Application of Robot to Hand Function Rehabilitation

Jiang, Jingang; Min, Zhaowei; Ma, Xikui; Zhang, Yongde; Song, Shichang

doi:10.2174/2212797611666180118094318

Cited by 6 publications

(3 citation statements)

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“…In this study, we selected five movements of interest, due to their importance in hand dexterity and fine motor skills: index-thumb pinch (IT-P), middle-thumb pinch (MT-P), ring-thumb pinch (RT-P), pinkie-thumb pinch (PT-P), and closed hand (CH) (see Figure 2) [48][49][50]. The EMG system selected was the Myo Armband (Thalmic Labs) that recorded eight differential channels at a sample rate of 200 Hz.…”

Section: Data Acquisitionmentioning

confidence: 99%

Progressive Rehabilitation Based on EMG Gesture Classification and an MPC-Driven Exoskeleton

Bonilla,

Bravo,

Bonilla

et al. 2023

Bioengineering

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Stroke is a leading cause of disability and death worldwide, with a prevalence of 200 millions of cases worldwide. Motor disability is presented in 80% of patients. In this context, physical rehabilitation plays a fundamental role for gradually recovery of mobility. In this work, we designed a robotic hand exoskeleton to support rehabilitation of patients after a stroke episode. The system acquires electromyographic (EMG) signals in the forearm, and automatically estimates the movement intention for five gestures. Subsequently, we developed a predictive adaptive control of the exoskeleton to compensate for three different levels of muscle fatigue during the rehabilitation therapy exercises. The proposed system could be used to assist the rehabilitation therapy of the patients by providing a repetitive, intense, and adaptive assistance.

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Section: Data Acquisitionmentioning

confidence: 99%

Progressive Rehabilitation Based on EMG Gesture Classification and an MPC-Driven Exoskeleton

Bonilla,

Bravo,

Bonilla

et al. 2023

Bioengineering

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“…However, these robotic systems are not yet available in hand therapy settings. A recent survey that aimed to examine patents and developments for hand rehabilitation robots found 28 systems, among which only 1, the Hand Exoskeleton Rehabilitation Robot, was designed to provide continuous passive motion (ie, the robot executes the motion of the patient’s upper limbs) as well as active independent movements (ie, the patient performs a motion according to his or her own ability) to the fingers and the thumb [ 9 ]. In another review, only 2 robotic devices were found for active independent movement of the hand [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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

Miguel-Cruz¹,

Guptill²,

Gregson³

et al. 2021

JMIR Res Protoc

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

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“…Based on the review of literature presented above, and analysis of other reviews in the topic [23,41,63,100,[111][112][113][114][115][116][117][118][119][120], we identified a few challenges that still remain to be addressed and which this work will target.…”

Section: Open Challengesmentioning

confidence: 99%

Cable-driven underactuated wearable robotic devices for hand assistance

Bernardo¹

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To address the first aim, we carried out a feasibility clinical trial with ten post-stroke patients performing Activities of Daily Living (ADLs). We evaluated the physiological and kinematic effects of using a preliminary version of our hand exoskeleton that supported only finger extension combined with an elbow-assisting soft wearable robot (exosuit). We observed a reduction in the mean electromyographic (EMG) activity of the Biceps Brachii (BB), Anterior Deltoid (AD) and Extensor Digitorum Communis (EDC) muscles, as well as in the coactivation of pairs of muscles typically associated with pathological synergies. Questionnaires filled out by the participants, alongside discussions with healthcare professionals, provided positive and constructive feedback. This encouraged our continued efforts to develop and refine the device to expand its functionalities.The next step was to develop a model of the behaviour of the structures for defined input tensions on the wires. The main design parameter considered in the model is the rotational stiffness of the joints. By selecting different joint stiffness values, specific motions can be achieved. An optimisation-based framework was developed to automatically adjust the design of the structures to the dimensions of the user's hands. The optimisation goal was to follow the first postural synergy of the hand, which is known to encode a large amount of information regarding common patterns of human hands in daily life.We experimentally verified the created model, and obtained low error of the angular trajectory of the structure's joints, also observing low Cartesian position error of the elements. Then, a 3D-printed index finger (dimensioned following the average male user) was actuated by a structure, and the finger's angular trajectories were compared to the simulated ones. Low errors were obtained for the Metacarpophalangeal (MCP) and Proximal Interphalangeal (PIP) joints, and a moderate error for the Distal Interphalangeal (DIP) joint. Importantly, we observed that the stiffness of the structure could be modulated by controlling the tensions applied on the flexion and extension tendons: increasing the co-contraction of the tendons resulted in an increased stiffness at the joints. The fingertip forces exerted by the structure were evaluated, and reached the desired threshold corresponding to the values typically applied by therapists on low to moderately impaired stroke patients. Finally, in a qualitative manner, we demonstrated the successful grasping of a diverse set of objects typically used in rehabilitation settings.The first main contribution of this thesis is the demonstration of the potential that wearable robots have in aiding the upper limbs of impaired users in ADLs. This provides an important building block of evidence towards the use of robotic devices for assistance. The next main contribution is an underactuated mechanism for hand assistance. This is coupled with an automatic, model-based procedure that designs structures optimised to achieve the first postur...

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Application of Robot to Hand Function Rehabilitation

Cited by 6 publications

References 0 publications

Progressive Rehabilitation Based on EMG Gesture Classification and an MPC-Driven Exoskeleton

Progressive Rehabilitation Based on EMG Gesture Classification and an MPC-Driven Exoskeleton

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

Cable-driven underactuated wearable robotic devices for hand assistance

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