Design Criteria of Soft Exogloves for Hand Rehabilitation- Assistance Tasks

This paper establishes design criteria for soft exogloves (SEG) to be used as rehabilitation or assistance devices. This research consists in identifying, selecting, and grouping SEG features based on the analysis of 91 systems that have been proposed during the last decade. Thus, function, mobility, and usability criteria are defined and explicitly discussed to highlight SEG design guidelines. Additionally, this study provides a detailed description of each system that was analysed including application, functional task, palm design, actuation type, assistance mode, degrees of freedom (DOF), target fingers, motions, material, weight, force, pressure (only for fluids), control strategy, and assessment. Such characteristics have been reported according to specific design methodologies and operating principles. Technological trends are contemplated in this contribution with emphasis on SEG design opportunity areas. In this review, suggestions, limitations, and implications are also discussed in order to enhance future SEG developments aimed at stroke survivors or people with hand disabilities

Pilot Test of Dosage Effects in HEXORR II for Robotic Hand Movement Therapy in Individuals With Chronic Stroke

Impaired use of the hand in functional tasks remains difficult to overcome in many individuals after a stroke. This often leads to compensation strategies using the less-affected limb, which allows for independence in some aspects of daily activities. However, recovery of hand function remains an important therapeutic goal of many individuals, and is often resistant to conventional therapies. In prior work, we developed HEXORR I, a robotic device that allows practice of finger and thumb movements with robotic assistance. In this study, we describe modifications to the device, now called HEXORR II, and a clinical trial in individuals with chronic stroke. Fifteen individuals with a diagnosis of chronic stroke were randomized to 12 or 24 sessions of robotic therapy. The sessions involved playing several video games using thumb and finger movement. The robot applied assistance to extension movement that was adapted based on task performance. Clinical and motion capture evaluations were performed before and after training and again at a 6-month followup. Fourteen individuals completed the protocol. Fugl-Meyer scores improved significantly at the 6 month time point compared to baseline, indicating reductions in upper extremity impairment. Flexor hypertonia (Modified Ashworth Scale) also decreased significantly due to the intervention. Motion capture found increased finger range of motion and extension ability after the intervention that continued to improve during the followup period. However, there was no change in a functional measure (Action Research Arm Test). At the followup, the high dose group had significant gains in hand displacement during a forward reach task. There were no other significant differences between groups. Future work with HEXORR II should focus on integrating it with functional task practice and incorporating grip and squeezing tasks.Trial Registration:ClinicalTrials.gov, NCT04536987. Registered 3 September 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT04536987

Cable Actuated Dexterous (CADEX) Glove for Effective Rehabilitation of the Hand for Patients with Neurological Diseases

Neuroplastic changes in motor cortex is essential for the recovery motor function of patients with neurological diseases. To enlarge neuroplastic change, various movements should be provided to stimulate larger motor cortical area, and because hands occupy the largest area, it is especially important. Many wearable robotic devices have been developed for rehabilitation of the hand, and soft robotic devices in particular have drawn attention for their compact design. However, most soft devices provide simple thumb motions, which flex or extend all joints without assistance of opposition/reposition of the carpometacarpal joint although the importance in producing various grasps. In this study, the design of a cable actuated dexterous (CADEX) glove is proposed. For dexterous motion, the structure and orientation of major finger tendons were replicated with exotendons (actuated cables), and four exotendons were used for the thumb with the path optimized to provide flexion/extension of the thumb and decoupled opposition/reposition of the carpometacarpal with other joints. To provide consistent motion, silicon was used for stable anchoring of exotendons while preventing slippage and reducing deformation. The motion generated by the CADEX glove was experimentally evaluated for a single healthy subject. The result shows that the CADEX glove could flex and extend the finger with various ratios among joints, and the opposition/reposition of carpometacarpal joint of the thumb could be achieved consistently with minimal effect on the other joints. The CADEX glove is expected to help providing various tasks which is expected to enhance the functional recovery of patients with neurological disease