Hand Rehabilitation Devices: A Comprehensive Systematic Review

Abstract

A cerebrovascular accident, or a stroke, can cause significant neurological damage, inflicting the patient with loss of motor function in their hands. Standard rehabilitation therapy for the hand increases demands on clinics, creating an avenue for powered hand rehabilitation devices. Hand rehabilitation devices (HRDs) are devices designed to provide the hand with passive, active, and active-assisted rehabilitation therapy; however, HRDs do not have any standards in terms of development or design. Although the categorization of an injury’s severity can guide a patient into seeking proper assistance, rehabilitation devices do not have a set standard to provide a solution from the beginning to the end stages of recovery. In this paper, HRDs are defined and compared by their mechanical designs, actuation mechanisms, control systems, and therapeutic strategies. Furthermore, devices with conducted clinical trials are used to determine the future development of HRDs. After evaluating the abilities of 35 devices, it is inferred that standard characteristics for HRDs should include an exoskeleton design, the incorporation of challenge-based and coaching therapeutic strategies, and the implementation of surface electromyogram signals (sEMG) based control.

A Review of Wrist Rehabilitation Robots and Highlights Needed for New Devices

“…Numerous ailments, including physical traumas, strokes, neurological disorders, sports-related injuries, and traffic accidents, can result in impairments to the wrist [1]. In particular, stroke is the leading cause of disability among adults worldwide, causing a high number of individuals to have motor and cognitive deficits [2,3]. The main consequence of this brain injury is the loss or weakening of the movements of the human body, especially of the upper limbs [4].…”

“…Compared to traditional care, robotic rehabilitation can be better performed at high intensity and frequency, being able to continuously monitor exercise performance so that the level of treatment is tailored to the patient's needs [16]. One of the applications of robotics in medicine is the development of devices to aid in the rehabilitation of the human wrist [1,3]. The human wrist is a joint having three degrees of freedom that connects the hand to the forearm, developing radial/ulnar deviation, flexion/extension, and pronation/supination movements [17].…”

Initial Testing of Robotic Exoskeleton Hand Device for Stroke Rehabilitation

“…Moggio et al published a meta-analysis comparing exoskeleton versus end-effector robot-assisted therapy for finger-hand motor recovery in stroke survivors [ 30 ]. Aggogeri et al [ 31 ] and Kabir et al [ 32 ] reviewed the research status in hand rehabilitation robotic technology and evaluated several devices to describe the current state of the art [ 31 ]. Another overview of hand rehabilitation robotics, which addressed everything from the hardware systems to the training paradigms, was published in 2017 [ 33 ].…”

“…The actuation mechanism’s main function is to transform the motion of the actuator to the fingers to achieve the hand therapy exercises. They depend on the nature of the actuator and can be categorized into main classifications: pneumatic actuation [ 27 , 36 ], linkage-based actuation [ 37 , 38 , 39 , 40 , 41 ], cable-driven systems [ 33 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ], and gear-motor actuation [ 32 ]. Linkage and gear-motor actuation are commonly used for hand rehabilitation devices.…”

Data-Driven Predictive Control of Exoskeleton for Hand Rehabilitation with Subspace Identification

“…It should assist in this instance with active-assistive rehabilitation procedures. Resistance exercises for muscle strengthening can be done once the patient regains his mobility [ 6 , 7 ]. Robot control design must have an adaptive structure to perform the rehabilitation processes.…”