Modeling & Analysis of Design Parameters for Portable Hand Orthoses to Assist Upper Motor Neuron Syndrome Impairments and Prototype Design

Wearable assistive robotics have the potential to address an unmet medical need of reducing disability in individuals with chronic hand impairments due to neurological trauma. Despite myriad prior works, few patients have seen the benefits of such devices. Following application experience with tendon-actuated soft robotic gloves and a collaborator\u27s orthosis with novel flat-spring actuators, we identified two common assumptions regarding hand orthosis design. The first was reliance on incomplete studies of grasping forces during activities of daily living as a basis for design criteria, leading to poor optimization. The second was a neglect of increases in muscle tone following neurological trauma, rendering most devices non-applicable to a large subset of the population. To address these gaps, we measured joint torques during activities of daily living with able-bodied subjects using dexterity representative of orthosis-aided motion. Next, we measured assistive torques needed to extend the fingers of individuals with increased flexor tone following TBI. Finally, we applied this knowledge to design a cable actuated orthosis for assisting finger extension, providing a basis for future work focused on an under-represented subgroup of patients

A soft, synergy-based robotic glove for grasping assistance

This paper presents a soft, tendon-driven, robotic glove designed to augment grasp capability and provide rehabilitation assistance for postspinal cord injury patients. The basis of the design is an underactuation approach utilizing postural synergies of the hand to support a large variety of grasps with a single actuator. The glove is lightweight, easy to don, and generates sufficient hand closing force to assist with activities of daily living. Device efficiency was examined through a characterization of the power transmission elements, and output force production was observed to be linear in both cylindrical and pinch grasp configurations. We further show that, as a result of the synergy-inspired actuation strategy, the glove only slightly alters the distribution of forces across the fingers, compared to a natural, unassisted grasping pattern. Finally, a preliminary case study was conducted using a participant suffering from an incomplete spinal cord injury (C7). It was found that through the use of the glove, the participant was able to achieve a 50% performance improvement (from four to six blocks) in a standard Box and Block test

Study and development of sensorimotor interfaces for robotic human augmentation

This thesis presents my research contribution to robotics and haptics in the context of human augmentation. In particular, in this document, we are interested in bodily or sensorimotor augmentation, thus the augmentation of humans by supernumerary robotic limbs (SRL). The field of sensorimotor augmentation is new in robotics and thanks to the combination with neuroscience, great leaps forward have already been made in the past 10 years. All of the research work I produced during my Ph.D. focused on the development and study of fundamental technology for human augmentation by robotics: the sensorimotor interface. This new concept is born to indicate a wearable device which has two main purposes, the first is to extract the input generated by the movement of the user's body, and the second to provide the somatosensory system of the user with an haptic feedback. This thesis starts with an exploratory study of integration between robotic and haptic devices, intending to combine state-of-the-art devices. This allowed us to realize that we still need to understand how to improve the interface that will allow us to feel the agency when using an augmentative robot. At this point, the path of this thesis forks into two alternative ways that have been adopted to improve the interaction between the human and the robot. In this regard, the first path we presented tackles two aspects conerning the haptic feedback of sensorimotor interfaces, which are the choice of the positioning and the effectiveness of the discrete haptic feedback. In the second way we attempted to lighten a supernumerary finger, focusing on the agility of use and the lightness of the device. One of the main findings of this thesis is that haptic feedback is considered to be helpful by stroke patients, but this does not mitigate the fact that the cumbersomeness of the devices is a deterrent to their use. Preliminary results here presented show that both the path we chose to improve sensorimotor augmentation worked: the presence of the haptic feedback improves the performance of sensorimotor interfaces, the co-positioning of haptic feedback and the input taken from the human body can improve the effectiveness of these interfaces, and creating a lightweight version of a SRL is a viable solution for recovering the grasping function

A hand exoskeleton for study of rehabilitation and assistance of spinal cord injury patients

A large number of people experience neurological disorders in their life time, and these patients seek to regain their body functions with rehabilitation and assistive devices. In this dissertation, we present the development of a hand exoskeleton, called Maestro, which is designed to advance research in fields of hand rehabilitation and hand assistive devices. Maestro is mechanically and electrically robust, accurate in sensing and actuation, and compatible to various rehabilitation schemes, subjects, hardware/software, and different operators. As a result of these features, Maestro has led to research on adaptive control theories for diverse properties of hands, the development of a hand-wrist exoskeleton, the development of a novel rehabilitation framework, progress of hand muscle fatigues, and assistance for SCI patients. Particularly on the assistance for SCI patients, we present that the advantage of a compliant hand assistive device may result in high success ratios for grasping various objects required in activities of daily living (ADL) with surface EMG sensors. The hand functions of SCI subjects are evaluated with and without Maestro through a standardized hand function test called Sollerman hand function test (SHFT). The results with six SCI subjects show that the hand functions of C6 and C7 SCI subjects improved with assistance from Maestro.Mechanical Engineerin

Fingertip position and force control for dexterous manipulation through accurate modeling of hand-exoskeleton-environment

Despite mechanical advancements in the design of hand exoskeleton devices to help people with hand disabilities regain partial hand function, their manipulation performance has remained far inferior compared to the human hand. State-of-the-art control strategies implemented on exoskeletons are mainly focused on robot joint-level position control, although accurate control of fingertip positions and forces is a requirement for reaching human-like dexterity and manipulation. The relationships between inputs (motor commands) and outputs (fingertip positions and forces) are highly nonlinear due to the inherent limitations in actuation structure of multiple degree of freedom (DOF) exoskeletons. Moreover, the simplified coupled models of finger joint movements do not hold when humans interact with external objects and exert forces at their fingertips. Therefore achieving dexterous manipulation will require accurate models of interaction between the fingers, hand exoskeleton system, and fingertip environment. In this thesis we accomplish, for the first time, fingertip position and force control with an assistive multi-DOF hand exoskeleton through accurate modeling of the hand-exoskeleton-environment. First, we provide kinematic and kinetic models for the human fingers, robot structure, and the Bowden cable power transmission for a fully actuated hand exoskeleton design. Next, we validate the models in simulation and demonstrate the successful control of fingertip position and forces in everyday drawing tasks. Finally, we utilize an experimental setup with a finger exoskeleton unit with two actuated DOF attached to an instrumented testbed finger to demonstrate successful tracking of fingertip position and forces within human accuracy levels through model-based control.Mechanical Engineerin

Design, development and deployment of a hand/wrist exoskeleton for home-based rehabilitation after stroke - SCRIPT project

YesChanges in world-wide population trends have provided new demands for new technologies in areas such as care and rehabilitation. Recent developments in the the field of robotics for neurorehabilitation have shown a range of evidence regarding usefulness of these technologies as a tool to augment traditional physiotherapy. Part of the appeal for these technologies is the possibility to place a rehabilitative tool in one’s home, providing a chance for more frequent and accessible technologies for empowering individuals to be in charge of their therapy. Objective: this manuscript introduces the Supervised Care and Rehabilitation Involving Personal Tele-robotics (SCRIPT) project. The main goal is to demonstrate design and development steps involved in a complex intervention, while examining feasibility of using an instrumented orthotic device for home-based rehabilitation after stroke. Methods: the project uses a user-centred design methodology to develop a hand/wrist rehabilitation device for home-based therapy after stroke. The patient benefits from a dedicated user interface that allows them to receive feedback on exercise as well as communicating with the health-care professional. The health-care professional is able to use a dedicated interface to send/receive communications and remote-manage patient’s exercise routine using provided performance benchmarks. Patients were involved in a feasibility study (n=23) and were instructed to use the device and its interactive games for 180 min per week, around 30 min per day, for a period of 6 weeks, with a 2-months follow up. At the time of this study, only 12 of these patients have finished their 6 weeks trial plus 2 months follow up evaluation. Results: with the “use feasibility” as objective, our results indicate 2 patients dropping out due to technical difficulty or lack of personal interests to continue. Our frequency of use results indicate that on average, patients used the SCRIPT1 device around 14 min of self-administered therapy a day. The group average for the system usability scale was around 69% supporting system usability. Conclusions: based on the preliminary results, it is evident that stroke patients were able to use the system in their homes. An average of 14 min a day engagement mediated via three interactive games is promising, given the chronic stage of stroke. During the 2nd year of the project, 6 additional games with more functional relevance in their interaction have been designed to allow for a more variant context for interaction with the system, thus hoping to positively influence the exercise duration. The system usability was tested and provided supporting evidence for this parameter. Additional improvements to the system are planned based on formative feedback throughout the project and during the evaluations. These include a new orthosis that allows a more active control of the amount of assistance and resistance provided, thus aiming to provide a more challenging interaction.This work has been partially funded under Grant FP7-ICT-288698(SCRIPT) of the European Community Seventh Framework Programme

Kinematics and Robot Design IV, KaRD2021

This volume collects the papers published on the special issue “Kinematics and Robot Design IV, KaRD2021” (https://www.mdpi.com/journal/robotics/special_issues/KaRD2021), which is the forth edition of the KaRD special-issue series, hosted by the open-access journal “MDPI Robotics”. KaRD series is an open environment where researchers can present their works and discuss all the topics focused on the many aspects that involve kinematics in the design of robotic/automatic systems. Kinematics is so intimately related to the design of robotic/automatic systems that the admitted topics of the KaRD series practically cover all the subjects normally present in well-established international conferences on “mechanisms and robotics”. KaRD2021, after the peer-review process, accepted 12 papers. The accepted papers cover some theoretical and many design/applicative aspects

WiGlove : A Passive Dynamic Orthosis for Home-based Post-stroke Rehabilitation of Hand and Wrist

Stroke survivors often experience varying levels of motor function deficits in their hands affecting their ability to perform activities of daily life. Recovering their hand functions through neurorehabilitation is a significant step in their recovery towards independent living. Home-based rehabilitation using robotic devices allows stroke survivors to train at their convenience independent of factors such as the availability of therapists’ appointments and the need for frequent travel to outpatient clinics. While many robotic solutions have been proposed to address the above concerns, most focus on training only the wrist or the fingers, neglecting the synergy between the two. To address this, the WiGlove was co-designed to allow hemiparetic stroke survivors to train both the wrist and fingers in the comfort of their homes. The central hypothesis of this work is to investigate if a device designed using user-centred methods featuring aspects of usability such as easy donning and doffing and wireless operation, can act as a feasible tool for home-based rehabilitation of the hand and wrist following stroke. In order to aid this investigation, we tackled this task in three stages of usability and feasibility evaluations. Firstly, healthy participants tried the current state of the art, the SCRIPT Passive Orthosis, as well as the WiGlove, in a counterbalanced, within-subject experiment and attested to WiGlove’s improvement in several aspects of usability such as ease of don/doffing, suitability for ADL, unblocked natural degrees of freedom, safety and aesthetic appeal. Subsequently, a heuristic evaluation with six stroke therapists validated these improvements and helped identify issues they perceived to potentially affect the device’s acceptance. Integrating this feedback, the updated WiGlove was subjected to a six-week summative feasibility evaluation with two stroke survivors, with varying levels of impairment, in their homes without supervision from the therapists. Results from this study were overwhelmingly positive on the usability and acceptance of the WiGlove. Furthermore, in the case of the first participant who trained with it for a total of 39 hours, notable improvements were observed in the participant’s hand functions. It showed that even without a prescribed training protocol, both participants were willing to train regularly with the WiGlove and its games, sometimes several times a day. These results demonstrate that WiGlove can be a promising tool for home-based rehabilitation for stroke survivors and serve as evidence for a larger user study with more participants with varying levels of motor impairments due to stroke. The findings of this study also offer preliminary evidence supporting the effectiveness of training with the WiGlove, particularly in the case of the first participant, who exhibited a significant reduction of tone in the hand as a result of increased training intensity. Owing to the participant’s satisfaction with the device, it was requested by him to extend his involvement in the study by using the WiGlove for a longer duration which was facilitated

Usability Assessment of a Cable-Driven Exoskeletal Robot for Hand Rehabilitation

Study design: Case series.Background: Robot-assisted rehabilitation mediated by exoskeletal devices is a popular topic of research. The biggest difficulty in the development of rehabilitation robots is the consideration of the clinical needs. This study investigated the usability of a novel cable-driven exoskeletal robot specifically designed for hand rehabilitation.Methods: The study consists of three steps, including prototype development, spasticity observation, and usability evaluation. First, we developed the prototype robot DexoHand to manipulate the patient's fingers based on the clinical needs and the cable-driven concept established in our previous work. Second, we applied DexoHand to patients with different levels of spasticity. Finally, we obtained the system usability scale (SUS) and assessed its usability.Results: Two healthy subjects were recruited in the pre-test, and 18 patients with stroke and four healthy subjects were recruited in the formal test for usability. The total SUS score obtained from the patients and healthy subjects was 94.77 ± 2.98 (n = 22), indicating an excellent level of usability. The satisfaction score was 4.74 ± 0.29 (n = 22), revealing high satisfaction with DexoHand. The tension profile measured by the cables showed the instantaneous force used to manipulate fingers among different muscle tone groups.Conclusions:DexoHand meets the clinical needs with excellent usability, satisfaction, and reliable tension force monitoring, yielding a feasible platform for robot-assisted hand rehabilitation

Biomechatronics: Harmonizing Mechatronic Systems with Human Beings

This eBook provides a comprehensive treatise on modern biomechatronic systems centred around human applications. A particular emphasis is given to exoskeleton designs for assistance and training with advanced interfaces in human-machine interaction. Some of these designs are validated with experimental results which the reader will find very informative as building-blocks for designing such systems. This eBook will be ideally suited to those researching in biomechatronic area with bio-feedback applications or those who are involved in high-end research on manmachine interfaces. This may also serve as a textbook for biomechatronic design at post-graduate level