151 research outputs found

    On the development of a cybernetic prosthetic hand

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    The human hand is the end organ of the upper limb, which in humans serves the important function of prehension, as well as being an important organ for sensation and communication. It is a marvellous example of how a complex mechanism can be implemented, capable of realizing very complex and useful tasks using a very effective combination of mechanisms, sensing, actuation and control functions. In this thesis, the road towards the realization of a cybernetic hand has been presented. After a detailed analysis of the model, the human hand, a deep review of the state of the art of artificial hands has been carried out. In particular, the performance of prosthetic hands used in clinical practice has been compared with the research prototypes, both for prosthetic and for robotic applications. By following a biomechatronic approach, i.e. by comparing the characteristics of these hands with the natural model, the human hand, the limitations of current artificial devices will be put in evidence, thus outlining the design goals for a new cybernetic device. Three hand prototypes with a high number of degrees of freedom have been realized and tested: the first one uses microactuators embedded inside the structure of the fingers, and the second and third prototypes exploit the concept of microactuation in order to increase the dexterity of the hand while maintaining the simplicity for the control. In particular, a framework for the definition and realization of the closed-loop electromyographic control of these devices has been presented and implemented. The results were quite promising, putting in evidence that, in the future, there could be two different approaches for the realization of artificial devices. On one side there could be the EMG-controlled hands, with compliant fingers but only one active degree of freedom. On the other side, more performing artificial hands could be directly interfaced with the peripheral nervous system, thus establishing a bi-directional communication with the human brain

    A virtual hand assessment system for efficient outcome measures of hand rehabilitation

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    Previously held under moratorium from 1st December 2016 until 1st December 2021.Hand rehabilitation is an extremely complex and critical process in the medical rehabilitation field. This is mainly due to the high articulation of the hand functionality. Recent research has focused on employing new technologies, such as robotics and system control, in order to improve the precision and efficiency of the standard clinical methods used in hand rehabilitation. However, the designs of these devices were either oriented toward a particular hand injury or heavily dependent on subjective assessment techniques to evaluate the progress. These limitations reduce the efficiency of the hand rehabilitation devices by providing less effective results for restoring the lost functionalities of the dysfunctional hands. In this project, a novel technological solution and efficient hand assessment system is produced that can objectively measure the restoration outcome and, dynamically, evaluate its performance. The proposed system uses a data glove sensorial device to measure the multiple ranges of motion for the hand joints, and a Virtual Reality system to return an illustrative and safe visual assistance environment that can self-adjust with the subject’s performance. The system application implements an original finger performance measurement method for analysing the various hand functionalities. This is achieved by extracting the multiple features of the hand digits’ motions; such as speed, consistency of finger movements and stability during the hold positions. Furthermore, an advanced data glove calibration method was developed and implemented in order to accurately manipulate the virtual hand model and calculate the hand kinematic movements in compliance with the biomechanical structure of the hand. The experimental studies were performed on a controlled group of 10 healthy subjects (25 to 42 years age). The results showed intra-subject reliability between the trials (average of crosscorrelation ρ = 0.7), inter-subject repeatability across the subject’s performance (p > 0.01 for the session with real objects and with few departures in some of the virtual reality sessions). In addition, the finger performance values were found to be very efficient in detecting the multiple elements of the fingers’ performance including the load effect on the forearm. Moreover, the electromyography measurements, in the virtual reality sessions, showed high sensitivity in detecting the tremor effect (the mean power frequency difference on the right Vextensor digitorum muscle is 176 Hz). Also, the finger performance values for the virtual reality sessions have the same average distance as the real life sessions (RSQ =0.07). The system, besides offering an efficient and quantitative evaluation of hand performance, it was proven compatible with different hand rehabilitation techniques where it can outline the primarily affected parts in the hand dysfunction. It also can be easily adjusted to comply with the subject’s specifications and clinical hand assessment procedures to autonomously detect the classification task events and analyse them with high reliability. The developed system is also adaptable with different disciplines’ involvements, other than the hand rehabilitation, such as ergonomic studies, hand robot control, brain-computer interface and various fields involving hand control.Hand rehabilitation is an extremely complex and critical process in the medical rehabilitation field. This is mainly due to the high articulation of the hand functionality. Recent research has focused on employing new technologies, such as robotics and system control, in order to improve the precision and efficiency of the standard clinical methods used in hand rehabilitation. However, the designs of these devices were either oriented toward a particular hand injury or heavily dependent on subjective assessment techniques to evaluate the progress. These limitations reduce the efficiency of the hand rehabilitation devices by providing less effective results for restoring the lost functionalities of the dysfunctional hands. In this project, a novel technological solution and efficient hand assessment system is produced that can objectively measure the restoration outcome and, dynamically, evaluate its performance. The proposed system uses a data glove sensorial device to measure the multiple ranges of motion for the hand joints, and a Virtual Reality system to return an illustrative and safe visual assistance environment that can self-adjust with the subject’s performance. The system application implements an original finger performance measurement method for analysing the various hand functionalities. This is achieved by extracting the multiple features of the hand digits’ motions; such as speed, consistency of finger movements and stability during the hold positions. Furthermore, an advanced data glove calibration method was developed and implemented in order to accurately manipulate the virtual hand model and calculate the hand kinematic movements in compliance with the biomechanical structure of the hand. The experimental studies were performed on a controlled group of 10 healthy subjects (25 to 42 years age). The results showed intra-subject reliability between the trials (average of crosscorrelation ρ = 0.7), inter-subject repeatability across the subject’s performance (p > 0.01 for the session with real objects and with few departures in some of the virtual reality sessions). In addition, the finger performance values were found to be very efficient in detecting the multiple elements of the fingers’ performance including the load effect on the forearm. Moreover, the electromyography measurements, in the virtual reality sessions, showed high sensitivity in detecting the tremor effect (the mean power frequency difference on the right Vextensor digitorum muscle is 176 Hz). Also, the finger performance values for the virtual reality sessions have the same average distance as the real life sessions (RSQ =0.07). The system, besides offering an efficient and quantitative evaluation of hand performance, it was proven compatible with different hand rehabilitation techniques where it can outline the primarily affected parts in the hand dysfunction. It also can be easily adjusted to comply with the subject’s specifications and clinical hand assessment procedures to autonomously detect the classification task events and analyse them with high reliability. The developed system is also adaptable with different disciplines’ involvements, other than the hand rehabilitation, such as ergonomic studies, hand robot control, brain-computer interface and various fields involving hand control

    Development of a hybrid assist-as-need hand exoskeleton for stroke rehabilitation.

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    Stroke is one of the leading causes of disability globally and can significantly impair a patient’s ability to function on a daily basis. Through physical rehabilitative measures a patient may regain a level of functional independence. However, required therapy dosages are often not met. Rehabilitation is typically implemented through manual one-to-one assistance with a physiotherapist, which quickly becomes labour intensive and costly. Hybrid application of functional electrical stimulation (FES) and robotic support can access the physiological benefits of direct muscle activation while providing controlled and repeatable motion assistance. Furthermore, patient engagement can be heightened through the integration of a volitional intent measure, such as electromyography (EMG). Current hybrid hand-exoskeletons have demonstrated that a balanced hybrid support profile can alleviate FES intensity and motor torque requirements, whilst improving reference tracking errors. However, these support profiles remain fixed and patient fatigue is not addressed. The aim of this thesis was to develop a proof-of-concept assist-as-need hybrid exoskeleton for post-stroke hand rehabilitation, with fatigue monitoring to guide the balance of support modalities. The device required the development and integration of a constant current (CC) stimulator, stimulus-resistant EMG device, and hand-exoskeleton. The hand exoskeleton in this work was formed from a parametric Watt I linkage model that adapts to different finger sizes. Each linkage was optimised with respect to angular precision and compactness using Differential Evolution (DE). The exoskeleton’s output trajectory was shown to be sensitive to parameter variation, potentially caused by finger measurement error and shifts in coupler placement. However, in a set of cylindrical grasping trials it was observed that a range of movement strategies could be employed towards a successful grasp. As there are many possible trajectories that result in a successful grasp, it was deduced that the exoskeleton can still provide functional assistance despite its sensitivity to parameter variation. The CC stimulator developed in this work has a part cost of USD 145andallowsflexibleadjustmentofwaveformparametersthroughanon−boardmicro−controller.Thedeviceisdesignedtooutputcurrentupto±30mAgivenavoltagecomplianceof±50V.Whenappliedacrossa2k℩load,thedeviceexhibitedalinearoutputtransferfunction,withamaximumramptrackingerrorof5Thestimulus−resistantEMGdevicebuildsoncurrentdesignsbyusinganovelSchmitttriggerbasedartefactdetectionchanneltoadaptivelyblankstimulationartefactswithoutstimulatorsynchronisation.ThedesignhasapartcostofUSD145 and allows flexible adjustment of waveform parameters through an on-board micro-controller. The device is designed to output current up to ±30mA given a voltage compliance of ±50V. When applied across a 2k℩ load, the device exhibited a linear output transfer function, with a maximum ramp tracking error of 5%. The stimulus-resistant EMG device builds on current designs by using a novel Schmitt trigger based artefact detection channel to adaptively blank stimulation artefacts without stimulator synchronisation. The design has a part cost of USD 150 and has been made open-source. The device demonstrated its ability to record EMG over its predominant energy spectrum during stimulation, through the stimulation electrodes or through separate electrodes. Pearson’s correlation coefficients greater than 0.84 were identified be- tween the normalised spectra of volitional EMG (vEMG) estimates during stimulation and of stimulation-free EMG recordings. This spectral similarity permits future research into applications such as spectral-based monitoring of fatigue and muscle coherence, posing an advantage over current same-electrode stimulation and recording systems, which can- not sample the lower end of the EMG spectrum due to elevated high-pass filter cut-off frequencies. The stimulus-resistant EMG device was used to investigate elicited EMG (eEMG)-based fatigue metrics during vEMG-controlled stimulation and hybrid support profiles. During intermittent vEMG-controlled stimulation, the eEMG peak-to-peak amplitude (PTP) index was the median frequency (MDF) had a negative correlation for all subjects with R > 0:62 during stimulation-induced wrist flexion and R > 0:55 during stimulation-induced finger flexion. During hybrid FES-robotic support trials, a 40% reduction in stimulus intensity resulted in an average 21% reduction in MDF gradient magnitudes. This reflects lower levels of fatigue during the hybrid support profile and indicates that the MDF gradient can provide useful information on the progression of muscle fatigue. A hybrid exoskeleton system was formed through the integration of the CC stimulator, stimulus-resistant EMG device, and the hand exoskeleton developed in this work. The system provided assist-as-need functional grasp assistance through stimulation and robotic components, governed by the user’s vEMG. The hybrid support profile demonstrated consistent motion assistance with lowered stimulation intensities, which in-turn lowered the subjects’ perceived levels of fatigue

    MUNDUS project : MUltimodal neuroprosthesis for daily upper limb support

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    Background: MUNDUS is an assistive framework for recovering direct interaction capability of severely motor impaired people based on arm reaching and hand functions. It aims at achieving personalization, modularity and maximization of the user’s direct involvement in assistive systems. To this, MUNDUS exploits any residual control of the end-user and can be adapted to the level of severity or to the progression of the disease allowing the user to voluntarily interact with the environment. MUNDUS target pathologies are high-level spinal cord injury (SCI) and neurodegenerative and genetic neuromuscular diseases, such as amyotrophic lateral sclerosis, Friedreich ataxia, and multiple sclerosis (MS). The system can be alternatively driven by residual voluntary muscular activation, head/eye motion, and brain signals. MUNDUS modularly combines an antigravity lightweight and non-cumbersome exoskeleton, closed-loop controlled Neuromuscular Electrical Stimulation for arm and hand motion, and potentially a motorized hand orthosis, for grasping interactive objects. Methods: The definition of the requirements and of the interaction tasks were designed by a focus group with experts and a questionnaire with 36 potential end-users. Five end-users (3 SCI and 2 MS) tested the system in the configuration suitable to their specific level of impairment. They performed two exemplary tasks: reaching different points in the working volume and drinking. Three experts evaluated over a 3-level score (from 0, unsuccessful, to 2, completely functional) the execution of each assisted sub-action. Results: The functionality of all modules has been successfully demonstrated. User’s intention was detected with a 100% success. Averaging all subjects and tasks, the minimum evaluation score obtained was 1.13 ± 0.99 for the release of the handle during the drinking task, whilst all the other sub-actions achieved a mean value above 1.6. All users, but one, subjectively perceived the usefulness of the assistance and could easily control the system. Donning time ranged from 6 to 65 minutes, scaled on the configuration complexity. Conclusions: The MUNDUS platform provides functional assistance to daily life activities; the modules integration depends on the user’s need, the functionality of the system have been demonstrated for all the possible configurations, and preliminary assessment of usability and acceptance is promising

    Limits to temporal synchronization in fundamental hand and finger actions

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    Coordinated movement is critical not only to sports technique and performance but to daily living and as such represents a fundamental area of research. Coordination requires being able to produce the right actions at the right time and has to incorporate perception, cognition, and forceful neuro-muscular interaction with the environment. Coordinated movements of the hands and fingers are some of the most complex activities undertaken where continuous learning and adaptation take place, but the temporal variability of the most basic movement components is still unknown. This thesis investigates the extent of temporal variability in the execution of four different simple hand and finger coordination tasks, with the purpose to find the various intrinsic temporal variability which limit the ability to coordinate the hands in space and time. Study one showed that in a synchronized bi-lateral two finger tapping test (<<1 cm movement to target) the best participant had a temporaltiming variability of 4.8 ms whereas the largest time variability could be as high as 24.8 ms. No obvious improvement was found after transfer practice, whereas the average time variability for asynchronized tapping decreased from 62.1 ms to 30.3 ms after instructed practice indicating a likely change in task grouping. Study two showed that in a unilateral thumb-index finger pinch and release test, the largest mean timing variability was 12 ms for pinching irrespective of performing the task in a slow alert manner or at a faster speed. However, the mean temporal variability for release was only 6.3 ms when the task was performed in a more alert manner and indicates that release is more accurately controlled temporally than grip. Study three suggested that in a unilateral sagittal plane throwing action of the lower arm and hand, that elbow and wrist coordination for dynamic index finger tip location was better with a radial-ulnar deviation, darts-type, throwing action than a wrist flexor-extensor type action, basketball free throw type action (the mean variability was 37.5 ms and 27.2 ms, respectively). Study four compared the variability in bi-lateral finger tapping between voluntary tapping and involuntary finger contraction tapping. Electrically stimulated neural contractions had significantly lower force onset variability than voluntary or direct magnetic stimulation of muscles (6 ms, 9.5 ms, and 10.3 ms for electrically stimulated, voluntary and Transcranial Magnetic Stimulation stimulated contraction). This work provides a comprehensive analysis of the temporal variability in various fundamental digital movement tasks that can aid with the understanding of basic human coordination in sporting, daily living and clinical areas

    Neurorehabilitation of the hand using the cybergrasp[TM] and mirror image

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    In recent years, researchers have explored the use of a mirror image as a means of rehabilitation for individuals suffering from hemiparesis. Through neuroimaging and functional testing, neurological improvement has been demonstrated in those that engage in mirror therapy. Bilateral training, or simultaneous movement of both sides of the body, has also been studied as a treatment method to improve function after cerebral vascular accident. The development of robotic systems to assist movement of the human body has played a major role in the fabrication of bilateral training devices. In this experiment, the CyberGraspℱ robotic exoskeleton was used to assist the paretic hand in simultaneous bilateral movement in three subjects more than 1 year post stroke. While the bilateral motion took place, the subject viewed a mirror image of their unaffected hand superimposed on their impaired hand. Results at the end of 2 weeks showed no major change in active digit extension, but a noted decrease in the stretch reflex and clinically significant improvements on the Jebsen Test of Hand Function. The system resulted in no major side effects. In conclusion, robot-assisted bilateral training in conjunction with mirror therapy may be a helpful treatment in patients suffering from hemiparesis due to neurological impairment. The experiment conducted demonstrated the feasibility of the system to be used in further research

    A robot for hand rehabilitation

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    Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, February 2001.Includes bibliographical references (p. 369-372).This thesis describes the design of a robot for hand rehabilitation and is based on earlier work done in the MIT Newman Lab for Biomechanics and Human Rehabilitation. The goal of the new robot described here is to provide rehabilitative therapy to the hand. MIT MANUS is an active therapy device previously designed and built in the Newman Lab. It has been used with success to improve strength and control of the upper extremity and promote recovery in stroke patients. However, research showed that only joints directly involved in robot therapy demonstrated greater improvement than the control group. This data was an impetus to design robotic therapy for other parts of the body. Another factor in the development of this robot was that there is a need for functional therapy. A robot which can provide active therapy using the functional tasks of the hand would be very novel. The robot design described in this thesis fulfills the requirements of such an idea. The robot will later be combined with controls software and video games to allow for active therapy of the hand. Included in this thesis is the background information on rehabilitative hand therapy, as well as on the anatomy and function of the hand, used for the design. Design options and choices are discussed. Finally the overall design and current status of the robot are presented.by Kristin Anne Jugenheimer.S.M

    Design and implementation of robotic devices for physical therapy of distal upper extremity

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    According to statistics of World Health Organization, hand injuries count for 1/3 of all injuries with more than one million emergency cases annually. Physical rehabilitation accounts for most of the recovery experienced by patients suffering from hand injury. Robotic devices decrease the cost of therapy while providing repetitive exercises with quantitative measurements. In this study, we present the design and implementation of two robotic devices for hand therapy. After kinematic type selection ensuring safety, ergonomics and adjustability; both of the devices are optimally dimensioned to achieve best kinematic and dynamic performance. The primary use for the first device is to assist flexion/extension motions of a finger within its full range, in a natural and coordinated manner, while keeping the tendon tension within acceptable limits to avoid rupture of the suture. The second device is designed for forearm/wrist and grasp therapy of a neurologically injured human arm and hand. Emphasizing the importance of coordinated movements of the wrist and the hand while performing activities of daily living (ADL) tasks, the device possesses 3 degrees of freedom and is designed to assist abduction/adduction and palmar/dorsal flexion of the wrist or pronation/supination of the forearm, concurrently with the grasping and releasing movements of the hand. Thanks to its modular, interchangeable end effectors, the device supports ADL exercises. Both devices are built and experimentally characterized. Human subject experiments and usability tests have been conducted for the devices and the efficacy of devices to deliver desired wrist and hand therapies have been demonstrated

    Optimizing Physical Function Following Distal Radius Fracture

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    Distal Radius Fracture (DRF) is one of the most frequent of all human bone fractures. Wrist and/or finger range of motion (ROM) and grip strength are standard outcome measures used by clinicians to evaluate recovery after a hand injury. ROM is considered to be an important component of joint mobility and relates to measures of functional impairment and disability. Impaired wrist and hand ROM are related to a decrease in grip strength, grasp ability, fine manipulation, and hand function. The relationship between ROM and other physical impairments as they relate to patient-rated outcomes after DRF have not been well identified. The thesis includes three studies. The first study (Chapter 2) is a systematic review and meta analysis of existing literature on the effects of laser irradiation on bone regeneration, suggesting that low power laser can enhance biomechanical indicators of bone during fracture healing in animal models. The second study (Chapter 3) explores the intra-rater, inter-rater, and inter-instrument reliability and construct validity of two digital electro goniometers to measure active wrist and active/passive index finger ROM in patients with limited wrist and/or hand. The results of this study demonstrate that digital goniometry is highly reliable for all measures across occasions, raters and instruments. The moderate correlation between individual joint motions and patient-rated self-reported function suggests that joint motion impairments contribute to functional disability. The third study (Chapter 4) has a specific focus on the relationship between physical impairment outcome measures and patient-rated wrist pain and function in early and late stages after distal radius fracture. Wrist flexion, extension, supination, pronation, grip strength, age and gender, were found to contribute significantly with wrist pain and function. Good wrist arc of motions (close to normal) and moderate grip strength must be recovered to have optimal wrist functional outcomes after distal radius fracture. The thesis concludes with a discussion of the next steps required toward understanding effective mechanisms to promote bone healing and earlier function after DRF, which may lead to more effective patient-centered treatment protocols. Keywords: Bone Healing, Distal Radius Fracture, Physical Impairment, Patient-Rated Wrist Evaluation
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