Purpose – Pediatric disorders, such as cerebral palsy and stroke, can result in thumb-in-palm deformity greatly limiting hand function. This not only limits children's ability to perform activities of daily living but also limits important motor skill development. Specifically, the isolated orthosis for thumb actuation (IOTA) is 2 degrees of freedom (DOF) thumb exoskeleton that can actuate the carpometacarpal (CMC) and metacarpophalangeal (MCP) joints through ranges of motion required for activities of daily living. The paper aims to discuss these issues. Design/methodology/approach – IOTA consists of a lightweight hand-mounted mechanism that can be secured and aligned to individual wearers. The mechanism is actuated via flexible cables that connect to a portable control box. Embedded encoders and bend sensors monitor the 2 DOF of the thumb and flexion/extension of the wrist. A linear force characterization was performed to test the mechanical efficiency of the cable-drive transmission and the output torque at the exoskeletal CMC and MCP joints was measured. Findings – Using this platform, a number of control modes can be implemented that will enable the device to be controlled by a patient to assist with opposition grasp and fine motor control. Linear force and torque studies showed a maximum efficiency of 44 percent, resulting in a torque of 2.39±1.06 in.-lbf and 0.69±0.31 in.-lbf at the CMC and MCP joints, respectively. Practical implications – The authors envision this at-home device augmenting the current in-clinic and at-home therapy, enabling telerehabilitation protocols. Originality/value – This paper presents the design and characterization of a novel device specifically designed for pediatric grasp telerehabilitation to facilitate improved functionality and somatosensory learning.

Athletes incorporate afferent signals from the mechanoreceptors of their plantar feet to provide information about posture, stability, and joint position. Sub-threshold stochastic resonance (SR) sensory enhancing insoles have been shown to improve balance and proprioception in young and elderly participant populations. Balance and proprioception are correlated with improved athletic performance, such as agility. Agility is defined as the ability to quickly change direction. An athlete's agility is commonly evaluated during athletic performance testing to assess their ability to participate in a competitive sporting event. Therefore, the purpose of this study was to examine the effects of SR insoles during a hexagonal agility task routinely used by coaches and sports scientists. Twenty recreational athletes were recruited to participate in this study. Each athlete was asked to perform a set of hexagonal agility trials while SR stimulation was either on or off. Vicon motion capture was used to measure feet position during six successful trials for each stimulation condition. Stimulation condition was randomized in a pairwise fashion. The study outcome measures were the task completion time and the positional accuracy of footfalls. Pairwise comparisons revealed a 0.12s decrease in task completion time (p=0.02) with no change in hopping accuracy (p=0.99) when SR stimulation was on. This is the first study to show athletic performance benefits while wearing proprioception and balance improving equipment on healthy participants. With further development, a self-contained sensory enhancing insole device could be used by recreational and professional athletes to improve movements that require rapid changes in direction.

The increased stride time and stride length variability may compromise the stability of gait during and after vigorous walking. However, participants may compensate by increasing double support time and stride width variability to maintain their stability under these adverse conditions. Furthermore, applying SR resulted in an additional increase of stride width variability and may potentially improve balance before, during, and after adverse walking conditions.