1
|
Lin HP, Xu Y, Zhang X, Woolley D, Zhao L, Liang W, Huang M, Cheng HJ, Zhang L, Wenderoth N. A usability study on mobile EMG-guided wrist extension training in subacute stroke patients-MyoGuide. J Neuroeng Rehabil 2024; 21:39. [PMID: 38515192 PMCID: PMC10956308 DOI: 10.1186/s12984-024-01334-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/07/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Effective stroke rehabilitation requires high-dose, repetitive-task training, especially during the early recovery phase. However, the usability of upper-limb rehabilitation technology in acute and subacute stroke survivors remains relatively unexplored. In this study, we introduce subacute stroke survivors to MyoGuide, a mobile training platform that employs surface electromyography (sEMG)-guided neurofeedback training that specifically targets wrist extension. Notably, the study emphasizes evaluating the platform's usability within clinical contexts. METHODS Seven subacute post-stroke patients (1 female, mean age 53.7 years, mean time post-stroke 58.9 days, mean duration per training session 48.9 min) and three therapists (one for eligibility screening, two for conducting training) participated in the study. Participants underwent ten days of supervised one-on-one wrist extension training with MyoGuide, which encompassed calibration, stability assessment, and dynamic tasks. All training records including the Level of Difficulty (LoD) and Stability Assessment Scores were recorded within the application. Usability was assessed through the System Usability Scale (SUS) and participants' willingness to continue home-based training was gauged through a self-developed survey post-training. Therapists also documented the daily performance of participants and the extent of support required. RESULTS The usability analysis yielded positive results, with a median SUS score of 82.5. Compared to the first session, participants significantly improved their performance at the final session as indicated by both the Stability Assessment Scores (p = 0.010, mean = 229.43, CI = [25.74-433.11]) and the LoD (p < 0.001; mean: 45.43, CI: [25.56-65.29]). The rate of progression differed based on the initial impairment levels of the patient. After training, participants expressed a keen interest in continuing home-based training. However, they also acknowledged challenges related to independently using the Myo armband and software. CONCLUSIONS This study introduces the MyoGuide training platform and demonstrates its usability in a clinical setting for stroke rehabilitation, with the assistance of a therapist. The findings support the potential of MyoGuide for wrist extension training in patients across a wide range of impairment levels. However, certain usability challenges, such as donning/doffing the armband and navigating the application, need to be addressed to enable independent MyoGuide training requiring only minimal supervision by a therapist.
Collapse
Affiliation(s)
- Hao-Ping Lin
- Singapore-ETH Centre, Future Health Technologies Programme, CREATE campus, 1 Create Way, CREATE Tower, #06-01, Singapore, 138602, Singapore
| | - Yang Xu
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Xue Zhang
- Department of Health Sciences and Technology, Neural Control of Movement Lab, ETH Zurich, Gloriastrasse 37/39 GLC G17.2, Zurich, 8092, Switzerland
| | - Daniel Woolley
- Department of Health Sciences and Technology, Neural Control of Movement Lab, ETH Zurich, Gloriastrasse 37/39 GLC G17.2, Zurich, 8092, Switzerland
| | - Lina Zhao
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Weidi Liang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Mengdi Huang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Hsiao-Ju Cheng
- Singapore-ETH Centre, Future Health Technologies Programme, CREATE campus, 1 Create Way, CREATE Tower, #06-01, Singapore, 138602, Singapore
| | - Lixin Zhang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Nicole Wenderoth
- Singapore-ETH Centre, Future Health Technologies Programme, CREATE campus, 1 Create Way, CREATE Tower, #06-01, Singapore, 138602, Singapore.
- Department of Health Sciences and Technology, Neural Control of Movement Lab, ETH Zurich, Gloriastrasse 37/39 GLC G17.2, Zurich, 8092, Switzerland.
| |
Collapse
|
2
|
Xie Q, Meng Q, Yu W, Wu Z, Xu R, Zeng Q, Zhou Z, Yang T, Yu H. Design of a SMA-based soft composite structure for wearable rehabilitation gloves. Front Neurorobot 2023; 17:1047493. [PMID: 36845070 PMCID: PMC9950102 DOI: 10.3389/fnbot.2023.1047493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 01/26/2023] [Indexed: 02/12/2023] Open
Abstract
The combination of smart soft composite structure based shape memory alloy (SMA) and exoskeleton technology has the advantages of light weight, energy saving, and great human-exoskeleton interaction. However, there are no relevant studies on the application of SMA-based soft composite structure (SSCS) in hand exoskeletons. The main difficulty is that directional mechanical properties of SSCS need to comply with fingers movement, and SSCS can deliver enough output torque and displacement to the relevant joints. This paper aims to study the application of SSCS for wearable rehabilitation gloves and explore its bionic driving mechanism. This paper proposes a soft wearable glove (Glove-SSCS) for hand rehabilitation actuated by the SSCS, based on finger force analysis under different drive modes. The Glove-SSCS can support five-finger flexion and extension, weighs only 120 g, and adopts modular design. Each drive module adopts a soft composite structure. And the structure integrates actuation, sensing and execution, including an active layer (SMA spring), a passive layer (manganese steel sheet), a sensing layer (bending sensor) and connection layers. To obtain a high-performance SMA actuators, the performance of SMA materials was tested in terms of temperature and voltage, temperature at the shortest length, pre-tensile length and load. And the human-exoskeleton coupling model of Glove-SSCS is established and analyzed from force and motion. The results show that the Glove-SSCS can realize bidirectional movements of fingers flexion and extension, with ranges of motion are 90-110° and 30-40°, and their cycles are 13-19 s and 11-13 s. During the use of Glove-SSCS, the temperature of gloves is from 25 to 67°C, and the surface temperature of hands is from 32 to 36°C. The temperature of Glove-SSCS can be kept at the lowest temperature of SMA operation without much impact on the human body.
Collapse
Affiliation(s)
- Qiaolian Xie
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
- Department of Medical Engineering, Chiba University, Chiba, Japan
| | - Qiaoling Meng
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Wenwei Yu
- Department of Medical Engineering, Chiba University, Chiba, Japan
- Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
| | - Zhiyu Wu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Rongna Xu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Qingxin Zeng
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Zhongchao Zhou
- Department of Medical Engineering, Chiba University, Chiba, Japan
| | - Tianyi Yang
- Department of Medical Engineering, Chiba University, Chiba, Japan
| | - Hongliu Yu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| |
Collapse
|
3
|
Wenk N, Penalver-Andres J, Buetler KA, Nef T, Müri RM, Marchal-Crespo L. Effect of immersive visualization technologies on cognitive load, motivation, usability, and embodiment. VIRTUAL REALITY 2023; 27:307-331. [PMID: 36915633 PMCID: PMC9998603 DOI: 10.1007/s10055-021-00565-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 07/22/2021] [Indexed: 05/09/2023]
Abstract
Virtual reality (VR) is a promising tool to promote motor (re)learning in healthy users and brain-injured patients. However, in current VR-based motor training, movements of the users performed in a three-dimensional space are usually visualized on computer screens, televisions, or projection systems, which lack depth cues (2D screen), and thus, display information using only monocular depth cues. The reduced depth cues and the visuospatial transformation from the movements performed in a three-dimensional space to their two-dimensional indirect visualization on the 2D screen may add cognitive load, reducing VR usability, especially in users suffering from cognitive impairments. These 2D screens might further reduce the learning outcomes if they limit users' motivation and embodiment, factors previously associated with better motor performance. The goal of this study was to evaluate the potential benefits of more immersive technologies using head-mounted displays (HMDs). As a first step towards potential clinical implementation, we ran an experiment with 20 healthy participants who simultaneously performed a 3D motor reaching and a cognitive counting task using: (1) (immersive) VR (IVR) HMD, (2) augmented reality (AR) HMD, and (3) computer screen (2D screen). In a previous analysis, we reported improved movement quality when movements were visualized with IVR than with a 2D screen. Here, we present results from the analysis of questionnaires to evaluate whether the visualization technology impacted users' cognitive load, motivation, technology usability, and embodiment. Reports on cognitive load did not differ across visualization technologies. However, IVR was more motivating and usable than AR and the 2D screen. Both IVR and AR rea ched higher embodiment level than the 2D screen. Our results support our previous finding that IVR HMDs seem to be more suitable than the common 2D screens employed in VR-based therapy when training 3D movements. For AR, it is still unknown whether the absence of benefit over the 2D screen is due to the visualization technology per se or to technical limitations specific to the device.
Collapse
Affiliation(s)
- N. Wenk
- Motor Learning and Neurorehabilitation Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - J. Penalver-Andres
- Motor Learning and Neurorehabilitation Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - K. A. Buetler
- Motor Learning and Neurorehabilitation Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - T. Nef
- Gerontechnology & Rehabilitation, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - R. M. Müri
- Gerontechnology & Rehabilitation, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
- Department of Neurology, University Neurorehabilitation, University Hospital Bern (Inselspital), University of Bern, Bern, Switzerland
| | - L. Marchal-Crespo
- Motor Learning and Neurorehabilitation Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
- Department of Cognitive Robotics, Delft University of Technology, Delft, The Netherlands
| |
Collapse
|
4
|
Occupational therapy using a robotic-assisted glove ameliorates finger dexterity and modulates functional connectivity in amyotrophic lateral sclerosis. J Clin Neurosci 2023; 107:144-149. [PMID: 36411175 DOI: 10.1016/j.jocn.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Although rehabilitation is recommended for amyotrophic lateral sclerosis (ALS), improvement of functional decline has hardly been achieved. We investigated the effect of occupational therapy that uses a robotic-assisted glove (RAG) on hand dexterity and the functional connectivities found in the brain of ALS patients. METHOD Ten patients diagnosed with ALS and admitted to the Shiga University of Medical Science (SUMS) Hospital from December 2018 to December 2021 participated in the study. These participants chose the hand side to wear RAG and exercised for two weeks. A sham movement was performed on the other side. We administered several functional assessments, including the Simple Test for Evaluating Hand Function (STEF), grip strength, pinch meter for grip strength, Canadian occupational performance measure (COPM), as well as nerve conduction study (NCS) before and after the exercise, and evaluated the results. We also analyzed six patients' resting-state functional magnetic resonance imaging (rs-fMRI). RESULTS Two-week robotic rehabilitation improved the STEF, grip strength, and COPM scores when compared with those of the other side. However, no significant effect was observed in the pinch meter and the NCS results. The rs-fMRI data analysis revealed that the robotic rehabilitation augmented two functional connectivities between the left pallidum-right supplementary motor cortex and right insular cortex-right sensorimotor network among the patients, which had beneficial effects. CONCLUSION The occupational therapy using RAG displayed improved hand dexterity. The enhanced functional connectivities around the sensorimotor network might be associated with the improvement in hand dexterity because of the RAG.
Collapse
|
5
|
Prange-Lasonder GB, Kottink AIR, Nikamp CDM, Buurke JH, Bos F, Van Der Sluis CK, Van Den Broek M, Onneweer B, Stolwijk-Swuste JM, Brink SM, Voet NBM, Rietman JS. Effect on Hand Function After Six-week Use of a Wearable Soft-Robotic Glove Assisting ADL: Interim Results of an Ongoing Clinical Study. IEEE Int Conf Rehabil Robot 2022; 2022:1-6. [PMID: 36176120 DOI: 10.1109/icorr55369.2022.9896605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In an ongoing study, an assistive wearable soft-robotic glove is tested at home for 6 weeks by subjects with decreased handgrip strength, due to different hand injuries or diseases, to assess whether use of this assistive grip-supporting glove will result in improved hand strength/ function. An interim analysis of the available dataset of 46 participants showed that (unsupported) grip strength and hand function improved after using the soft-robotic glove as assistive aid during activities of daily living (ADLs) during 6 weeks at home. After glove use is ended, this is maintained for at least 4 weeks. Considering that in the current situation the analysis is underpowered, these interim results are promising for finding a clinical (therapeutic) effect of using a soft-robotic glove as assistance during ADLs. If this is the case, this might open up entirely new opportunities for extending rehabilitation into people's homes, while also providing them with assistance to directly support performance of daily activities. Such a combination is becoming available with the development of mature and user-friendly wearable soft-robotic devices. This would enable very high doses of training throughout the day, in the most functional, task-specific way possible, and possibly prevention of learned non-use.
Collapse
|
6
|
Zanatta F, Giardini A, Pierobon A, D'Addario M, Steca P. A systematic review on the usability of robotic and virtual reality devices in neuromotor rehabilitation: patients' and healthcare professionals' perspective. BMC Health Serv Res 2022; 22:523. [PMID: 35443710 PMCID: PMC9020115 DOI: 10.1186/s12913-022-07821-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The application of virtual reality (VR) and robotic devices in neuromotor rehabilitation has provided promising evidence in terms of efficacy, so far. Usability evaluations of these technologies have been conducted extensively, but no overviews on this topic have been reported yet. METHODS A systematic review of the studies on patients' and healthcare professionals' perspective through searching of PubMed, Medline, Scopus, Web of Science, CINAHL, and PsychINFO (2000 to 2021) was conducted. Descriptive data regarding the study design, participants, technological devices, interventions, and quantitative and qualitative usability evaluations were extracted and meta-synthetized. RESULTS Sixty-eight studies were included. VR devices were perceived as having good usability and as a tool promoting patients' engagement and motivation during the treatment, as well as providing strong potential for customized rehabilitation sessions. By contrast, they suffered from the effect of learnability and were judged as potentially requiring more mental effort. Robotics implementation received positive feedback along with high satisfaction and perceived safety throughout the treatment. Robot-assisted rehabilitation was considered useful as it supported increased treatment intensity and contributed to improved patients' physical independence and psychosocial well-being. Technical and design-related issues may limit the applicability making the treatment difficult and physically straining. Moreover, cognitive and communication deficits were remarked as potential barriers. CONCLUSIONS Overall, VR and robotic devices have been perceived usable so far, reflecting good acceptance in neuromotor rehabilitation programs. The limitations raised by the participants should be considered to further improve devices applicability and maximise technological rehabilitation effectiveness. TRIAL REGISTRATION PROSPERO registration ref. CRD42021224141 .
Collapse
Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy.
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| |
Collapse
|
7
|
Guillén-Climent S, Garzo A, Muñoz-Alcaraz MN, Casado-Adam P, Arcas-Ruiz-Ruano J, Mejías-Ruiz M, Mayordomo-Riera FJ. A usability study in patients with stroke using MERLIN, a robotic system based on serious games for upper limb rehabilitation in the home setting. J Neuroeng Rehabil 2021; 18:41. [PMID: 33622344 PMCID: PMC7901008 DOI: 10.1186/s12984-021-00837-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/10/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Neuroscience and neurotechnology are transforming stroke rehabilitation. Robotic devices, in addition to telerehabilitation, are increasingly being used to train the upper limbs after stroke, and their use at home allows us to extend institutional rehabilitation by increasing and prolonging therapy. The aim of this study is to assess the usability of the MERLIN robotic system based on serious games for upper limb rehabilitation in people with stroke in the home environment. METHODS 9 participants with a stroke in three different stages of recovery (subacute, short-term chronic and long-term chronic) with impaired arm/hand function, were recruited to use the MERLIN system for 3 weeks: 1 week training at the Maimonides Biomedical Research Institute of Cordoba (IMIBIC), and 2 weeks at the patients' homes. To evaluate usability, the System Usability Scale (SUS), Adapted Intrinsic Motivation Inventory (IMI), Quebec User Evaluation of Satisfaction with assistive Technology (QUEST), and the ArmAssist Usability Assessment Questionnaire were used in the post-intervention. Clinical outcomes for upper limb motor function were assessed pre- and post-intervention. RESULTS 9 patients participated in and completed the study. The usability assessment reported a high level of satisfaction: mean SUS score 71.94 % (SD = 16.38), mean QUEST scale 3.81 (SD = 0.38), and mean Adapted IMI score 6.12 (SD = 1.36). The results of the ArmAssist Questionnaire showed an average of 6 out of 7, which indicates that MERLIN is extremely intuitive, easy to learn and easy to use. Regarding clinical assessment, the Fugl-Meyer scores showed moderate improvements from pre- to post-intervention in the total score of motor function (p = 0.002). There were no significant changes in the Modified Ashworth scale outcomes (p = 0.169). CONCLUSIONS This usability study indicates that home-based rehabilitation for upper limbs with the MERLIN system is safe, useful, feasible and motivating. Telerehabilitation constitutes a major step forward in the use of intensive rehabilitation at home. Trial registration ClinicalTrials.gov, NCT04405609. Registered 06 January 2020-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04405609.
Collapse
Affiliation(s)
- Silvia Guillén-Climent
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain.
| | - Ainara Garzo
- Neurorehabilitation area, Health Division of TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastián, Spain
| | - María Nieves Muñoz-Alcaraz
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
- Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
- Córdoba and Guadalquivir Health District, Andalusia Health Service, Córdoba, Spain
| | - Pablo Casado-Adam
- Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
| | - Javier Arcas-Ruiz-Ruano
- Neurorehabilitation area, Health Division of TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastián, Spain
| | - Manuela Mejías-Ruiz
- Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
| | - Fernando Jesús Mayordomo-Riera
- Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
- Department of Applied Physics, Radiology and Physical Medicine, University of Córdoba, Córdoba, Spain
| |
Collapse
|
8
|
Dávila-Vilchis JM, Ávila-Vilchis JC, Vilchis-González AH, LAZ-Avilés. Design Criteria of Soft Exogloves for Hand Rehabilitation-Assistance Tasks. Appl Bionics Biomech 2020; 2020:2724783. [PMID: 32802156 PMCID: PMC7416241 DOI: 10.1155/2020/2724783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022] Open
Abstract
This paper establishes design criteria for soft exogloves (SEG) to be used as rehabilitation or assistance devices. This research consists in identifying, selecting, and grouping SEG features based on the analysis of 91 systems that have been proposed during the last decade. Thus, function, mobility, and usability criteria are defined and explicitly discussed to highlight SEG design guidelines. Additionally, this study provides a detailed description of each system that was analysed including application, functional task, palm design, actuation type, assistance mode, degrees of freedom (DOF), target fingers, motions, material, weight, force, pressure (only for fluids), control strategy, and assessment. Such characteristics have been reported according to specific design methodologies and operating principles. Technological trends are contemplated in this contribution with emphasis on SEG design opportunity areas. In this review, suggestions, limitations, and implications are also discussed in order to enhance future SEG developments aimed at stroke survivors or people with hand disabilities.
Collapse
Affiliation(s)
| | - Juan C. Ávila-Vilchis
- Faculty of Engineering, Universidad Autónoma del Estado de México, Toluca 50130, Mexico
| | | | - LAZ-Avilés
- Faculty of Engineering, Universidad Autónoma del Estado de México, Toluca 50130, Mexico
- Cátedras CONACYT, Universidad Autónoma del Estado de México, Toluca 50130, Mexico
| |
Collapse
|
9
|
Waerling RD, Kjaer TW. A systematic review of impairment focussed technology in neurology. Disabil Rehabil Assist Technol 2020; 17:234-247. [DOI: 10.1080/17483107.2020.1776776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | - Troels Wesenberg Kjaer
- University of Copenhagen, Denmark
- Department of Neurology, Zealand University Hospital, Denmark
| |
Collapse
|
10
|
Tran P, Jeong S, Wolf SL, Desai JP. Patient-Specific, Voice-Controlled, Robotic FLEXotendon Glove-II System for Spinal Cord Injury. IEEE Robot Autom Lett 2020. [DOI: 10.1109/lra.2020.2965900] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
11
|
Osuagwu BA, Timms S, Peachment R, Dowie S, Thrussell H, Cross S, Shirley R, Segura-Fragoso A, Taylor J. Home-based rehabilitation using a soft robotic hand glove device leads to improvement in hand function in people with chronic spinal cord injury:a pilot study. J Neuroeng Rehabil 2020; 17:40. [PMID: 32138780 PMCID: PMC7057671 DOI: 10.1186/s12984-020-00660-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 02/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Loss of hand function following high level spinal cord injury (SCI) is perceived as a high priority area for rehabilitation. Following discharge, it is often impractical for the specialist care centre to provide ongoing therapy for people living with chronic SCI at home, which can lead to further deterioration of hand function and a direct impact on an individual's capability to perform essential activities of daily living (ADL). OBJECTIVE This pilot study investigated the therapeutic effect of a self-administered home-based hand rehabilitation programme for people with cervical SCI using the soft extra muscle (SEM) Glove by Bioservo Technologies AB. METHODS Fifteen participants with chronic cervical motor incomplete (AIS C and D) SCI were recruited and provided with the glove device to use at home to complete a set task and perform their usual ADL for a minimum of 4 h a day for 12 weeks. Assessment was made at Week 0 (Initial), 6, 12 and 18 (6-week follow-up). The primary outcome measure was the Toronto Rehabilitation Institute hand function test (TRI-HFT), with secondary outcome measures including pinch dynamometry and the modified Ashworth scale. RESULTS The TRI-HFT demonstrated improvement in hand function at Week 6 of the therapy including improvement in object manipulation (58.3 ±3.2 to 66.9 ±1.8, p ≈ 0.01), and palmar grasp assessed as the length of the wooden bar that can be held using a pronated palmar grip (29.1 ±6.0 cm to 45.8 ±6.8 cm, p <0.01). A significant improvement in pinch strength, with reduced thumb muscle hypertonia was also detected. Improvements in function were present during the Week 12 assessment and also during the follow-up. CONCLUSIONS Self-administered rehabilitation using the SEM Glove is effective for improving and retaining gross and fine hand motor function for people living with chronic spinal cord injury at home. Retention of improved hand function suggests that an intensive activity-based rehabilitation programme in specific individuals is sufficient to improve long-term neuromuscular activity. Future studies should characterise the neuromuscular mechanism of action and the minimal rehabilitation programme necessary with the assistive device to improve ADL tasks following chronic cervical SCI. TRIAL REGISTRATION NUMBER Trial registration: ISRCTN, ISRCTN98677526, Registered 01/June/2017 - Retrospectively registered, http://www.isrctn.com/ISRCTN98677526.
Collapse
Affiliation(s)
- Bethel A.C. Osuagwu
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, HP21 8AL UK
| | - Sarah Timms
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, HP21 8AL UK
| | - Ruth Peachment
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, HP21 8AL UK
| | - Sarah Dowie
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, HP21 8AL UK
| | - Helen Thrussell
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, HP21 8AL UK
| | - Susan Cross
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, HP21 8AL UK
| | - Rebecca Shirley
- Bucks Healthcare Plastics, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, HP21 8AL UK
| | | | - Julian Taylor
- Instituto de Ciencias de la Salud, Talavera de la Reina, Castilla-La Mancha, 45600 Spain
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, 45071 Spain
| |
Collapse
|
12
|
van Ommeren AL, Sawaryn B, Prange-Lasonder GB, Buurke JH, Rietman JS, Veltink PH. Detection of the Intention to Grasp During Reaching in Stroke Using Inertial Sensing. IEEE Trans Neural Syst Rehabil Eng 2019; 27:2128-2134. [DOI: 10.1109/tnsre.2019.2939202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
13
|
Radder B, Prange-Lasonder GB, Kottink AIR, Holmberg J, Sletta K, van Dijk M, Meyer T, Melendez-Calderon A, Buurke JH, Rietman JS. Home rehabilitation supported by a wearable soft-robotic device for improving hand function in older adults: A pilot randomized controlled trial. PLoS One 2019; 14:e0220544. [PMID: 31386685 PMCID: PMC6684161 DOI: 10.1371/journal.pone.0220544] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 07/17/2019] [Indexed: 01/19/2023] Open
Abstract
Background New developments, based on the concept of wearable soft-robotic devices, make it possible to support impaired hand function during the performance of daily activities and intensive task-specific training. The wearable soft-robotic ironHand glove is such a system that supports grip strength during the performance of daily activities and hand training exercises at home. Design This pilot randomized controlled clinical study explored the effect of prolonged use of the assistive ironHand glove during daily activities at home, in comparison to its use as a trainings tool at home, on functional performance of the hand. Methods In total, 91 older adults with self-perceived decline of hand function participated in this study. They were randomly assigned to a 4-weeks intervention of either assistive or therapeutic ironHand use, or control group (received no additional exercise or treatment). All participants performed a maximal pinch grip test, Box and Blocks test (BBT), Jebsen-Taylor Hand Function Test (JTHFT) at baseline and after 4-weeks of intervention. Only participants of the assistive and therapeutic group completed the System Usability Scale (SUS) after the intervention period. Results Participants of the assistive and therapeutic group reported high scores on the SUS (mean = 73, SEM = 2). The therapeutic group showed improvements in unsupported handgrip strength (mean Δ = 3) and pinch strength (mean Δ = 0.5) after 4 weeks of ironHand use (p≤0.039). Scores on the BBT and JTHFT improved not only after 4 weeks of ironHand use (assistive and therapeutic), but also in the control group. Only handgrip strength improved more in the therapeutic group compared to the assistive and control group. No significant correlations were found between changes in performance and assistive or therapeutic ironHand use (p≥0.062). Conclusion This study showed that support of the wearable soft-robotic ironHand system either as assistive device or as training tool may be a promising way to counter functional hand function decline associated with ageing.
Collapse
Affiliation(s)
- Bob Radder
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
- * E-mail:
| | - Gerdienke B. Prange-Lasonder
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
| | - Anke I. R. Kottink
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biosystems and Signals, University of Twente, Enschede, the Netherlands
| | - Johnny Holmberg
- Eskilstuna Kommun Vård- och omsorgsförvaltningen, Eskilstuna, Sweden
| | - Kristin Sletta
- Eskilstuna Kommun Vård- och omsorgsförvaltningen, Eskilstuna, Sweden
| | - Manon van Dijk
- National Foundation for the Elderly, Bunnik, the Netherlands
| | | | - Alejandro Melendez-Calderon
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, United States of America
- Cereneo Advanced Rehabilitation Institute, Vitznau, Switzerland
| | - Jaap H. Buurke
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biosystems and Signals, University of Twente, Enschede, the Netherlands
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, United States of America
| | - Johan S. Rietman
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, United States of America
| |
Collapse
|
14
|
Shahid T, Gouwanda D, Nurzaman SG, Gopalai AA. Moving toward Soft Robotics: A Decade Review of the Design of Hand Exoskeletons. Biomimetics (Basel) 2018; 3:E17. [PMID: 31105239 PMCID: PMC6352684 DOI: 10.3390/biomimetics3030017] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/11/2018] [Accepted: 07/13/2018] [Indexed: 11/17/2022] Open
Abstract
Soft robotics is a branch of robotics that deals with mechatronics and electromechanical systems primarily made of soft materials. This paper presents a summary of a chronicle study of various soft robotic hand exoskeletons, with different electroencephalography (EEG)- and electromyography (EMG)-based instrumentations and controls, for rehabilitation and assistance in activities of daily living. A total of 45 soft robotic hand exoskeletons are reviewed. The study follows two methodological frameworks: a systematic review and a chronological review of the exoskeletons. The first approach summarizes the designs of different soft robotic hand exoskeletons based on their mechanical, electrical and functional attributes, including the degree of freedom, number of fingers, force transmission, actuation mode and control strategy. The second approach discusses the technological trend of soft robotic hand exoskeletons in the past decade. The timeline analysis demonstrates the transformation of the exoskeletons from rigid ferrous materials to soft elastomeric materials. It uncovers recent research, development and integration of their mechanical and electrical components. It also approximates the future of the soft robotic hand exoskeletons and some of their crucial design attributes.
Collapse
Affiliation(s)
- Talha Shahid
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia.
| | - Darwin Gouwanda
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia.
| | - Surya G Nurzaman
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia.
| | - Alpha A Gopalai
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia.
| |
Collapse
|
15
|
Radder B, Prange-Lasonder GB, Kottink AI, Holmberg J, Sletta K, Van Dijk M, Meyer T, Buurke JH, Rietman JS. The effect of a wearable soft-robotic glove on motor function and functional performance of older adults. Assist Technol 2018; 32:9-15. [DOI: 10.1080/10400435.2018.1453888] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Bob Radder
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
| | - Gerdienke B. Prange-Lasonder
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
| | - Anke I.R. Kottink
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biosystems and Signals, University of Twente, Enschede, the Netherlands
| | - Johnny Holmberg
- Eskilstuna Kommun Vård-och omsorgsförvaltningen, Eskilstuna, Sweden
| | - Kristin Sletta
- Eskilstuna Kommun Vård-och omsorgsförvaltningen, Eskilstuna, Sweden
| | - Manon Van Dijk
- National Foundation for the Elderly, Bunnik, the Netherlands
| | | | - Jaap H. Buurke
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biosystems and Signals, University of Twente, Enschede, the Netherlands
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, USA
| | - Johan S. Rietman
- Roessingh Research and Development, Enschede, the Netherlands
- Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
16
|
Chu CY, Patterson RM. Soft robotic devices for hand rehabilitation and assistance: a narrative review. J Neuroeng Rehabil 2018; 15:9. [PMID: 29454392 PMCID: PMC5816520 DOI: 10.1186/s12984-018-0350-6] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 02/05/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The debilitating effects on hand function from a number of a neurologic disorders has given rise to the development of rehabilitative robotic devices aimed at restoring hand function in these patients. To combat the shortcomings of previous traditional robotics, soft robotics are rapidly emerging as an alternative due to their inherent safety, less complex designs, and increased potential for portability and efficacy. While several groups have begun designing devices, there are few devices that have progressed enough to provide clinical evidence of their design's therapeutic abilities. Therefore, a global review of devices that have been previously attempted could facilitate the development of new and improved devices in the next step towards obtaining clinical proof of the rehabilitative effects of soft robotics in hand dysfunction. METHODS A literature search was performed in SportDiscus, Pubmed, Scopus, and Web of Science for articles related to the design of soft robotic devices for hand rehabilitation. A framework of the key design elements of the devices was developed to ease the comparison of the various approaches to building them. This framework includes an analysis of the trends in portability, safety features, user intent detection methods, actuation systems, total DOF, number of independent actuators, device weight, evaluation metrics, and modes of rehabilitation. RESULTS In this study, a total of 62 articles representing 44 unique devices were identified and summarized according to the framework we developed to compare different design aspects. By far, the most common type of device was that which used a pneumatic actuator to guide finger flexion/extension. However, the remainder of our framework elements yielded more heterogeneous results. Consequently, those results are summarized and the advantages and disadvantages of many design choices as well as their rationales were highlighted. CONCLUSION The past 3 years has seen a rapid increase in the development of soft robotic devices for hand rehabilitative applications. These mostly preclinical research prototypes display a wide range of technical solutions which have been highlighted in the framework developed in this analysis. More work needs to be done in actuator design, safety, and implementation in order for these devices to progress to clinical trials. It is our goal that this review will guide future developers through the various design considerations in order to develop better devices for patients with hand impairments.
Collapse
Affiliation(s)
- Chia-Ye Chu
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, 76107 TX USA
| | - Rita M. Patterson
- Department of Family and Manipulative Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, 76107 TX USA
| |
Collapse
|