Giving Them a Hand: Wearing a Myoelectric Elbow-Wrist-Hand Orthosis Reduces Upper Extremity Impairment in Chronic Stroke

Peters, Heather; Page, Stephen J.; Persch, Andrew

doi:10.1016/j.apmr.2016.12.016

Cited by 53 publications

(55 citation statements)

References 23 publications

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“…The participants voiced their preference for controlling the assistance without their unaffected hand and easily learned to use the automatic mode for one specific task. However, this trial and previous trials have shown that for severely affected arms a well-placed button is more usable over a variety of tasks than motion triggered control and often users' electromyography signals are too weak or sporadic to be used for control [17,53,54]. Most participants required practice to learn how a fork or pen should be oriented in the affected hand and suspected they would need similar practice in their household before understanding how to best incorporate the gloved hand into their daily routine.…”

Section: User Preferences For Hand Robot Design Featuresmentioning

confidence: 82%

“…A number of sensor types (i.e. button [12,14,16], electromyography [17,18], motion [10,14], force [19], voice [20], vision [21,22] and electroencephalography [13] have been selected to control robot assistance based on varied motivations such as robust operation or motivating neuromuscular activation. However, other than button control, these control strategies are still in an experimental stage that requires experts to manually tune each user's orthosis [17].…”

Section: Capabilities Of Wearable Hand Robotsmentioning

confidence: 99%

“…Key contributors to the performance increases were mounting the 80 N actuators to a wrist brace and adding flexion tendons on the palmar side. Although integrating a wrist brace was negatively weighted in a previous hand robot metric [21], wrist braces have been used to provide a rigid mounting point for actuators and to apply strong forces without orthosis migration [15,17,41,42]. In addition to these features, the wrist brace provided us with an anchoring point for the palmar tendons, which was necessary to create the opposition required for a tripod pinch instead of a lateral pinch.…”

Section: Enhancing Finger Extension and Range Of Motionmentioning

confidence: 99%

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Hand Extension Robot Orthosis (HERO) Grip Glove: enabling independence amongst persons with severe hand impairments after stroke

Yurkewich

Kozak

Hébert

et al. 2020

J NeuroEngineering Rehabil

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Background: The Hand Extension Robot Orthosis (HERO) Grip Glove was iteratively designed to meet requests from therapists and persons after a stroke who have severe hand impairment to create a device that extends all five fingers, enhances grip strength and is portable, lightweight, easy to put on, comfortable and affordable. Methods: Eleven persons who have minimal or no active finger extension (Chedoke McMaster Stage of Hand 1-4) post-stroke were recruited to evaluate how well they could perform activities of daily living and finger function assessments with and without wearing the HERO Grip Glove. Results: The 11 participants showed statistically significant improvements (p < 0.01), while wearing the HERO Grip Glove, in the water bottle grasp and manipulation task (increase of 2.3 points, SD 1.2, scored using the Chedoke Hand and Arm Inventory scale from 1 to 7) and in index finger extension (increase of 147 o , SD 44) and range of motion (increase of 145 o , SD 36). The HERO Grip Glove provided 12.7 N (SD 8.9 N) of grip force and 11.0 N (SD 4.8) of pinch force to their affected hands, which enabled those without grip strength to grasp and manipulate blocks, a fork and a water bottle, as well as write with a pen. The participants were 'more or less satisfied' with the HERO Grip Glove as an assistive device (average of 3.3 out of 5 on the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 Scale). The highest satisfaction scores were given for safety and security (4.6) and ease of use (3.8) and the lowest satisfaction scores were given for ease of donning (2.3), which required under 5 min with assistance. The most common requests were for greater grip strength and a smaller glove size for small hands. Conclusions: The HERO Grip Glove is a safe and effective tool for enabling persons with a stroke that have severe hand impairment to incorporate their affected hand into activities of daily living, which may motivate greater use of the affected upper extremity in daily life to stimulate neuromuscular recovery.

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Section: User Preferences For Hand Robot Design Featuresmentioning

confidence: 82%

Section: Capabilities Of Wearable Hand Robotsmentioning

confidence: 99%

Section: Enhancing Finger Extension and Range Of Motionmentioning

confidence: 99%

See 1 more Smart Citation

Hand Extension Robot Orthosis (HERO) Grip Glove: enabling independence amongst persons with severe hand impairments after stroke

Yurkewich

Kozak

Hébert

et al. 2020

J NeuroEngineering Rehabil

View full text Add to dashboard Cite

show abstract

“…The positive aspect of this is that restoring arm and finger extension is fairly straight forward using either mechanical assistance [35,36] or electrical stimulation [37–39]. Systems for these assistance modalities are already on the market and could be coupled with upper arm support to improve their effectiveness.…”

Section: Discussionmentioning

confidence: 99%

A pilot study into reaching performance after severe to moderate stroke using upper arm support

Williams

2018

PLoS ONE

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Stroke effects millions of people each year and can have a significant impact on the ability to use the impaired arm and hand. One of the results of stroke is the development of an abnormal shoulder-elbow flexion synergy, where lifting the arm can cause the elbow, wrist, and finger flexors to involuntarily contract, reducing the ability to reach with the arm and hand opening. This study explored the effect of using support at the upper arm to improve hand and arm reaching performance. Nine participants were studied while performing a virtual reaching task under three conditions: while the weight of their impaired arm was supported by a robot arm, while unsupported, and while using their non-impaired arm. Most subjects exhibited faster and more accurate reaching while supported compared to unsupported. For the subjects who could voluntarily open their hand, most were able to more swiftly open their hand when using upper arm support. In many cases, performance with support was not statistically different than the unaffected arm and hand. Muscle activity of the impaired limb with upper arm support showed decreased effort to lift the arm and reduced biceps activity in most subjects, pointing to a reduction in the abnormal flexion synergy while using upper arm support. While arm support can help to reduce the activation of abnormal synergies, weakness resulting from hemiparesis remains an issue impacting performance. Future systems will need to address both of these causes of disability to more fully restore function after stroke.

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“…Powered hand exoskeletons are a newly emerging technology that have demonstrated promising results in alleviating functional challenges associated with hand impairment or weakness [4,5]. These systems attach to segments of the hand, and actively assist digit flexion and extension to aid in performance of functional grasping tasks by applying forces to appropriate areas of the user's digits.…”

Section: Introductionmentioning

confidence: 99%

Defining the design requirements for an assistive powered hand exoskeleton

et al. 2018

Preprint

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The goal of this study was to identify design criteria for the development of an assistive powered hand exoskeleton by consulting with potential end users. Structured interviews with clinicians and patients with hand impairment were carried out and the results were tabulated. Three participants with impaired hand function also underwent a quantitative measurement session regarding hand function. The objective of the measurement sessions was to understand the characteristics, abilities and limitations of the upper limb of individuals who could benefit from a hand exoskeleton device, in order to better define design criteria and control options for such a device. For the most part, clinicians and participants with hand impairment agreed on expectations for a hand exoskeleton device on topics including important grasp patterns, wear time, and grip strength. However, their expectation seemed to diverge on the topic of control, where clinicians felt simple reliable control strategies would be preferred, but patients desired intuitive control. This research has identified key features of hand exoskeleton design requirements that will need to be met in order to have acceptable clinical translation to patient populations. Including endusers in the design of such a device is essential for successful patient-oriented technology development.

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Giving Them a Hand: Wearing a Myoelectric Elbow-Wrist-Hand Orthosis Reduces Upper Extremity Impairment in Chronic Stroke

Cited by 53 publications

References 23 publications

Hand Extension Robot Orthosis (HERO) Grip Glove: enabling independence amongst persons with severe hand impairments after stroke

Hand Extension Robot Orthosis (HERO) Grip Glove: enabling independence amongst persons with severe hand impairments after stroke

A pilot study into reaching performance after severe to moderate stroke using upper arm support

Defining the design requirements for an assistive powered hand exoskeleton

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