Robotic Approaches for Rehabilitation of Hand Function After Stroke

Abstract

The goal of this review was to discuss the impairments in hand function after stroke and present previous work on robot-assisted approaches to movement neurorehabilitation. Robotic devices offer a unique training environment that may enhance outcomes beyond what is possible with conventional means. Robots apply forces to the hand, allowing completion of movements while preventing inappropriate movement patterns. Evidence from the literature is emerging that certain characteristics of the human-robot interaction are preferable. In light of this evidence, the robotic hand devices that have undergone clinical testing are reviewed, highlighting the authors' work in this area. Finally, suggestions for future work are offered. The ability to deliver therapy doses far higher than what has been previously tested is a potentially key advantage of robotic devices that needs further exploration. In particular, more efforts are needed to develop highly motivating home-based devices, which can increase access to high doses of assisted movement therapy.

Pneumatic Multi-Pocket Elastomer Actuators for Metacarpophalangeal Joint Flexion and Abduction-Adduction

“…Thus, as the population ages in developed countries, demand for rehabilitation therapy increases to support the people in remaining as functioning members of society. This has led to increased interest towards developing devices that could be used for supporting, protecting and recovering the functions of the aging human body [1][2][3][4].…”

Effects of Functional Electrical Stimulation with and without a Wrist-Hand Orthosis on Hand Opening in Individuals with Chronic Hemiparetic Stroke: A Pilot Study

“…Motor impairments strongly affect daily life activities [3,4]. For individuals with severely affected arms post stroke, the evidence that conventional therapy can restore meaningful hand function is not strong [4][5][6][7][8].…”

Characterization of a hand-wrist exoskeleton, READAPT, via kinematic analysis of redundant pointing tasks

“…Often, the anatomical, biomechanical, and functional couplings of the hand and wrist are overlooked in robotic rehabilitation. A number of hand and wrist exoskeletons have been separately developed [7]- [9], and the efficacy of robot-aided rehabilitation has been clinically verified [10]. Still, most devices do not allow for coordinated movement of the wrist and hand.…”