Design and preliminary assessment of Vanderbilt hand exoskeleton

Biomimetic Design of a Tendon-Driven Myoelectric Soft Hand Exoskeleton for Upper-Limb Rehabilitation

Degenerative diseases and injuries that compromise hand movement reduce individual autonomy and tend to cause financial and psychological problems to their family nucleus. To mitigate these limitations, over the past decade, hand exoskeletons have been designed to rehabilitate or enhance impaired hand movements. Although promising, these devices still have limitations, such as weight and cost. Moreover, the movements performed are not kinematically compatible with the joints, thereby reducing the achievements of the rehabilitation process. This article presents the biomimetic design of a soft hand exoskeleton actuated using artificial tendons designed to achieve low weight, volume, and cost, and to improve kinematic compatibility with the joints, comfort, and the sensitivity of the hand by allowing direct contact between the hand palm and objects. We employed two twisted string actuators and Bowden cables to move the artificial tendons and perform the grasping and opening of the hand. With this configuration, the heavy part of the system was reallocated to a test bench, allowing for a lightweight set of just 232 g attached to the arm. The system was triggered by the myoelectric signals of the biceps captured from the user's skin to encourage the active participation of the user in the process. The device was evaluated by five healthy subjects who were asked to simulate a paralyzed hand, and manipulate different types of objects and perform grip strength. The results showed that the system was able to identify the intention of movement of the user with an accuracy of 90%, and the orthosis was able to enhance the ability of handling objects with gripping force up to 1.86 kgf.

Gait multi-objectives optimization of lower limb exoskeleton robot based on BSO-EOLLFF algorithm

Aiming at problems of low optimization accuracy and slow convergence speed in the gait optimization algorithm of lower limb exoskeleton robot, a novel gait multi-objectives optimization strategy based on beetle swarm optimization (BSO)-elite opposition-based learning (EOL) levy flight foraging (LFF) algorithm was proposed. In order to avoid the algorithm from falling into the local optimum, the EOL strategy with global search capability, the LFF strategy with local search capability and the dynamic mutation strategy with high population diversity were introduced to improve optimization performance. The optimization was performed by establishing a multi-objectives optimization function with the robot’s gait zero moment point (ZMP) stability margin and driving energy consumption. The joint comparative tests were carried out in SolidWorks, ADAMS and MATLAB software. The simulation results showed that compared with the particle swarm optimization algorithm and the BSO algorithm, the ZMP stability margin obtained by the BSO-EOLLFF algorithm was increased, and the average driving energy consumption was reduced by 25.82% and 17.26%, respectively. The human-machine experiments were conducted to verify the effectiveness and superiority. The robot could realize stable and smooth walking with less energy consumption. This research will provide support for the application of exoskeleton robot.

Hand grip support for rehabilitation and assistance: from patent to TRL5

In the last decades, the continuous increase in the number of the vast cohort of chronic patients that constantly need medical assistance and supervision, and the widespread lack of therapist has brought to an increased interest in the role of medical technologies in rehabilitative programs and assistive scenarios. Current clinical evidence in rehabilitation demonstrates that there is an important and increasing demand for innovative therapeutic solutions to recover the hand functions to prevent patients to need assistance in performing daily life activities. This works describes the pathway from patent to TRL5 of a device to support hand grip actions and interaction with daily life objects. E-KIRO is based on the use of electromagnets, which are able to attach/detach interactive objects equipped with a ferromagnetic plate. Five end-users used the device and scored it with excellent usability based on the System Usability Scale.

Hand Rehabilitation Devices: A Comprehensive Systematic Review

A cerebrovascular accident, or a stroke, can cause significant neurological damage, inflicting the patient with loss of motor function in their hands. Standard rehabilitation therapy for the hand increases demands on clinics, creating an avenue for powered hand rehabilitation devices. Hand rehabilitation devices (HRDs) are devices designed to provide the hand with passive, active, and active-assisted rehabilitation therapy; however, HRDs do not have any standards in terms of development or design. Although the categorization of an injury's severity can guide a patient into seeking proper assistance, rehabilitation devices do not have a set standard to provide a solution from the beginning to the end stages of recovery. In this paper, HRDs are defined and compared by their mechanical designs, actuation mechanisms, control systems, and therapeutic strategies. Furthermore, devices with conducted clinical trials are used to determine the future development of HRDs. After evaluating the abilities of 35 devices, it is inferred that standard characteristics for HRDs should include an exoskeleton design, the incorporation of challenge-based and coaching therapeutic strategies, and the implementation of surface electromyogram signals (sEMG) based control.

The Middleware for an Exoskeleton Assisting Upper Limb Movement

This article presents the possibilities of newly developed middleware dedicated for distributed and modular control systems. The software enables the exchange of information locally, within one control module, and globally, between many modules. The executed information exchange system speed tests confirmed the correct operation of the software. The middleware was used in the control system of the active upper-limb exoskeleton. The upper-limb rehabilitation exoskeleton structure with six degrees of mechanical freedom is presented. The tests were performed using the prototype with three joints. The drives’ models of individual joints were developed and simulated. As a result, the courses of the motion trajectory were shown for different kinds of pressure on the force sensors, and different methods of signal filtering. The tests confirmed a correct operation of middleware and drives control system.

A Novel Clinical-Driven Design for Robotic Hand Rehabilitation: Combining Sensory Training, Effortless Setup, and Large Range of Motion in a Palmar Device

Neurorehabilitation research suggests that not only high training intensity, but also somatosensory information plays a fundamental role in the recovery of stroke patients. Yet, there is currently a lack of easy-to-use robotic solutions for sensorimotor hand rehabilitation. We addressed this shortcoming by developing a novel clinical-driven robotic hand rehabilitation device, which is capable of fine haptic rendering, and that supports physiological full flexion/extension of the fingers while offering an effortless setup. Our palmar design, based on a parallelogram coupled to a principal revolute joint, introduces the following novelties: (1) While allowing for an effortless installation of the user's hand, it offers large range of motion of the fingers (full extension to 180° flexion). (2) The kinematic design ensures that all fingers are supported through the full range of motion and that the little finger does not lose contact with the finger support in extension. (3) We took into consideration that a handle is usually comfortably grasped such that its longitudinal axis runs obliquely from the metacarpophalangeal joint of the index finger to the base of the hypothenar eminence. (4) The fingertip path was optimized to guarantee physiologically correct finger movements for a large variety of hand sizes. Moreover, the device possesses a high mechanical transparency, which was achieved using a backdrivable cable transmission. The transparency was further improved with the implementation of friction and gravity compensation. In a test with six healthy participants, the root mean square of the human-robot interaction force was found to remain as low as 1.37 N in a dynamic task. With its clinical-driven design and easy-to-use setup, our robotic device for hand sensorimotor rehabilitation has the potential for high clinical acceptance, applicability and effectiveness.

Development of Hand-Assistance Device using Hand-Joint Orthosis and Neuromuscular Electrical Stimulation

The development of self-help devices has attracted attention in the light of improving the activities of daily living (ADL) in patients with finger paralysis. These devices are required to reduce discomfort and enable greater degrees of grasping motions in patients. In this study, we developed a lightweight self-help device that uses neuromuscular electrical stimulation and hand-joint orthosis to finely control the fingers. In addition, we examined the possible grasping actions by testing how well the users of this device exhibited improvements in their ADL. Our results indicate that our self-help device can potentially be adapted to address finger paralysis.

Wearable Assistive Robotics: A Perspective on Current Challenges and Future Trends

Wearable assistive robotics is an emerging technology with the potential to assist humans with sensorimotor impairments to perform daily activities. This assistance enables individuals to be physically and socially active, perform activities independently, and recover quality of life. These benefits to society have motivated the study of several robotic approaches, developing systems ranging from rigid to soft robots with single and multimodal sensing, heuristics and machine learning methods, and from manual to autonomous control for assistance of the upper and lower limbs. This type of wearable robotic technology, being in direct contact and interaction with the body, needs to comply with a variety of requirements to make the system and assistance efficient, safe and usable on a daily basis by the individual. This paper presents a brief review of the progress achieved in recent years, the current challenges and trends for the design and deployment of wearable assistive robotics including the clinical and user need, material and sensing technology, machine learning methods for perception and control, adaptability and acceptability, datasets and standards, and translation from lab to the real world.

Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic

During the COVID-19 pandemic, the higher susceptibility of post-stroke patients to infection calls for extra safety precautions. Despite the imposed restrictions, early neurorehabilitation cannot be postponed due to its paramount importance for improving motor and functional recovery chances. Utilizing accessible state-of-the-art technologies, home-based rehabilitation devices are proposed as a sustainable solution in the current crisis. In this paper, a comprehensive review on developed home-based rehabilitation technologies of the last 10 years (2011-2020), categorizing them into upper and lower limb devices and considering both commercialized and state-of-the-art realms. Mechatronic, control, and software aspects of the system are discussed to provide a classified roadmap for home-based systems development. Subsequently, a conceptual framework on the development of smart and intelligent community-based home rehabilitation systems based on novel mechatronic technologies is proposed. In this framework, each rehabilitation device acts as an agent in the network, using the internet of things (IoT) technologies, which facilitates learning from the recorded data of the other agents, as well as the tele-supervision of the treatment by an expert. The presented design paradigm based on the above-mentioned leading technologies could lead to the development of promising home rehabilitation systems, which encourage stroke survivors to engage in under-supervised or unsupervised therapeutic activities.

Myoelectric untethered robotic glove enhances hand function and performance on daily living tasks after stroke

Introduction

Wearable robots controlled using electromyography could motivate greater use of the affected upper extremity after stroke and enable bimanual activities of daily living to be completed independently.

Methods

We have developed a myoelectric untethered robotic glove (My-HERO) that provides five-finger extension and grip assistance.

Results

The myoelectric controller detected the grip and release intents of the 9 participants after stroke with 84.7% accuracy. While using My-HERO, all 9 participants performed better on the Fugl-Meyer Assessment-Hand (8.4 point increase, scale out of 14, p < 0.01) and the Chedoke Arm and Hand Activity Inventory (8.2 point increase, scale out of 91, p < 0.01). Established criteria for clinically meaningful important differences were surpassed for both the hand function and daily living task assessments. The majority of participants provided satisfaction and usability questionnaire scores above 70%. Seven participants desired to use My-HERO in the clinic and at home during their therapy and daily routines.

Conclusions

People with hand impairment after stroke value that myoelectric untethered robotic gloves enhance their motion and bimanual task performance and motivate them to use their muscles during engaging activities of daily living. They desire to use these gloves daily to enable greater independence and investigate the effects on neuromuscular recovery.

Wearable Robotic Glove Design Using Surface-Mounted Actuators

We propose a novel wearable robotic glove or exo-glove design scalable to the variation of the hand kinematics. While most of the traditional robot hand is driven by rotating the joint directly with a rigid body, our exo-glove deforms a robotic finger's skin and, thus, the hand skeleton joints. Multiple tendons woven on the exo-glove's surface can make multi-DOF finger joint motions. We allocated tendons to mimic a hand's intrinsic and extrinsic muscles. Thus, a robotic hand actuated with the exo-glove can perform natural finger motions, including abduction/adduction and flexion/extension of finger joints. Moreover, additional tendons for the thumb enable power grips and the robotic hand's human-like motion. The proposed design approach places all the actuators on the surface without directly actuating any of the hand skeleton's joint. Therefore, a random hand skeleton can work as a robotic hand by putting the wearable robotic glove on it. Thus, the proposed model provides a high degree of freedom on choosing hand skeletons. We expect the aforementioned biomimetic features of our proposed method will benefit not only traditional robotic hands design but also the design of prosthetic hands and robot power-assisted hand glove.

Characterization and wearability evaluation of a fully portable wrist exoskeleton for unsupervised training after stroke

BACKGROUND

Chronic hand and wrist impairment are frequently present following stroke and severely limit independence in everyday life. The wrist orientates and stabilizes the hand before and during grasping, and is therefore of critical importance in activities of daily living (ADL). To improve rehabilitation outcomes, classical therapy could be supplemented by novel therapies that can be applied in unsupervised settings. This would enable more distributed practice and could potentially increase overall training dose. Robotic technology offers new possibilities to address this challenge, but it is critical that devices for independent training are easy and appealing to use. Here, we present the development, characterization and wearability evaluation of a fully portable exoskeleton for active wrist extension/flexion support in stroke rehabilitation.

METHODS

First we defined the requirements, and based on these, constructed the exoskeleton. We then characterized the device with standardized haptic and human-robot interaction metrics. The exoskeleton is composed of two modules placed on the forearm/hand and the upper arm. These modules weigh 238 g and 224 g, respectively. The forearm module actively supports wrist extension and flexion with a torque up to 3.7 Nm and an angular velocity up to 530 deg/s over a range of 154∘. The upper arm module includes the control electronics and battery, which can power the device for about 125 min in normal use. Special emphasis was put on independent donning and doffing of the device, which was tested via a wearability evaluation in 15 healthy participants and 2 stroke survivors using both qualitative and quantitative methods.

RESULTS

All participants were able to independently don and doff the device after only 4 practice trials. For healthy participants the donning and doffing process took 61 ±15 s and 24 ±6 s, respectively. The two stroke survivors donned and doffed the exoskeleton in 54 s/22 s and 113 s/32 s, respectively. Usability questionnaires revealed that despite minor difficulties, all participants were positive regarding the device.

CONCLUSIONS

This study describes an actuated wrist exoskeleton which weighs less than 500 g, and which is easy and fast to don and doff with one hand. Our design has put special emphasis on the donning aspect of robotic devices which constitutes the first barrier a user will face in unsupervised settings. The proposed device is a first and intermediate step towards wearable rehabilitation technologies that can be used independently by the patient and in unsupervised settings.

Preliminary Assessment of a Hand and Arm Exoskeleton for Enabling Bimanual Tasks for Individuals With Hemiparesis

The design and preliminary assessment of a semi-powered hand and arm exoskeleton is described. The exoskeleton is designed to enable bimanual activities of daily living for individuals with chronic, upper-limb hemiparesis resulting from stroke. Specifically, the device augments the user's grasp strength and ability to extend the affected hand for bimanual tasks and supplements wrist and elbow stability while conducting these tasks. The exoskeleton is battery-powered and self-contained with all electronics and power units placed within the device structure. A preliminary assessment of the exoskeleton was performed with three subjects having right-sided upper-limb motor deficit resulting from stroke. For subjects with limited hand and arm functionality, the exoskeleton increased grasp strength and improved the ability to perform representative bimanual tasks.

Myoelectric Control of a Soft Hand Exoskeleton Using Kinematic Synergies

Soft hand exoskeletons offer a lightweight, low-profile alternative to rigid rehabilitative robotic systems, enabling their use to restore activities of daily living (ADL) in those with hand paresis due to stroke or other conditions. The hand exoskeleton with embedded synergies (HEXOES) is a soft cable-driven hand exoskeleton capable of independently actuating and sensing 10 degrees of freedom (DoF) of the hand. Control of the 10 DoF exoskeleton is dimensionally reduced using three manually defined synergies in software corresponding to thumb, index, and 3-finger flexion and extension. In this paper, five healthy subjects control HEXOES using a neural network which decodes synergy weights from contralateral electromyography (EMG) activity. The three synergies are manipulated in real time to grasp and lift 15 ADL objects of various sizes and weights. The neural network's training and validation mean squared error, object grasp time, and grasp success rate were measured for five healthy subjects. The final training error of the neural network was 4.8 ± 1.8% averaged across subjects and tasks, with 8.3 ± 3.4% validation error. The time to reach, grasp, and lift an object was 11.15 ± 4.35 s on average, with an average success rate of 66.7% across all objects. The complete system demonstrates real time use of biosignals and machine learning to allow subjects to operate kinematic synergies to grasp objects using a wearable hand exoskeleton. Future work and applications are further discussed, including possible design improvements and enrollment of individuals with stroke.

Design Requirements of Generic Hand Exoskeletons and Survey of Hand Exoskeletons for Rehabilitation, Assistive, or Haptic Use

Most current hand exoskeletons have been designed specifically for rehabilitation, assistive, or haptic applications to simplify the design requirements. Clinical studies on poststroke rehabilitation have shown that adapting assistive or haptic applications into physical therapy sessions significantly improves the motor learning and treatment process. The recent technology can lead to the creation of generic hand exoskeletons that are application-agnostic. In this paper, our motivation is to create guidelines and best practices for generic exoskeletons by reviewing the literature of current devices. First, we describe each application and briefly explain their design requirements, and then list the design selections to achieve these requirements. Then, we detail each selection by investigating the existing exoskeletons based on their design choices, and by highlighting their impact on application types. With the motivation of creating efficient generic exoskeletons in the future, we finally summarize the best practices in the literature.

Hybrid Control Interface of a Semi-soft Assistive Glove for People with Spinal Cord Injuries

Active assistive devices have been designed to augment the hand grasping capabilities of individuals with spinal cord injuries (SCI). An intuitive bio-signal of wrist extension has been utilized in the device control, which imitates the passive grasping effect of tenodesis. However, controlling these devices in this manner limits the wrist joint motion while grasping. This paper presents a novel hybrid control interface and corresponding algorithms (i.e., a hybrid control method) of the Semi-soft Assistive Glove (SAG) developed for individuals with C6/C7-SCI. The secondary control interface is implemented to enable/disable the grasp trigger signal generated by the primary interface detecting the wrist extension. A simulation study reveals that the hybrid control method can facilitate grasping situations faced in daily activities. Empirical results with three healthy subjects suggest that the proposed method can assist the user to reach and grasp objects with the SAG naturally.

A Lightweight Linear Actuating System for Finger Articulation: A Proof-of-Concept Study

This paper provides a proof of concept for an actuating system comprised of a linear actuator and a spring steel strip that enables bidirectional articulation of a finger by transmitting the force directly to the finger tip. This proposed design can be distinguished from other orthosis designs, which use rigid linkages or cables with DC motors or fluidic systems for force generation and transmission. We designed an experimental setup with a 3D-printed model finger to mimic a passive human finger on which the actuation system was mounted and tested. The finger was positioned such that it would curl upward to lift various masses when articulated by the actuating system to demonstrate the system's force generation capability. We tested two linear actuators and two steel strips, using a wide range of masses to determine which would be the most suitable components for our design. We analyzed motion profiles, joint angles, force generation, and actuator stroke velocities during various experimental trials. Our results demonstrate that our actuating system is capable of generating sufficient forces and motions with an adequate response time to be used in the design of a hand orthosis for grasping/releasing assistance. From our tests, a prototype was designed with three linear actuators positioned on the dorsal side of the hand and actuated the thumb, index, and middle fingers. Future work will include sensor integration and performance evaluation of the orthosis.