine healthy controls (HC). Correlation analysis demonstrated a positive correlation between average pinch-in duration and disease activity (DA) and a negative correlation between standard deviation of applied pressure during wrist rotation and joint inflammation. Logistic regression models achieved 83% and 91% classification performance discriminating HC from PsA patients with low DA (LDA) and PsA patients with and without joint inflammation, respectively. Results presented here are promising and create a proof-of-concept, paving the way for further validation in larger cohorts.

Feasibility and efficacy of an early sensory-motor rehabilitation program on hand function in patients with stroke: a pilot, single-subject experimental design.

Hand and upper limb functional impairments following stroke lead to limitations in performing activities of daily living. We aimed to investigate feasibility and efficacy of an early sensory-motor rehabilitation program on hand and upper limb function in patients with acute stroke. A pilot, single-subject experimental, A-B-A study. Stroke unit of an educational hospital and an outpatient occupational therapy clinic. A convenience sample including five people with acute stroke. Participants received 3h of an intensive hand and upper limb sensory and motor rehabilitation program, 5days per week for 3months (15-min mental imagery, 15-min action observation, 30-min mirror therapy, 1.5-h constraint-induced movement therapy, and 30-min bilateral arm training). Activities were chosen based on the task-oriented occupational therapy approach. An assessor blinded to intervention program measured sensory and motor functions using action research arm test, box and block test, Semmes-Weinstein monofilaments, and upper extremity section of Fugl-Meyer assessment. Assessment data points in intervention and follow-up phases compared to baseline were in higher levels, sloped upwardly, and increased significantly for all participants in all outcome measures. The present pilot study showed that a package of nowadays evidence-based rehabilitation methods including mental imagery, action observation, mirror therapy, modified constraint-induced movement therapy, bilateral arm training, and task-oriented occupational therapy approach is able to improve sensory and motor functions of the hand and upper limb in patients with acute stroke.

ExoMechHand prototype development and testing with EMG signals for hand rehabilitation

Rehabilitation is a major requirement to improve the quality of life and mobility of patients with disabilities. The use of rehabilitative devices without continuous supervision of medical experts is increasing manifold, mainly due to prolonged therapy costs and advancements in robotics. Due to ExoMechHand's inexpensive cost, high robustness, and efficacy for participants with median and ulnar neuropathies, we have recommended it as a rehabilitation tool in this study. ExoMechHand is coupled with three different resistive plates for hand impairment. For efficacy, ten unhealthy subjects with median or ulnar nerve neuropathies are considered. After twenty days of continuous exercise, three subjects showed improvement in their hand grip, range of motion of the wrist, or range of motion of metacarpophalangeal joints. The condition of the hand is assessed by features of surface-electromyography signals. A Machine-learning model based on these features of fifteen subjects is used for staging the condition of the hand. Machine-learning algorithms are trained to indicate the type of resistive plate to be used by the subject without the need for examination by the therapist. The extra-trees classifier came out to be the most effective algorithm with 98% accuracy on test data for indicating the type of resistive plate, followed by random-forest and gradient-boosting with accuracies of 95% and 93%, respectively. Results showed that the staging of hand condition could be analyzed by sEMG signal obtained from the flexor-carpi-ulnaris and flexor-carpi-radialis muscles in subjects with median and ulnar neuropathies.

IMPROVING REHABILITATION OUTCOMES FOR PEOPLE AGING WITH LONG-TERM HAND IMPAIRMENTS

Abstract Despite the importance of hand and upper extremity function in ADL performance and successful aging-in-place, contextual and engaging in-home rehabilitation interventions that promote use, feedback of progress, and long-term monitoring of changes in functional ability among individuals with chronic upper limb deficits are lacking. This presentation will present the findings from three TechSAge pilot projects focused on the use of technology to support in-home rehabilitation for individuals aging with long-term upper extremity disabilities. DigiHand, is a smartphone-based application combined with sensor-embedded objects used in daily activities (e.g., coffee cup) that enables users to self-manage their own rehabilitation, obtain feedback on progress to refine movements, and allow remote monitoring by therapists. Similarly, KeyStroke is an in-home piano training mobile app that provides engaging music exercises to promote long-term rehabilitation and therapists’ monitoring of progress of stroke survivors. Finally, 3DP for AT is generating design requirements to support the development of an open-source software tool that would allow assistive technology service providers, who are novice users of 3D printers, to create and fabricate highly customized 3D-printed assistive devices that are more durable, aesthetic, and will better meet the unique needs of people aging with long-term hand impairments.

A mirror therapy system using virtual reality and an actuated exoskeleton for the recovery of hand motor impairments: a study of acceptability, usability, and embodiment

Hand motor impairments are one of the main causes of disabilities worldwide. Rehabilitation procedures like mirror therapy are given crucial importance. In the traditional setup, the patient moves the healthy hand in front of a mirror; the view of the mirrored motion tricks the brain into thinking that the impaired hand is moving as well, stimulating the recovery of the lost hand functionalities. We propose an innovative mirror therapy system that leverages and couples cutting-edge technologies. Virtual reality recreates an immersive and effective mirroring effect; a soft hand exoskeleton accompanies the virtual visual perception by physically inducing the mirrored motion to the real hand. Three working modes of our system have been tested with 21 healthy users. The system is ranked as acceptable by the system usability scale; it does not provoke adverse events or sickness in the users, according to the simulator sickness questionnaire; the three execution modes are also compared w.r.t. the sense of embodiment, evaluated through another customized questionnaire. The achieved results show the potential of our system as a clinical tool and reveal its social and economic impact.

Evaluation of occupational and non-occupational risk factors associated with carpal tunnel syndrome-related symptoms in office workers

Abstract Background : While the main occupational and non-occupational risk factors associated with carpal tunnel syndrome are known, we still need to understand which of these factors has a stronger correlation with carpal tunnel-related symptoms in office workers and to improve future work-space recommendations accordingly. Objective : This study aimed to investigate the relationship between occupational and non-occupational risk factors and carpal tunnel syndrome-related symptoms among office workers who use a computer in their dayto-day activities. Methods : The data used in this study were collected from May to September 2022 through an online questionnaire from one respondent to another through different forms of social media, using the snowball method. The recorded data were further analysed using an SPSS program. In this way, we analysed quantitative variables by calculating the means, the medians, the standard deviation and the normal distribution and qualitative variables by reporting them as absolute values and percentages of the total. We compared different subgroups of samples using the chi-square test and the binary regression method. A p-value of less than 0.05 was the threshold of statistical significance. Results : This study evaluated 130 office workers and identified and analysed the complex relationships between occupational and non-occupational risk factors of CTS and CTS symptoms grouped as pain, sensory function impairment and motor function impairment. Through data analysis and further logistic regression analysis, we concluded that while sensory function impairment is mostly associated with occupational factors such as computer typing with one hand, pain and motor function impairment are associated with both non-occupational, well-known risk factors (female sex, high BMI) and number of hours on the computer outside of work, and occupational risk factors like using both a mouse and an external keyboard, having a chair with adequate arm support and typing with one hand. Conclusion : Both occupational and non-occupational risk factors contribute to the development of CTS-related symptoms. Our dataset highlights the complex relationship between CTS occupational and non-occupational risk factors in office workers, thus providing insights for future workplace recommendations and preventive strategies.

Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury

BackgroundRobotic hand orthoses (RHO) aim to provide grasp assistance for people with sensorimotor hand impairment during daily tasks. Many of such devices have been shown to bring a functional benefit to the user. However, assessing functional benefit is not sufficient to evaluate the usability of such technologies for daily life application. A comprehensive and structured evaluation of device usability not only focusing on effectiveness but also efficiency and satisfaction is required, yet often falls short in existing literature. Mixed methods evaluations, i.e., assessing a combination of quantitative and qualitative measures, allow to obtain a more holistic picture of all relevant aspects of device usability. Considering these aspects already in early development stages allows to identify design issues and generate generalizable benchmarks for future developments.MethodsWe evaluated the short-term usability of the RELab tenoexo, a RHO for hand function assistance, in 15 users with tetraplegia after a spinal cord injury through a comprehensive mixed methods approach. We collected quantitative data using the Action Research Arm Test (ARAT), the System Usability Scale (SUS), and timed tasks such as the donning process. In addition, qualitative data were collected through semi-structured interviews and user observations, and analyzed with a thematic analysis to enhance the usability evaluation. All insights were attributed and discussed in relation to specifically defined usability attributes such as comfort, ease of use, functional benefit, and safety.ResultsThe RELab tenoexo provided an immediate functional benefit to the users, resulting in a mean improvement of the ARAT score by 5.8 points and peaking at 15 points improvement for one user (clinically important difference: 5.7 points). The mean SUS rating of 60.6 represents an adequate usability, however, indicating that especially the RHO donning (average task time = 295 s) was perceived as too long and cumbersome. The participants were generally very satisfied with the ergonomics (size, dimensions, fit) of the RHO. Enhancing the ease of use, specifically in donning, increasing the provided grasping force, as well as the availability of tailoring options and customization were identified as main improvement areas to promote RHO usability.ConclusionThe short-term usability of the RELab tenoexo was thoroughly evaluated with a mixed methods approach, which generated valuable data to improve the RHO in future iterations. In addition, learnings that might be transferable to the evaluation and design of other RHO were generated, which have the potential to increase the daily life applicability and acceptance of similar technologies.

The relation between synovitis of individual finger joints and grip force over the first 5 years in early rheumatoid arthritis — a cohort study

Objective The objective of this study was to investigate the relation between swelling and tenderness of individual finger joints and grip force in patients with early rheumatoid arthritis (RA).Methods In an inception cohort of patients with early RA (symptom duration < 12 months), all patients were examined by the same rheumatologist, and grip force was measured using the Grippit instrument at inclusion, 1 and 5 years. The average grip force values of each hand were evaluated and expressed as % of expected values, based on age- and sex-specific reference values. Linear regression analyses were used to assess the cross-sectional relation between the involvement of individual finger joints and grip force. In generalized estimating equations, the impact of time-varying synovitis/tenderness on grip force over time was estimated. Analyses were adjusted for wrist involvement, erythrocyte sedimentation rate, and patient-reported pain.ResultsIn 215 patients with early RA, grip force was 39% of expected at diagnosis, and increased to 56% after 5 years. Synovitis of the first metacarpophalangeal (MCP) joint (60% and 69% at baseline in the right and left hand) was associated with reduced grip force at inclusion (adjusted ß − 9.2 percentage unit of expected grip force; 95% CI − 13.6 to − 4.8 for both hands combined) and at all follow-up evaluations. Synovitis of MCP I and MCP IV (12% at baseline) was significantly associated with reduced grip force over time in both hands. Proximal interphalangeal (PIP) joint swelling, and tenderness of MCP or PIP joints, had less impact on grip force.ConclusionMCP I synovitis is the major contributor to reduced grip force in patients with early RA. This underlines the importance of the involvement of the thumb for impaired hand function in RA. MCP IV synovitis, but not PIP involvement or finger joint tenderness, also has a substantial impact on grip force.

ASSESSMENT OF THE QUALITY OF LIFE OF CHILDREN WITH NATAL SPINAL INJURY AND OPTIMIZATION OF REHABILITATION MEASURES

The purpose of this study was to compare upper limb function and quality of life in preschool children with complications of birth injuries to the cervical spinal cord and spine. Research methods: the study used a clinical neurological examination and the results of the Pediatric Outcomes Data Collection Instrument (PODCI) scale, neurofunctional (electroneuromyography - ENMG), neuroimaging (ultrasound - ultrasound of the cervical spinal cord and spine) research methods. Results and discussion. Upper extremity dysfunction is an area that primarily reduces quality of life in children with HSDD. This result highlights how difficult it is to manipulate objects with the upper limbs during certain activities, such as lifting heavy books, pouring milk, opening a previously opened can, using cutlery, combing hair, buttoning clothes, putting on a coat, and writing with a pencil. All of these may be related to the limited range of motion in these children, which is impaired by muscle weakness, simultaneous activation of antagonists, differences in the length of the affected limb, and contractures. Subsequently, children with HSDD demonstrate limitations in performing functional tasks that are necessary for independence in daily activities and quality of life, as well as tasks requiring fine motor skills. Conclusion. Thus, the quality of life of preschool children before treatment was reduced on all scales. When the results for each domain were analyzed separately, both groups showed poor results in the domain that reflects hand activity among all domains. Impaired hand function is the main area that reduces the quality of life in children with complications of PTSD. This domain has the lowest score compared to other domains, which has also been confirmed by other studies. As a result of the course of rehabilitation measures, a positive statistically significant dynamics of quality of life indicators was noted KEYWARDS. Children, natal spinal injury, the quality of life, rehabilitation measures.

A Pilot Study of an Innovative Hand Exoskeleton: Nuada Glove.

The human hand is a crucial anatomical structure, and its complexity enables humans to grasp tools essential for daily life activities.Consequently, hand disabilities have a negativeand profoundimpact on people'sautonomy in performing everyday tasks.The Nuada Glove (Nuada,Braga, Portugal) is a wearable exoskeleton robotic device designed to assist individuals with hand impairments or weakness inregaining hand function, particularly in grasping movements.This pilot studyaims to evaluateits impact on improving hand function in first-time users with hand disabilities and to assess its usability.A total of 63 participants with hand disabilities were asked to complete a series of exercises that simulated various human grasping motions, initially without any assistanceand then with the Nuada Glove. Of the participants,98% exhibited measurable improvement in hand function in at least one exercise.This pilot study, conducted in a controlled environment, clearly demonstrated thebenefits of the Nuada Glove and its ease of use.Future studies should expand from this one to assess the use of the Nuada Glove in a real-world environment with continuous use.

Restoring Function of the Flexor Tendons of the Hand: State of the Science in Kazakhstan.

We conducted a literature review to highlight the diagnosis and treatment of hand flexor tendon injuries and discuss the current state of the science of hand surgery in the Republic of Kazakhstan. We reviewed the Google Scholar, PubMed, Web of Science, Elsevier, and National Center for Biotechnology Information databases and other printed sources for open access articles in three languages. We accepted relevant scientific articles that reflected the peculiarities of restoring function of the tendon flexors of the hand. We reviewed articles from the present to the previous 20 years and included 31 of these sources in our literature review. The medical examination of a patient who has sustained a flexor tendon injury should be thorough and gradual, supported by ultrasound and X-ray examination. For effective restoration of hand function following a hand injury, it is important for the surgeon to conduct a step-by-step assessment of the damage that has occurred to soft tissues, superficial and deep tendons, bones, nerves, and blood vessels. The main goal of tendon repair is to preserve tendon function. It is also known that early postoperative tendon movement leads to faster healing. The most frequent complications associated with flexor tendon repair include the development of adhesions, wound infection, tendon rupture, impaired hand function, and scar formation. Relative to the state of the science in the Republic of Kazakhstan, we conclude that hand surgery should be performed by highly skilled specialists in the field of microsurgery in a specialized department with microsurgical equipment.

A Tailorable Robotic Hand Orthosis to Support Children with Neurological Hand Impairments: a Case Study in a Child's Home.

Neurological disorders such as traumatic brain injuries (TBI) can lead to hand impairments in children, negatively impacting their quality of life. Fully wearable robotic hand orthoses (RHO) have been proposed to actively support children and promote the use of the impaired limb in daily life. Here we report a case study on the feasibility of using the pediatric RHO PEXO for assistance at home in a 13- year-old child with hand impairment after TBI. The size and functionalities of the RHO were first fully tailored to the child's needs. We trained the child and their parent on independently using the RHO before taking it home for a period of two weeks. The use of the RHO improved hand ability. Additionally, the tailoring and training benefited the unimanual capacity (Box and Block Test score +2 after tailoring) and bimanual performance (Assisting Hand Assessment score +4) of the child with PEXO. Further, it increased device acceptance by the child and the parent. The child used PEXO at home for 76 minutes distributed over three days during eating and drinking tasks. Personal and environmental factors caused the moderate use. No adverse events or safety-related issues occurred. This study highlights the value of tailoring an assistive RHO and, for the first time, demonstrates the feasibility of home use of a pediatric RHO by children with neurological hand impairments.

A bidirectional fabric-based soft robotic glove for hand function assistance in patients with chronic stroke

BackgroundChronic stroke patients usually experience reduced hand functions, impeding their ability to perform activities of daily living (ADLs) independently. Additionally, improvements in hand functions by physical therapy beyond six months after the initial onset of stroke are much slower than in the earlier months. As such, chronic stroke patients could benefit from an assistive device to enhance their hand functions, allowing them to perform ADLs independently daily. In recent years, soft robotics has provided a novel approach to assistive devices for motor impaired individuals, offering more compliant and lightweight alternatives to traditional robotic devices. The scope of this study is to demonstrate the viability of a fabric-based soft robotic (SR) glove with bidirectional actuators in assisting chronic stroke study participants with hand impairments in performing ADLs.MethodsForce and torque measurement tests were conducted to characterize the SR Glove, and hand functional tasks were given to eight chronic stroke patients to assess the efficacy of the SR Glove as an assistive device. The tasks involved object manipulation tasks that simulate ADLs, and the series of tasks was done by the participants once without assistance for baseline data, and once while using the SR Glove. A usability questionnaire was also given to each participant after the tasks were done to gain insight into how the SR Glove impacts their confidence and reliance on support while performing ADLs.ResultsThe SR Glove improved the participants’ manipulation of objects in ADL tasks. The difference in mean scores between the unassisted and assisted conditions was significant across all participants. Additionally, the usability questionnaire showed the participants felt more confident and less reliant on support while using the SR Glove to perform ADLs than without the SR Glove.ConclusionsThe results from this study demonstrated that the SR Glove is a viable option to assist hand function in chronic stroke patients who suffer from hand motor impairments.

Cerebral Palsy: Opinions on Development, Occurrence, Presentation and Management

Cerebral palsy (CP) is the most common childhood disability affecting motor function as a result of injury to the underdeveloped brain, occurring in 2-3 children in every 1000 live births. However, CP as a disease is been studied well, and understood by the pathologist, general physicians, researchers, obstetricians, and paediatricians. The motor disorders of cerebral palsy are often associated with disturbances of sensation, perception, cognition, communication, and behaviour, epilepsy, and secondary musculoskeletal problems. There are multiple risk factors have been identified for CP in the last decade, likely; premature birth (before 37 weeks) and low birth weight (less than 2.7 KG) these. two are most classically associated with CP. Others include the mother’s systemic illness, substance abuse, maternal undernutrition, Gestational diabetes, excessive bleeding per vagina, and preeclampsia, along with multiple gestations, C-section, vacuum-assisted delivery, forceps delivery, post-term delivery, induction of labour, obstructed labour, asphyxia, etc. When considered to be a movement disorder, it can be classified as spastic, dyskinetic, or ataxic. When considering the area of presentation, it can be quadriplegic, hemiplegic, diplegic, and monoplegic. Hypertonicity of the muscles is the most common symptom along with other motor issues such as impaired balance, coordination, and hand function. periventricular leukomalacia is the most common neurological finding seen. Keeping cognizance of the impairment these symptoms can cause to the independent functioning of the child in society, early diagnosis is extremely important.

Design of a Custom Force Fixture Fitting Miniature Load Cells for Individual Finger Force Measurement

This research aims to address limitations of current hand grip measurement techniques by designing, building, and testing a more robust cylindrical dynamometer capable of measuring orthogonal force components while accounting for forces exerted by individual finger segments. The novel grip fixture consists of three static beams instrumented with strain gauges measuring orthogonal forces and eight attached miniature compensating load cells accounting for force contribution from finger segments. Following device fabrication and calibration, data was validated in a pilot study (n=6) where grip strengths were compared between the custom fixture and a Jamar dynamometer. Data suggests the custom dynamometer provides hand grip strength measurement comparable to that produced on a traditional dynamometer (p &gt; 0.05). Future research studies using a similar device can guide therapy for patients with impaired hand strength by providing clinical professionals with a more complete profile of the forces exerted by hand segments.

The place of virtual reality in the rehabilitation of patients with multiple sclerosis

Multiple sclerosis (MS) is a chronic autoimmune disease that limits the ability to work and lead an active lifestyle, mostly in young adults. Physical activity, along with drug therapy, is an essential part of the life of a person with MS. In the last decades, rehabilitation of MS patients has made great progress. However, the problem of compliance is still relevant. Virtual reality (VR) based rehabilitation can not only improve the quality of the training process but also increase patient compliance.Objective: to study the literature data on the effectiveness of the techniques of VR in reducing the severity of symptoms of MS and improving the quality of life.Materials and methods. A thorough literature search of the MEDLINE (Pubmed), eLibrary, and Google Schcolar databases was performed. Papers that met two criteria were included in the study: study population – patients with MS; presence of at least one comparison group (standard therapy or no therapy).Results. Based on the results of the analysis, 44 articles were selected. The efficacy of VR in reducing symptoms of MS such as fatigue, balance disturbances, risk factors for falls, mobility, apraxia, impaired hand function was described, as well as the impact on overall quality of life and its components.Conclusions. The VR rehabilitation can have its own place in the general system of physical rehabilitation and also become an effective tool to increase motivation and quality of life at all stages of rehabilitation.

Actuated Thumb Exoskeleton with Variable Axes of Rotation For Stroke Rehabilitation

Chronic hand impairment is very common amongst stroke survivors. More specifically, movement of the thumb is highly restricted causing a major decrease in the functionality of the entire hand. The non-orthogonal, non-intersecting joint axes of the thumb and the many actuating muscles involved make it very difficult to understand the thumb, let alone provide techniques for rehabilitation. Thus, an exoskeleton that incorporatesthe 5 anatomical Degrees of Freedom (DOF) of the thumb, both for actuation and measuring, was created in order to better understand motor control of the thumb, both in neurologically intact individuals and in stroke survivors. A mounting bracket was developed to affix the exoskeleton to a forearm brace. The exoskeleton was then tested to determine if it restricted movement. The movement space of the thumb was tracked both withthe thumb connected to the exoskeleton and for the free thumb using a Digital Motion Analysis System (DMAS). Neurologically intact subjects were able to cover an average of 72% of their normal thumb working space while wearing the exoskeleton. Most of the restriction occurred in the upper region of the workspace. Thus, the device seems to allow considerable freedom of movement of the thumb, particularly in the region of the workspace used for everyday tasks. Subjects remarked that thumb movement felt quite natural. Further research using this exoskeleton can be done to better understand the impairments that occur in the thumb and thus provide better insight into rehabilitation methods. For example, the use of a system including motors and flexible shafts to drive the joints of the exoskeleton which in turn drives the joints of the thumb might provide a successful mode of rehabilitation.

Feasibility of force myography for the direct control of an assistive robotic hand orthosis in non-impaired individuals

BackgroundAssistive robotic hand orthoses can support people with sensorimotor hand impairment in many activities of daily living and therefore help to regain independence. However, in order for the users to fully benefit from the functionalities of such devices, a safe and reliable way to detect their movement intention for device control is crucial. Gesture recognition based on force myography measuring volumetric changes in the muscles during contraction has been previously shown to be a viable and easy to implement strategy to control hand prostheses. Whether this approach could be efficiently applied to intuitively control an assistive robotic hand orthosis remains to be investigated.MethodsIn this work, we assessed the feasibility of using force myography measured from the forearm to control a robotic hand orthosis worn on the hand ipsilateral to the measurement site. In ten neurologically-intact participants wearing a robotic hand orthosis, we collected data for four gestures trained in nine arm configurations, i.e., seven static positions and two dynamic movements, corresponding to typical activities of daily living conditions. In an offline analysis, we determined classification accuracies for two binary classifiers (one for opening and one for closing) and further assessed the impact of individual training arm configurations on the overall performance.ResultsWe achieved an overall classification accuracy of 92.9% (averaged over two binary classifiers, individual accuracies 95.5% and 90.3%, respectively) but found a large variation in performance between participants, ranging from 75.4 up to 100%. Averaged inference times per sample were measured below 0.15 ms. Further, we found that the number of training arm configurations could be reduced from nine to six without notably decreasing classification performance.ConclusionThe results of this work support the general feasibility of using force myography as an intuitive intention detection strategy for a robotic hand orthosis. Further, the findings also generated valuable insights into challenges and potential ways to overcome them in view of applying such technologies for assisting people with sensorimotor hand impairment during activities of daily living.

Exploring the Role of a Large Language Model on Carpal Tunnel Syndrome Management: An Observation Study of ChatGPT

Recently, large language models, such as ChatGPT, have emerged as promising tools to facilitate scientific research and health care management. The present study aimed to explore the extent of knowledge possessed by ChatGPT concerning carpal tunnel syndrome (CTS), a compressive neuropathy that may lead to impaired hand function and that is frequently encountered in the field of hand surgery. Six questions pertaining to diagnosis and management of CTS were posed to ChatGPT. The responses were subsequently analyzed and evaluated based on their accuracy, coherence, and comprehensiveness. In addition, ChatGPT was requested to provide five high-level evidence references in support of its answers. A simulated doctor-patient consultation was also conducted to assess whether ChatGPT could offer safe medical advice. ChatGPT supplied clinically relevant information regarding CTS, although at a relatively superficial level. In the context of doctor-patient interaction, ChatGPT suggested a diagnostic pathway that deviated from the widely accepted clinical consensus on CTS diagnosis. Nevertheless, it incorporated differential diagnoses and valuable management options for CTS. Although ChatGPT demonstrated the ability to retain and recall information from previous patient conversations, it infrequently produced pertinent references, many of which were either nonexistent or incorrect. ChatGPT displayed the capability to deliver validated medical information on CTS to nonmedical individuals. However, the generation of nonexistent and inaccurate references by ChatGPT presents a challenge to academic integrity. To increase their utility in medicine and academia, large language models must go through specialized reputable data set training and validation from experts. It is essential to note that at present, large language models cannot replace the expertise of health care professionals and may act as a supportive tool.