Hand Orthosis Research Articles

Continuous versus discrete robotic feedback for brain-computer interfaces aimed for neurorehabilitation.

Brain-Computer Interfaces (BCI) can allow control of external devices using motor imagery (MI) decoded from electroencephalography (EEG). Although BCI have a wide range of applications including neurorehabilitation, the low spatial resolution of EEG, coupled to the variability of cortical activations during MI, make control of BCI based on EEG a challenging task. An assessment of BCI control with different feedback timing strategies was performed. Two different feedback timing strategies were compared, comprised by passive hand movement provided by a robotic hand orthosis. One of the timing strategies, the continuous, involved the partial movement of the robot immediately after the recognition of each time segment in which hand MI was performed. The other feedback, the discrete, was comprised by the entire movement of the robot after the processing of the complete MI period. Eighteen healthy participants performed two sessions of BCI training and testing, one with each feedback. Significantly higher BCI performance (65.4 ± 17.9% with the continuous and 62.1 ± 18.6% with the discrete feedback) and pronounced bilateral alpha and ipsilateral beta cortical activations were observed with the continuous feedback. It was hypothesized that these effects, although heterogenous across participants, were caused by the enhancement of attentional and closed-loop somatosensory processes. This is important, since a continuous feedback timing could increase the number of BCI users that can control a MI-based system or enhance cortical activations associated with neuroplasticity, important for neurorehabilitation applications.

Portable 3D-printed hand orthosis with spatial stiffness distribution personalized for assisting grasping in daily living.

Stroke survivors having limited finger coordination require an active hand orthosis to assist them with grasping tasks for daily activities. The orthosis should be portable for constant use; however, portability imposes constraints on the number, size, and weight of the actuators, which increase the difficulty of the design process. Therefore, a tradeoff exists between portability and the assistive force. In this study, a personalized spatial stiffness distribution design is presented for a portable and strengthful hand orthosis. The spatial stiffness distribution of the orthosis was optimized based on measurements of individual hand parameters to satisfy the functional requirements of achieving sufficient grip aperture in the pre-grasping phase and minimal assistive force in the grasping phase. Ten stroke survivors were recruited to evaluate the system. Sufficient grip aperture and high grip strength-to-weight ratio were achieved by the orthosis via a single motor. Moreover, the orthosis significantly restored the range of motion and improved the performance of daily activities. The proposed spatial stiffness distribution can suggest a design solution to make strengthful hand orthoses with reduced weight.

Comparison of 3D Printing and Traditional Hand Orthosis Fabrication

Traditional methods of custom orthosis fabrication are prone to challenges and limitations. Three-dimensional (3D) printing has been piloted with lower extremity orthotics and worthy of exploration with upper extremities. The aim of this study was to compare three-dimensionally printed wrist immobilization splints to conventionally made orthoses in terms of fabrication, comfort, and functionality. Three healthy participants with no history of wrist or hand conditions were recruited to be fitted for conventional and 3D-printed wrist immobilization splints. A sequential mixed-methods study design was conducted to explore comfort, fabrication, and functionality. An ethnographic study was conducted afterward to further understand the fabrication process of 3D-printed orthotics. The Quebec User Evaluation of Satisfaction with Assistive Technology and a Splint Analysis form was used to assess comfort. The function was assessed using the Jebsen-Taylor Hand Function Test. A five-point satisfaction Likert scale was used to evaluate fabrication. Although the results were not statistically significant due to the small sample size, 3D-printed orthotics appear to provide some benefits over traditional methods.

3D-Printed Polycaprolactone Mechanical Characterization and Suitability Assessment for Producing Wrist-Hand Orthoses.

In this research, the mechanical properties of 3D-printed polycaprolactone (PCL), a biocompatible and biodegradable semi-crystalline polyester, available as feedstock for additive manufacturing technology based on the material extrusion process, were determined. The influence of the infill pattern (zig-zag vs. gyroid) and ultraviolet (UV-B) exposure over the specimens' mechanical performances were also investigated to gather relevant data on the process parameter settings for different applications. Specimens and samples of 3D-printed PCL were analyzed through tensile and flexural tests. The experimental data showed the good repeatability of the manufacturing process, as well as a mechanical behavior independent of the specimens' infill pattern at full density. No differences between the failure patterns of the tensile specimens were recorded. UV-B exposure proved to have a significant negative impact on the specimens' tensile strength. The 3D printing of PCL and PCL blends is reported mainly for use in scaffold manufacturing or drug delivery applications. As another novelty, the suitability of commercial PCL filaments for producing patient-customized wrist-hand orthoses was also assessed in this study. Semi-cylindrical PCL samples mimicking the forearm part of a wrist-hand orthosis with hexagonal open pockets were 3D-printed and mechanically tested. The results were discussed in comparison to samples with a similar design, made of polylactic acid. The experiments revealed the need to carefully calibrate the manufacturing parameters to generate defect-free, good quality prints. Once settings were established, promising results were obtained when producing orthoses in a ready-to-use form. On the other hand, the attempts to thermoform flat 3D-printed PCL orthoses proved unsuccessful.

Using a 3D-Printed Hand Orthosis to Improve Three-Jaw Chuck Hand Function in Individuals With Cervical Spinal Cord Injury: A Feasibility Study.

Individuals with cervical spinal cord injury (C-SCI) often use a tenodesis grip to compensate for their hand function deficits. Although clinical evidence confirms that assistive devices can help achieve hand function improvements, the currently available devices have some limitations in terms of their price and accessibility and the difference in the user's muscle strength. Therefore, in this study, we developed a 3D-printed wrist-driven orthosis to improve the gripping effect and tested the feasibility of this device by assessing its functional outcomes. A total of eight participants with hand function impairment due to a C-SCI were enrolled, and a wrist-driven orthosis with a triple four-bar linkage was designed. The hand function of the participants was assessed before and after they wore the orthosis, and the outcomes were assessed using a pinch force test, a dexterity test (Box and block test, BBT), and a Spinal Cord Independence Measure Version III questionnaire. In the results, before the participants wore the device, the pinch force was 0.26 lb. However, after they wore the device, it increased by 1.45 lb. The hand dexterity also increased by 37%. After 2 weeks, the pinch force increased by 1.6 lb and the hand dexterity increased by 78%. However, no significant difference was observed in the self-care ability. The results showed that this 3D-printed device with a triple four-bar linkage for individual with C-SCI improved pinch strength and hand dexterity in these patients, but did not improve their self-care ability. It may help patient in the early stages of C-SCI to learn and use the tenodesis grip easily. However, the usability of the device in daily life needs further research.

Finite Element Analysis and Fabrication of Voronoi Perforated Wrist Hand Orthosis Based on Reverse Engineering Modelling Method

Other than surgery, post-stroke spasticity, fractures due to accidents, sports injuries, and musculoskeletal disorders due to office work on the wrist can be treated using a wrist-hand orthosis. The customized conventional methods usually have some drawbacks, which are more expensive, take a long time to manufacture, and require expert skills from medical therapists. The presence of reverse engineering (RE) technology can be applied in the medical field, such as the manufacture of prosthetic or orthosis devices. This study aims to develop a reverse engineering-based wrist-hand orthosis design, analyze it using the finite element method, and fabricate it. Research methods included 3D scanning, CAD modelling, model analysis, 3D printing, and postprocessing. The model material used was PLA with variations in the thickness of 5 mm, 5.5 mm, and 6 mm, and the load values range from 0 N to 30 N. The results of the equivalent stress analysis showed that the 5 mm thickness model could withstand a load of 30 N with a maximum equivalent stress of 23.46 MPa. With a safety factor value of 2.56, it was still relatively safe, and a critical area was at the back end of the model's palm between the thumb and index finger. The equivalent elastic strain and deformation results also had the same graphic trend with the maximum values for the same model, which were 0.0076 mm and 0.614 mm, respectively. The 3D printing FDM result showed that the Voronoi perforated wrist-hand orthosis prototype was sturdy, fit, and comfortable. It is expected to hold muscle tone and immobilize for hand rehabilitation.

Reduced pain and improved daily activities for individuals with hand osteoarthritis using a silicone wrist hand orthosis

BackgroundSymptoms of hand osteoarthritis (OA), such as pain, reduced grip strength, loss of range of motion (ROM) and joint stiffness, can lead to impaired hand function and difficulty with daily activities. Rehabilitative interventions with orthoses are commonly in the treatment of hand OA to reduce pain, improve hand strength and ROM, provide support for improved function and help with joint stability. PurposeThe objectives of this perception-based study were to evaluate the effect of a silicone wrist hand orthoses (SWHO) on pain and daily functioning. Study DesignThis study is a qualitative descriptive study. The patient received outcome (PRO) questions in the study were based on the Patient Rated Wrist and/or Hand Evaluation (PRWHE), a 15-item questionnaire designed to measure wrist pain and disability in activities of daily living. MethodsPatients with OA using a SWHO were asked to complete a questionnaire about the effectiveness of the brace after wearing it for 3 weeks. Primary outcome measure was general daily functioning with and without the use of the SWHO. Secondary outcome measures were change in pain symptoms and limitations for certain activities with and without the aid. ResultsThe results of this large-scale PROM study of 551 patients on the effectiveness of SWHOs in patients with hand OA show an improvement in overall daily functioning of 77% and a 61% reduction in perceived pain. This study adds to the evidence reported by systematic reviews of conservative interventions for hand OA and further quantifies the effects of a tailor made SWHO. This study confirms that wearing a wrist orthosis has a particularly significant impact on the execution of static and repetitive wrist-straining activities. ConclusionThe study on the effectiveness of a SWHO in patients with hand OA shows that the use of a SWHO contributes to general daily function, reduces pain and increases the breadth of potential daily activities. This study shows that the use of a SWHO appears to offer pain relief and suitable support to the joint.

A 3D-printed soft orthotic hand actuated with twisted and coiled polymer muscles triggered by electromyography signals

<p class="Abstract">Various wearable robotic hands, prosthetic hands, and orthotic exoskeletons developed in the last decade aim to rehabilitate patients whose daily quality of life is affected from hand impairments – however, a majority of these devices are controlled by bulky, expensive, noisy, and uncomfortable actuators. Twisted and coiled polymer (TCP) muscles are novel smart actuators that address these key drawbacks. They have been utilized in soft robotics, hand orthosis exoskeletons, and powered hand orthotic devices; they are also light- weight, high-performance, and inexpensive to manufacture. Previously, TCP muscles have been controlled via power supplies with mechanical switches that are not portable, hence making it unfeasible for long term applications. In this work, a portable control system for TCP muscles via electromyography (EMG) signals that are captured through electrodes placed on the arm of the user and processed through a channel of electrical components to actuate 4-ply TCP muscles, which is demonstrated on a 3D-Printed soft orthotic hand. With portable EMG control, orthotic devices can become more independently accessible to the user, making these devices novel instruments for measuring, aiding, and expediting the progress of hand impairment rehabilitation.</p>

Novel Procedure for Determining the Finger Force in Flexion Depending on the Finger Position

Abstract Introduction: The design and development of a novel dynamic hand orthosis that allows individual and progressive adaptation to the patient’s condition require knowledge about the maximum voluntary contraction forces of the fingers. The following work presents a test setup and procedure for determination of isometric finger contraction forces during flexion depending on various finger positions and finger tasks. Methods: The test setup places hand and fingers in certain positions (position 0: grasping of a plate; position 1-3: circular grasping of cylinders of three different diameters). The force measurement is carried out using pressure sensing: A capacitive force sensor is placed on each fingertip. To perform various finger tasks, the subjects are asked for isometric contraction of defined finger groups and single fingers against the boundary system. For proof of the concept, measurements are performed with six subjects and compared with reference values from the literature. Results: The separated finger force of each finger can be captured during the finger tasks in varying positions. Furthermore, the total finger force of all active fingers can be determined. It is shown that the total finger force during contraction of all fingers (IMRLtask; 78.4N ± 25.8N, d2) is higher than during contraction of the index finger (25.8N ± 3.4N, d2). Furthermore, the single finger force of the index finger is higher than the index finger activity in IMRL-task. The results also show a tendency for the finger contraction force to increase with increasing flexion. Further investigations may require improvements to the method. In this proof of concept, this potential is revealed and discussed. However, the functionality of the test setup and procedure can be demonstrated.

A study of dynamic hand orthosis combined with unilateral task-oriented training in subacute stroke: A functional near-infrared spectroscopy case series.

BackgroundMotor dysfunction in the upper extremities after stroke prohibits people with stroke from being independent in daily living. The application of fNIRS to explore brain activity under rehabilitation intervention is a research focus on neurorehabilitation.ObjectiveThe purpose of this study was to explore, using a grip-release ring motor task, the activated changes of regions of interest and changes in motor function utilizing fNIRS technology and test scales on persons with stroke who received unilateral task-oriented therapy with a hand orthosis in the early subacute stroke period before and after intervention. The study aimed to find a sensitive motor task and region of interest first, then to evaluate the feasibility and mechanism of this rehabilitation method by utilizing fNIRS technology in the next randomized controlled trial.MethodsIn this case series, eight right-handed, right hemiplegia subacute stroke persons (6 males,2 females from age 47 to 72) were enrolled. They received 30 min of unilateral task-oriented therapy without orthosis and 30 min of unilateral task-oriented therapy with orthosis (5 days/week) for 4 weeks. Activated channel numbers and beta values based on oxygenated hemoglobin concentration change using a grip-release ring motor task were estimated with fNIRS. Clinical outcome measures, including grip strength evaluation, action research arm test, and Fugl-Meyer assessment of the arm, were evaluated at the same time.ResultsIndividual activation analysis showed that, after intervention, Subjects 1, 2, 6, 7, and 8 had the maximum mean beta value located in the left premotor cortex, while Subjects 4 and 5 had the maximum mean beta value located in the left sensorimotor cortex. The activation analysis of Subject 3 showed the maximum mean beta value located in the right premotor cortex. Deactivations of left sensorimotor cortex, left premotor cortex, and bilateral prefrontal cortex were observed after intervention which were different from other cases. Group activation analysis showed that bilateral cerebral hemispheres were activated in all eight participants, with right hemisphere and right supplementary motor cortex activated dominantly. After the intervention, the activation of bilateral hemispheres decreased but in different brain regions; there was a trend that the activation intensity of left sensorimotor cortex, right premotor cortex, and right prefrontal cortex decreased while activation intensity of left premotor cortex and left prefrontal cortex increased. Each participant demonstrated improvements in all the clinical test scales after intervention.ConclusionsLeft premotor cortex, left sensorimotor cortex, and right supplementary motor cortex may be the primary regions of interest. Grasp-release ring task was not appropriate to achieve our fNIRS research objective and a more sensitive motor task or more sensitive evaluating indicator should be used in further studies.

Individuals with moderate to severe hand impairments may struggle to use EMG control for assistive devices.

Neurological trauma, such as stroke, traumatic brain injury (TBI), spinal cord injury, and cerebral palsy can cause mild to severe upper limb impairments. Hand impairment makes it difficult for individuals to complete activities of daily living, especially bimanual tasks. A robotic hand orthosis or hand exoskeleton can be used to restore partial function of an intact but impaired hand. It is common for upper extremity prostheses and orthoses to use electromyography (EMG) sensing as a method for the user to control their device. However some individuals with an intact but impaired hand may struggle to use a myoelectrically controlled device due to potentially confounding muscle activity. This study was conducted to evaluate the application of conventional EMG control techniques as a robotic orthosis/exoskeleton user input method for individuals with mild to severe hand impairments. Nine impaired subjects and ten healthy subjects were asked to perform repeated contractions of muscles in their forearm and then onset analysis and feature classification were used to determine the accuracy of the employed EMG techniques. The average accuracy for contraction identification across employed EMG techniques was 95.4% ± 4.9 for the healthy subjects and 73.9% ± 13.1 for the impaired subjects with a range of 47.0% ± 19.1 - 91.6% ± 8.5. These preliminary results suggest that the conventional EMG control technologies employed in this paper may be difficult for some impaired individuals to use due to their unreliable muscle control.

Thumb Stabilization and Assistance in a Robotic Hand Orthosis for Post-Stroke Hemiparesis.

We propose a dual-cable method of stabilizing the thumb in the context of a hand orthosis designed for individuals with upper extremity hemiparesis after stroke. This cable network adds opposition/reposition capabilities to the thumb, and increases the likelihood of forming a hand pose that can successfully manipulate objects. In addition to a passive-thumb version (where both cables are of fixed length), our approach also allows for a single-actuator active-thumb version (where the extension cable is actuated while the abductor remains passive), which allows a range of motion intended to facilitate creating and maintaining grasps. We performed experiments with five chronic stroke survivors consisting of unimanual resistive-pull tasks and bimanual twisting tasks with simulated real-world objects; these explored the effects of thumb assistance on grasp stability and functional range of motion. Our results show that both active- and passive-thumb versions achieved similar performance in terms of improving grasp force generation over a no-device baseline, but active thumb stabilization enabled users to maintain grasps for longer durations.

Hand orthosis design for the rehabilitation of people with rheumatoid arthritis

This project is based on the design and development of a hand orthosis controlled by wireless communication through a mobile application, developed in MIT AppInventor, and a web interface, designed in HTML and CSS; using a NODEMCU ESP8266 V3 development board as a microcontroller in order to obtain the benefit of Wi-Fi communication without ruling out the use of Bluetooth technology. This medical device is focused on the rehabilitation of patients with Rheumatoid Arthritis, or some other pathology that directly affects mobility in the joints of the hands. Similarly, the device has an electromyography module, designed from scratch, in order to monitor the patient's muscle activity and, in the future, achieve control of the orthosis through the possible actions issued by the user or patient. On the other hand, a "Local Network" was implemented with the aim of migrating or embodying the project within a rehabilitation center and having its own communication network, isolated from the outside. Thus, the rehabilitation doctor or physical therapist will be the only person who can control the device when the patient comes to the clinic for therapy or progress review.

Adaptive Semi-Supervised Intent Inferral to Control a Powered Hand Orthosis for Stroke.

In order to provide therapy in a functional context, controls for wearable robotic orthoses need to be robust and intuitive. We have previously introduced an intuitive, user-driven, EMG-based method to operate a robotic hand orthosis, but the process of training a control that is robust to concept drift (changes in the input signal) places a substantial burden on the user. In this paper, we explore semi-supervised learning as a paradigm for controlling a powered hand orthosis for stroke subjects. To the best of our knowledge, this is the first use of semi-supervised learning for an orthotic application. Specifically, we propose a disagreement-based semi-supervision algorithm for handling intrasession concept drift based on multimodal ipsilateral sensing. We evaluate the performance of our algorithm on data collected from five stroke subjects. Our results show that the proposed algorithm helps the device adapt to intrasession drift using unlabeled data and reduces the training burden placed on the user. We also validate the feasibility of our proposed algorithm with a functional task; in these experiments, two subjects successfully completed multiple instances of a pick-and-handover task.

Theta-gamma coupling as a cortical biomarker of brain-computer interface-mediated motor recovery in chronic stroke.

Chronic stroke patients with upper-limb motor disabilities are now beginning to see treatment options that were not previously available. To date, the two options recently approved by the United States Food and Drug Administration include vagus nerve stimulation and brain–computer interface therapy. While the mechanisms for vagus nerve stimulation have been well defined, the mechanisms underlying brain–computer interface-driven motor rehabilitation are largely unknown. Given that cross-frequency coupling has been associated with a wide variety of higher-order functions involved in learning and memory, we hypothesized this rhythm-specific mechanism would correlate with the functional improvements effected by a brain–computer interface. This study investigated whether the motor improvements in chronic stroke patients induced with a brain–computer interface therapy are associated with alterations in phase–amplitude coupling, a type of cross-frequency coupling. Seventeen chronic hemiparetic stroke patients used a robotic hand orthosis controlled with contralesional motor cortical signals measured with EEG. Patients regularly performed a therapeutic brain–computer interface task for 12 weeks. Resting-state EEG recordings and motor function data were acquired before initiating brain–computer interface therapy and once every 4 weeks after the therapy. Changes in phase–amplitude coupling values were assessed and correlated with motor function improvements. To establish whether coupling between two different frequency bands was more functionally important than either of those rhythms alone, we calculated power spectra as well. We found that theta–gamma coupling was enhanced bilaterally at the motor areas and showed significant correlations across brain–computer interface therapy sessions. Importantly, an increase in theta–gamma coupling positively correlated with motor recovery over the course of rehabilitation. The sources of theta–gamma coupling increase following brain–computer interface therapy were mostly located in the hand regions of the primary motor cortex on the left and right cerebral hemispheres. Beta–gamma coupling decreased bilaterally at the frontal areas following the therapy, but these effects did not correlate with motor recovery. Alpha–gamma coupling was not altered by brain–computer interface therapy. Power spectra did not change significantly over the course of the brain–computer interface therapy. The significant functional improvement in chronic stroke patients induced by brain–computer interface therapy was strongly correlated with increased theta–gamma coupling in bihemispheric motor regions. These findings support the notion that specific cross-frequency coupling dynamics in the brain likely play a mechanistic role in mediating motor recovery in the chronic phase of stroke recovery.

Computational Design of an Additively Manufactured Origami-Based Hand Orthosis

AbstractThis work investigates the application of origami as the underlying principle to realize a novel 3D printed hand orthosis design. Due to the special property of some origami to become rigid when forming a closed surface, the orthosis can be printed flat to alleviate the most of the post-processing, and at the same time provide rigid support for the immobilized limb in the folded state. The contributions are the origami-based hand orthosis design and corresponding computational design method, as well as lessons learned regarding the application of origami for the hand orthosis design.

Upper Limb Training with a Dynamic Hand Orthosis in Early Subacute Stroke: A Pilot Randomized Trial.

To investigate the effect of the addition of a dynamic hand orthosis to unilateral task-oriented training in early subacute stroke. Pilot randomized trial with concealed allocation, measurer blinding, and intention-to-treat analysis. Rehabilitation hospital. Thirty subacute stroke patients with moderate-to-severe upper limb disability. All participants received 4 weeks (60 min per day, 5 days a week) of unilateral task-oriented training. The experimental group (n = 15) wore a dynamic hand orthosis during half of the training time (i.e. 30 min per day). Primary outcome was the upper limb activity measured using the Action Research Arm Test (ARAT) measured at baseline and 4 weeks. Secondary outcomes were the Nine-hole Peg Test, Fugl-Meyer Assessment for upper extremity, grip strength, modified Ashworth Scale, Barthel Index and EuroQol-5D. No difference between groups was found for the primary outcome ARAT (mean difference 4/57, 95% confidence interval (95% CI) -5 to 13) nor for any secondary outcome. No additional benefit was found of wearing a dynamic hand orthosis during unilateral taskoriented training in the early subacute period.

784 A Burn Resting Hand Orthosis Fit Checklist

IntroductionResting hand orthoses (RHO) are often used to manage hand burns but can be difficult for inexperienced clinicians to fabricate, assess, and utilize without causing complications to the patient. Previously we had shared data on how we reduced RHO related complications by utilizing burn and hand certified staff to fabricate RHOs.MethodsAdvanced clinicians certified in either hand, burn, or both were queried to describe the methodology they utilized to fabricate an effective RHO. From this query, a list of conditions was created. These conditions were presented to the entire group of certified clinicians and re-examined. Conditions were recorded if consensus was reached on their inclusion for a guide to fabricate a successful RHO.ResultsA 14-condition checklist, with 8 essential items, was developed. It is intended that this checklist can be utilized by less experienced clinicians to guide safe and effective RHO management. ConclusionsThe checklist is a straightforward way to assess commonly identified issues with RHO and offers a potential resource to manage effective fabrication for novice or inexperienced clinicians.

Effect of SaeboTM Orthosis Along with Functional Electrical Stimulation on Hand Function in Patients with Subacute Stroke: A Randomized Controlled Trial

Background: In stroke, there is loss of basic hand function like straightening of the fingers, grip strength andgrasping of the item which make dependent for their basic activity of daily living. The Saebo-FlexTM orthoticis a mechanical device, which enables an individual to open hand, pick up the objects and release during tasksorientedexercises. It facilitating thumb and finger extension movements by recruiting voluntary thumb and fingerflexor movement.Objectives: To determine the effect of FES along with Saebo-FlexTM device on Fugl Meyer assessment score forupper extremity, on Grip Strength, on Pinch Strength and on Hand Dexterity.Methodology: 20 participants were randomly divided into experimental (Saebo-FlexTM hand orthosis + FES +Conventional physiotherapy) and control (FES + conventional physiotherapy) group. Intervention was given for45min/session, 5 session/ week for 6 weeks. Assessment was done using Fugl Meyer assessment-upper extremity,Chedock hand inventory programme, Nine-hole peg test, Hand dynamometer and Pinch gauge on Day 0,Day 12 and Day 42 of the intervention period.Results: The results were found to be non-significant (p>0.05) for all outcome measures. Statistically significantresults were obtained for FMA-UE (p=0.018) on comparison of mean difference scores at Day 0, and Day 42,CAHAI scores (p=0.011) on comparison of mean difference scores at Day 0 and Day 42.Conclusion: According to finding, the integrated intervention of Saebo-FlexTM device along with FunctionalElectrical Stimulation can be used effectively to improve the upper extremity motor functions in sub acute strokesurvivors.

Evaluation of 3D printed customizable hand orthosis for forearm fractures based on Finite Element Modelling

Forearm fractures are very prevalent in the pediatric and adult population which is mostly caused by trauma or injury. Cast immobilization is done is such cases. Casting is a noninvasive procedure used to stabilize fractures and when combined with other fixation devices provides additional comfort. The traditional Plaster of Paris cast and Fiberglass cast are the most known types of fracture casts that has certain complications associated with it. The proposed work entails the design and development of a light weight intelligent cast that immobilizes and stabilizes the fracture as well as assures comfort and promotes aeration to the patient at the same time. A generalized mathematical equation has been derived and implemented in this study using the Talamana method to determine the dimensions of the cast to ensure proper fit. In this work, a materialistic approach has been followed in which the materials were explored and compared with their respective physical properties to choose the ideal one. The cast was evaluated and assessed using the technique of Finite Element Analysis (FEA) to enhance its mechanical strength and to visualize the stress and strain distributions under different loading conditions.