Muscle-tendon units provide limited contributions to the passive stiffness of the index finger metacarpophalangeal joint

Contribution of Soft Tissue Passive Forces in Thumb Carpometacarpal Joint Distraction

Thumb carpometacarpal joint space changes when the surrounding soft tissues including the capsule, ligaments, and tendons are stretched or pulled away. When at rest, joint forces originate from passive contraction of muscles and the involvement of joint capsule and ligaments. Previous biomechanical models of hand and finger joints have mostly focused on the assessment of joint properties when muscles were active. This study aims to present an experimental-numerical biomechanical model of thumb carpometacarpal joint to explore the contribution of tendons, ligaments, and other soft tissues in the passive forces during distraction. Five fresh cadaveric specimens were tested using a distractor device to measure the applied forces upon gradual distraction of the intact joint. The subsequent step involved inserting a minuscule sensor into the joint capsule through a small incision, while preserving the integrity of tendons and ligaments, in order to accurately measure the fundamental intra-articular forces. A numerical model was also used to calculate the passive forces of tendons and ligaments. Before the separation of bones, the forces exerted by tendons and ligaments were relatively small compared to the capsule force, which accounted for approximately 92% of the total applied force. Contribution of tendons and ligaments, however, increased by further distraction. The passive force contribution by tendons at 2-mm distraction was determined less than 11%, whereas it reached up to 74% for the ligaments. The present study demonstrated that the ligament-capsule complex plays significant contribution in passive forces of thumb carpometacarpal joint during distraction.

An online method to monitor hand muscle tone during robot-assisted rehabilitation

Introduction: Robot-assisted neurorehabilitation is becoming an established method to complement conventional therapy after stroke and provide intensive therapy regimes in unsupervised settings (e.g., home rehabilitation). Intensive therapies may temporarily contribute to increasing muscle tone and spasticity, especially in stroke patients presenting tone alterations. If sustained without supervision, such an increase in muscle tone could have negative effects (e.g., functional disability, pain). We propose an online perturbation-based method that monitors finger muscle tone during unsupervised robot-assisted hand therapy exercises. Methods: We used the ReHandyBot, a novel 2 degrees of freedom (DOF) haptic device to perform robot-assisted therapy exercises training hand grasping (i.e., flexion-extension of the fingers) and forearm pronosupination. The tone estimation method consisted of fast (150 ms) and slow (250 ms) 20 mm ramp-and-hold perturbations on the grasping DOF, which were applied during the exercises to stretch the finger flexors. The perturbation-induced peak force at the finger pads was used to compute tone. In this work, we evaluated the method performance in a stiffness identification experiment with springs (0.97 and 1.57 N/mm), which simulated the stiffness of a human hand, and in a pilot study with subjects with increased muscle tone after stroke and unimpaired, which performed one active sensorimotor exercise embedding the tone monitoring method. Results: The method accurately estimates forces with root mean square percentage errors of 3.8% and 11.3% for the soft and stiff spring, respectively. In the pilot study, six chronic ischemic stroke patients [141.8 (56.7) months after stroke, 64.3 (9.5) years old, expressed as mean (std)] and ten unimpaired subjects [59.9 (6.1) years old] were tested without adverse events. The average reaction force at the level of the fingertip during slow and fast perturbations in the exercise were respectively 10.7 (5.6) N and 13.7 (5.6) N for the patients and 5.8 (4.2) N and 6.8 (5.1) N for the unimpaired subjects. Discussion: The proposed method estimates reaction forces of physical springs accurately, and captures online increased reaction forces in persons with stroke compared to unimpaired subjects within unsupervised human-robot interactions. In the future, the identified range of muscle tone increase after stroke could be used to customize therapy for each subject and maintain safety during intensive robot-assisted rehabilitation.

Human-like Endtip Stiffness Modulation Inspires Dexterous Manipulation with Robotic Hands

We present a novel method for biomechanically inspired mechanical and control design by quantifying stable manipulation regions in 3D space for tendon-driven systems. Using this method, we present an analysis of the stiffness properties for a human-like index finger and thumb. Although some studies have previously evaluated biomechanical stiffness for grasping and manipulation, no prior works have evaluated the effect of anatomical stiffness parameters throughout the reachable workspace of the index finger or thumb. The passive stiffness model of biomechanically accurate tendon-driven human-like fingers enables analysis of conservatively passive stable regions. The passive stiffness model of the index finger shows that the greatest stiffness ellipsoid volume is aligned to efficiently oppose the anatomical thumb. The thumb model reveals that the greatest stiffness aligns with abduction/adduction near the index finger and shifts to align with the flexion axes for more efficient opposition of the ring or little fingers. Based on these models, biomechanically inspired stiffness controllers that efficiently utilize the underlying stiffness properties while maximizing task criteria can be developed. Trajectory tracking tasks are experimentally tested on the index finger to show the effect of stiffness and stability boundaries on performance.

Verification of Finger Joint Stiffness Estimation Method With Soft Robotic Actuator

Stroke has been the leading cause of disability due to the induced spasticity in the upper extremity. The constant flexion of spastic fingers following stroke has not been well described. Accurate measurements for joint stiffness help clinicians have a better access to the level of impairment after stroke. Previously, we conducted a method for quantifying the passive finger joint stiffness based on the pressure-angle relationship between the spastic fingers and the soft-elastic composite actuator (SECA). However, it lacks a ground-truth to demonstrate the compatibility between the SECA-facilitated stiffness estimation and standard joint stiffness quantification procedure. In this study, we compare the passive metacarpophalangeal (MCP) joint stiffness measured using the SECA with the results from our designed standalone mechatronics device, which measures the passive metacarpophalangeal joint torque and angle during passive finger rotation. Results obtained from the fitting model that concludes the stiffness characteristic are further compared with the results obtained from SECA-Finger model, as well as the clinical score of Modified Ashworth Scale (MAS) for grading spasticity. These findings suggest the possibility of passive MCP joint stiffness quantification using the soft robotic actuator during the performance of different tasks in hand rehabilitation.

Effect of Age and Body Size on the Wrist's Viscoelasticity in Healthy Participants From 3 to 90 Years Old and Reliability Assessment

Excessive or insufficient levels of passive musculoarticular stiffness (PMAS) can lead to joint impairment or instability. Quantifying the PMAS may provide a better understanding of neurological or musculoskeletal disorders. The aims of the present study were multiple: first, to assess the reliability of quantifying PMAS and to collect normative data on the wrist in healthy participants, and second, to assess the effect of age and body size on PMAS. For this purpose, a total of 458 participants from 3 to 90 years old were analyzed with an electromechanical oscillation device (EOD). Passive sinusoidal movements were induced in a flexion/extension pattern in the participants' wrists, enabling an objective measurement of elastic stiffness (EL) and viscous stiffness (VI). Both the dominant and non-dominant wrists were assessed. Two-way repeated-measures ANOVA revealed a sex differentiation from puberty (12-18 years old) and an increase of EL and VI from childhood to adulthood and a decrease of stiffness at old age. EL and VI values were associated with body size characteristics and age. After body size normalization, EL was no longer influenced by the variables measured. On the other hand, VI remained moderately influenced by age and body size. The current study was able to provide normative data of PMAS in the wrist of healthy participants.

Simultaneous Kinematic and Contact Force Modeling of a Human Finger Tendon System Using Bond Graphs and Robotic Validation

This paper aims to use bond graph modeling to create the most comprehensive finger tendon model and simulation to date. Current models are limited to either free motion without external contact or fixed finger force transmission between tendons and fingertip. The forward dynamics model, presented in this work, simultaneously simulates the kinematics of tendon-finger motion and contact forces of a central finger given finger tendon inputs. The model equations derived from bond graphs are accompanied by nonlinear relationships modeling the anatomical complexities of moment arms, tendon slacking, and joint range of motion (ROM). The structure of the model is validated using a robotic testbed, Utah's Anatomically correct Robotic Testbed (UART) finger. Experimental motion of the UART finger during free motion (no external contact) and surface contact are simulated using the bond graph model. The contact forces during the surface contact experiments are also simulated. On average, the model was able to predict the steady-state pose of the finger with joint angle errors less than 6 deg across both free motion and surface contact experiments. The static contact forces were accurately predicted with an average of 11.5% force magnitude error and average direction error of 12 deg.

Towards the Exploitation of Physical Compliance in Segmented and Electrically Actuated Robotic Legs: A Review Focused on Elastic Mechanisms

Physical compliance has been increasingly used in robotic legs, due to its advantages in terms of the mechanical regulation of leg mechanics and energetics and the passive response to abrupt external disturbances during locomotion. This article presents a review of the exploitation of physical compliance in robotic legs. Particular attention has been paid to the segmented, electrically actuated robotic legs, such that a comparable analysis can be provided. The utilization of physical compliance is divided into three main categories, depending on the setting locations and configurations, namely, (1) joint series compliance, (2) joint parallel compliance, and (3) leg distal compliance. With an overview of the representative work related to each category, the corresponding working principles and implementation processes of various physical compliances are explained. After that, we analyze in detail some of the structural characteristics and performance influences of the existing designs, including the realization method, compliance profile, damping design, and quantitative changes in terms of mechanics and energetics. In parallel, the design challenges and possible future works associated with physical compliance in robotic legs are also identified and proposed. This article is expected to provide useful paradigmatic implementations and design guidance for physical compliance for researchers in the construction of novel physically compliant robotic legs.

Bio-inspired tendon driven mechanism for simultaneous finger joints flexion using a soft hand exoskeleton

A new tendon driven mechanism, embedded into a soft hand exoskeleton for rehabilitation and assistance, was proposed in this study. The proposed solution was a pulley flexion mechanism inspired by the human musculoskeletal system to enable a natural and comfortable finger flexion. A biomechanical constraint for the finger flexion motion states that the relation between the proximal interphalangeal joint angle of the finger should always be flexed around 1.5 times the distal interphalangeal joint angle. The study aimed to comply with this constraint, by simultaneously distributing the forces over the distal and middle finger phalanges. For evaluation, the voluntary and exoskeleton flexions were compared based on the relation between the proximal and distal interphalangeal joint angles. The results showed that during the exoskeleton flexion the relation between the interphalangeal joints complied with the biomechanical constraint, where the proximal interphalangeal joint angle was 1.5 times larger than the distal interphalangeal joint. This ensures that the mechanism flexes the finger comfortably. The proposed solution is therefore a promising design for a novel soft exoskeleton that will be used for training and assistance of patients with hand paralysis.

Model-based analysis of the stiffness of the wrist joint in active and passive conditions

The control of joint stiffness is a fundamental mechanism used to control human movements. While many studies have observed how stiffness is modulated for tasks involving shoulder and elbow motion, a limited amount of knowledge is available for wrist movements, though the wrist plays a crucial role in manipulation. We have developed a computational framework based on a realistic musculoskeletal model, which al to calculate the passive and active components of the wrist joint stiffness. We first used the framework to validate the musculoskeletal model against experimental measurements of the wrist joint stiffness, and then to study the contribution of different muscle groups to the passive joint stiffness. We finally used the framework to study the effect of muscle co-contraction on the active joint stiffness. The results show that thumb and finger muscles play a crucial role in determining the passive wrist joint stiff- ness: in the neutral posture, the direction of maximum stiffness aligns with the experimental measurements, and the magnitude increases by 113% when they are included. Moreover, the analysis of the controllability of joint stiffness showed that muscle co-contraction positively correlates with the stiffness magnitude and negatively correlates with the variability of the stiffness orientation (p < 0.01 in both cases). Finally, an exhaustive search showed that with appropriate selection of a muscle activation strategy, the joint stiffness orientation can be arbitrarily modulated. This observation suggests the absence of biomechanical constraints on the controllability of the orientation of the wrist joint stiffness.

Incorporating the length-dependent passive-force generating muscle properties of the extrinsic finger muscles into a wrist and finger biomechanical musculoskeletal model

Dynamic movement trajectories of low mass systems have been shown to be predominantly influenced by passive viscoelastic joint forces and torques compared to momentum and inertia. The hand is comprised of 27smallmass segments. Because of the influence of the extrinsic finger muscles, the passive torques about each finger joint become a complex function dependent on the posture of multiple joints of the distal upper limb. However, biomechanical models implemented for the dynamic simulation of hand movements generally don't extend proximally to include the wrist and distal upper limb. Thus, they cannot accurately represent these complex passive torques. The purpose of this short communication is to both describe a method to incorporate the length-dependent passive properties of the extrinsic index finger muscles into a biomechanical model of the upper limb and to demonstrate their influence on combined movement of the wrist and fingers. Leveraging a unique set of experimental data, that describes the net passive torque contributed by the extrinsic finger muscles about the metacarpophalangeal joint of the index finger as a function of both metacarpophalangeal and wrist postures, we simulated the length-dependent passive properties of the extrinsic finger muscles. Dynamic forward simulations demonstrate that a model including these properties passively exhibits coordinated movement between the wrist and finger joints, mimicking tenodesis, a behavior that is absent when the length-dependent properties are removed. This work emphasizes the importance of incorporating the length-dependent properties of the extrinsic finger muscles into biomechanical models to study healthy and impaired hand movements.

A Simulation Framework for Virtual Prototyping of Robotic Exoskeletons

A number of robotic exoskeletons are being developed to provide rehabilitation interventions for those with movement disabilities. We present a systematic framework that allows for virtual prototyping (i.e., design, control, and experimentation (i.e. design, control, and experimentation) of robotic exoskeletons. The framework merges computational musculoskeletal analyses with simulation-based design techniques which allows for exoskeleton design and control algorithm optimization. We introduce biomechanical, morphological, and controller measures to optimize the exoskeleton performance. A major advantage of the framework is that it provides a platform for carrying out hypothesis-driven virtual experiments to quantify device performance and rehabilitation progress. To illustrate the efficacy of the framework, we present a case study wherein the design and analysis of an index finger exoskeleton is carried out using the proposed framework.

An index finger exoskeleton with series elastic actuation for rehabilitation: Design, control and performance characterization

Rehabilitation of the hands is critical for the restoration of independence in activities of daily living for individuals exhibiting disabilities of the upper extremities. There is initial evidence that robotic devices with force-control-based strategies can help in effective rehabilitation of human limbs. However, to the best of our knowledge, none of the existing hand exoskeletons allow for accurate force or torque control. In this work, we present a novel index finger exoskeleton with Bowden-cable-based series elastic actuation allowing for bidirectional torque control of the device with high backdrivability and low reflected inertia. We present exoskeleton and finger joint torque controllers along with an optimization-based offline parameter estimator. Finally, we carry out tests with the developed prototype to characterize its kinematics, dynamics, and controller performance. Results show that the device preserves the characteristics of natural motion of finger and can be controlled to achieve both exoskeleton and finger joint torque control. Finally, dynamic transparency tests show that the device can be controlled to offer minimal resistance to finger motion. Beyond the present application of the device as a hand rehabilitation exoskeleton, it has the potential to be used as a haptic device for teleoperation.

Compliance in parallel to actuators for improving stability of robotic hands during grasping and manipulation

Humans exploit the inherent biomechanical compliance in their fingers to achieve stability and dexterity during many manipulation tasks. The compliance is a result of muscles and tendons (series compliance) and flexible joints (parallel compliance). While the effects of series compliance have been studied in many robotic systems, research on the effects of joint compliance arranged in parallel with the actuators is limited. In this paper, we first demonstrate, through mathematical modeling, that introducing parallel compliance improves stability and robustness in the presence of time delay in a generic robotic joint. We also provide guidelines to balance the benefits of added stability with the increased actuator load when implementing parallel compliance in robotic joints. The result is experimentally validated on a one-degree-of-freedom tendon-driven joint. We build upon this result to design two 2-DOF tendon-driven fingers with parallel compliance, and develop an impedance control law for object manipulation with the fingers. The experimental results demonstrate, for the first time, the advantages of introducing parallel compliance in robotic hands during dexterous manipulation tasks, specifically in achieving smoother trajectory tracking, improved stability, and robustness to impacts.

Finger joint laxity, number of previous pregnancies and pregnancy induced back pain in a cohort study

Background

General joint hypermobility is estimated to affect about 10% of the population and is a prerequisite of heritable connective tissue disorders where fragile connective tissue is a prominent feature. Pregnancy induced back pain is common whereas about 10% of women still have disabling pain several years after childbirth. The pathogenesis of the pain condition is uncertain, although several risk factors are suggested including general joint hypermobility. In the present study, the possible association of peripheral joint mobility in early pregnancy on the incidence of back pain with onset during pregnancy and persisting after childbirth was explored.

Methods

A cohort of 200 pregnant women recruited from antenatal health care clinics was assessed by questionnaire and clinical examination, including measurement of passive abduction of the left fourth finger, throughout pregnancy and at 13 weeks postpartum. Comparisons were made between women with and without back pain. Statistical tests used were χ²-test, t-test, Spearman correlation and multiple logistic regression.

Results

In the cohort, the mean passive abduction angle of the left fourth finger increased from 40.1° in early pregnancy to 41.8° at the postpartum appointment. At the postpartum appointment, women in the back pain group had a significantly larger mean passive abduction angle of the left fourth finger of 4.4°, twice as many previous pregnancies and deliveries, and more than twice as frequent back pain in previous pregnancy, as compared with women with no persistent back pain. A similar pattern was displayed in late pregnancy. In a multiple regression analysis, the passive abduction angle of the left fourth finger in early pregnancy and the number of previous pregnancies were positively, significantly and independently associated to the incidence of back pain in late pregnancy and postpartum.

Conclusions

Finger joint laxity as a reflection of constitutional weakness of connective tissue and number of previous pregnancies were associated with the development of back pain induced in pregnancy and persisting after childbirth. These factors may provide a foundation for development of targeted prevention strategies, but this have to be confirmed in future research including measurement of general joint laxity.

Control strategies for the index finger of a tendon-driven hand

To understand how versatile dexterity is achieved in the human hand and to achieve it in a robotic form, we have constructed an anatomically correct testbed (ACT) hand. This paper focuses on the development of control strategies for the index finger motion and implementation of joint passive behavior in the ACT hand. A direct muscle position control and a force-optimized joint control are implemented for position tracking through muscle force control. The relationships between the muscle and joint motions play a critical role in both of the controllers and we implemented a Gaussian process regression technique to determine these relationships. Our experiments demonstrate that the direct muscle position controller allows for fast position tracking, while the force-optimized joint controller allows for the exploitation of actuation redundancy in the finger critical for this redundant system. We demonstrate that by implementing a passive force–length relationship at each muscle we are able to precisely match joint stiffness of the metacarpophalangeal (MCP) joint of the ACT to that of a human MCP joint. We also show the results from improved position tracking when implemented in the presence of passive muscle control schemes. The control schemes for position tracking and passive behavior are inspired by human neuromuscular control, and form the building blocks for developing future human-like control approaches.