Exoskeletal Devices for Hand Assistance and Rehabilitation: A Comprehensive Analysis of State-of-the-Art Technologies

Noronha, Bernardo; Accoto, Dino

doi:10.1109/tmrb.2021.3064412

Cited by 52 publications

(24 citation statements)

References 128 publications

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“…Also, robotic hand orthoses for both, assistance and therapy, have gained momentum in the last decade. Interestingly, a recent review on the technological maturity of such hand orthoses provided very similar insights in terms of TRL which indicates that our data might realistically represent the current WRD maturity state [32]. In both analyses, TRL 4 (= technology tested in lab environment) appears to be a bottleneck for numerous WRD developments, indicating the first implementation barrier between basic research and application, also known as "valley of death".…”

Section: Contexts Of Use and Maturity Of Wearable Robotssupporting

confidence: 62%

An Analysis of Usability Evaluation Practices And Contexts of Use In Wearable Robotics

Meyer

Gassert

Lambercy

2021

Preprint

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Background : User-centered design approaches have gained attention over the past decade, aiming to tackle the technology acceptance issues of wearable robotic devices to assist, support or augment human capabilities. While there is a consensus that usability is key to user-centered design, dedicated usability evaluation studies are scarce and clear evaluation guidelines are missing. However, the careful consideration and integration of user needs appears to be essential to successfully develop an effective, efficient, and satisfactory human-robot interaction. Methods : Through an online survey for developers of wearable robotics, we wanted to understand how the design and evaluation in actual daily practice compares to what is reported in literature. With a total of 31 questions, we analyzed the most common wearable robotic device applications and their technology maturity, and how these influence usability evaluation practices. Results : A total of 158 responses from a heterogeneous population were collected and analyzed. The dataset representing contexts of use for augmentation (16.5%), assistance (38.0%), therapy (39.8%), as well as few other specifc applications (5.7%), allowed for an insightful analysis of the influence of technology maturity on user involvement and usability evaluation. We identifed functionality, ease of use, and performance as the most evaluated usability attributes and could specify which measures are used to assess them. Also, we could underline the frequent use of qualitative measures alongside the expected high prevalence of performance-metrics. In conclusion of the analysis, we derived evaluation recommendations to foster user-centered design and usability evaluation. Conclusion : This analysis might serve as state-of-the-art comparison and recommendation for usability studies in wearable robotics. We believe that by motivating for more balanced, comparable and user-oriented evaluation practices, we may support the wearable robotics field in tackling the technology acceptance limitations.

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Section: Contexts Of Use and Maturity Of Wearable Robotssupporting

confidence: 62%

An Analysis of Usability Evaluation Practices And Contexts of Use In Wearable Robotics

Meyer

Gassert

Lambercy

2021

Preprint

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“…In the past decades, robotic exoskeletons were mostly stationary, enabling limited movement, that is, finger extension/flexion, but no functional grasping. 57 First systems allowing manipulation of objects outside the laboratory still came with bulky control boxes and battery units that did not allow patients to move around freely. 6 Building on various technological advancements, a new generation of portable and versatile exoskeletons has emerged.…”

Section: B/nes For Clinical Application: Where Are We?mentioning

confidence: 99%

“…Depending on the characteristics of construction, 3 distinct types of these exoskeletons can be distinguished: rigid, soft, and hybrid exoskeletons. 57 Exoskeletons with rigid components can typically exert high forces and can be controlled with great accuracy. However, such systems are often obtrusive and heavy (eg, MyoPro by Myomo, ~1.600 g), increasing the risk of injuries.…”

Section: B/nes For Clinical Application: Where Are We?mentioning

confidence: 99%

Brain–Computer Interface-Controlled Exoskeletons in Clinical Neurorehabilitation: Ready or Not?

Colucci

Vermehren

Cavallo

et al. 2022

Neurorehabil Neural Repair

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The development of brain–computer interface-controlled exoskeletons promises new treatment strategies for neurorehabilitation after stroke or spinal cord injury. By converting brain/neural activity into control signals of wearable actuators, brain/neural exoskeletons (B/NEs) enable the execution of movements despite impaired motor function. Beyond the use as assistive devices, it was shown that—upon repeated use over several weeks—B/NEs can trigger motor recovery, even in chronic paralysis. Recent development of lightweight robotic actuators, comfortable and portable real-world brain recordings, as well as reliable brain/neural control strategies have paved the way for B/NEs to enter clinical care. Although B/NEs are now technically ready for broader clinical use, their promotion will critically depend on early adopters, for example, research-oriented physiotherapists or clinicians who are open for innovation. Data collected by early adopters will further elucidate the underlying mechanisms of B/NE-triggered motor recovery and play a key role in increasing efficacy of personalized treatment strategies. Moreover, early adopters will provide indispensable feedback to the manufacturers necessary to further improve robustness, applicability, and adoption of B/NEs into existing therapy plans.

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“…However, they can be difficult to model and control [15] and attaching them to the body is not trivial [16]. For these reasons, hybrid wearable robots that employ features characteristic of both soft and rigid systems in a complementary manner have become increasingly popular in recent years [17]. Such exoskeletons leverage the soft components for increased compliance and comfort with the hard ones for embedding safety features and improving power transmission.…”

Section: Introductionmentioning

confidence: 99%

Soft, Lightweight Wearable Robots to Support the Upper Limb in Activities of Daily Living: A Feasibility Study on Chronic Stroke Patients

Noronha

Little

et al. 2022

IEEE Trans. Neural Syst. Rehabil. Eng.

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Stroke can be a devastating condition that impairs the upper limb and reduces mobility. Wearable robots can aid impaired users by supporting performance of Activities of Daily Living (ADLs). In the past decade, soft devices have become popular due to their inherent malleable and low-weight properties that makes them generally safer and more ergonomic. In this study, we present an improved version of our previously developed gravity-compensating upper limb exosuit and introduce a novel hand exoskeleton. The latter uses 3D-printed structures that are attached to the back of the fingers which prevent undesired hyperextension of joints. We explored the feasibility of using this integrated system in a sample of 10 chronic stroke patients who performed 10 ADLs. We observed a significant reduction of 30.3 ± 3.5% (mean ± standard error), 31.2 ± 3.2% and 14.0 ± 5.1% in the mean muscular activity of the Biceps Brachii (BB), Anterior Deltoid (AD) and Extensor Digitorum Communis muscles, respectively. Additionally, we observed a reduction of 14.0 ± 11.5%, 14.7 ± 6.9% and 12.8 ± 4.4% in the coactivation of the pairs of muscles BB and Triceps Brachii (TB), BB and AD, and TB and Pectoralis Major (PM), respectively, typically associated to pathological muscular synergies, without significant degradation of healthy muscular coactivation. There was also a significant increase of elbow flexion angle (12.1±1.5°). These results further cement the potential of using lightweight wearable devices to assist impaired users.

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Exoskeletal Devices for Hand Assistance and Rehabilitation: A Comprehensive Analysis of State-of-the-Art Technologies

Cited by 52 publications

References 128 publications

An Analysis of Usability Evaluation Practices And Contexts of Use In Wearable Robotics

An Analysis of Usability Evaluation Practices And Contexts of Use In Wearable Robotics

Brain–Computer Interface-Controlled Exoskeletons in Clinical Neurorehabilitation: Ready or Not?

Soft, Lightweight Wearable Robots to Support the Upper Limb in Activities of Daily Living: A Feasibility Study on Chronic Stroke Patients

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