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Akhuj A, Phansopkar P. Integrated Physical Therapy in a Unique Case of Holstein-Lewis Fracture With Radial Palsy: A Case Report. Cureus 2024; 16:e57117. [PMID: 38681423 PMCID: PMC11055539 DOI: 10.7759/cureus.57117] [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: 03/05/2024] [Accepted: 03/28/2024] [Indexed: 05/01/2024] Open
Abstract
The term "Holstein-Lewis fracture" describes a spiral fracture that occurs in the shaft of the humerus at its distal third, which has been linked to radial nerve palsy in adults, and operative treatment is the preferred method of treating the trapped nerve at the fracture site. This paper describes a clinical case involving a 20-year-old male patient demonstrating a humeral fracture syndrome accompanied by complications associated with radial nerve palsy. After the necessary investigation, he was diagnosed with a Holstein-Lewis fracture with radial nerve paralysis; he underwent open reduction internal fixation (ORIF), after which he was referred to physical therapy. Developing a successful postoperative rehabilitation program that consists mostly of functional physical therapy interventions is essential for the treatment of this condition. Outcome measures like the Numerical Pain Rating Scale (NPRS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and Patient-Rated Wrist Evaluation (PRWE) score were recorded before and after rehabilitation, and pain reduction, improvement in strength, range of motion (ROM), grip strength, and activities of daily living (ADL) were found. The purpose of this case report is to present a comprehensive treatment plan that includes ROM exercises, cryotherapy, and strengthening of grip using a robotic glove for a patient who had a wrist drop and underwent ORIF surgery. This tailored intervention was effective in speeding up the return of functional abilities and improving function in ADLs.
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Affiliation(s)
- Aditi Akhuj
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pratik Phansopkar
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Jayavel P, Karthik V, Mathunny JJ, Jothi S, Devaraj A. Hand assistive device with suction cup (HADS) technology for poststroke patients. Proc Inst Mech Eng H 2024; 238:160-169. [PMID: 38189258 DOI: 10.1177/09544119231221190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
A stroke is a neurological disease that primarily causes paralysis. Besides paraplegia, all other types of paralysis affect the upper extremity. Advanced technologies, such as wearable devices and rehabilitation regimens, are also being developed to enhance the functional ability of a stroke person to grasp and release daily living objects. In this research, we developed a rehabilitation functional assist device combining a flexion and extension mechanism with suction cup technology (hybrid technology) to help post-stroke patients improve their hand grip strength in day-to-day grasping activities. Ten poststroke hemiplegia patients were studied to test the functional ability of the impaired hand by wearing and not wearing the device. The outcomes were validated by three standard clinical tests, such as the Toronto Rehabilitation Institute - Hand Functional Test (TRI-HFT), the Chedoke Arm Hand Activity Inventory (CAHAI-9), and the Fugl-Meyer Assessment (FMA) with overall score improvements of 14.5 ± 3.8-25 ± 2.2 (p = 0.005), 5.4 ± 2.8-10 ± 1.6 (p = 0.008), and 9.6 ± 2.6-17 ± 2.4 (p = 0.005) respectively. The p-value for each of the three evaluations was less than 0.05, indicating significantly improved results and the average feedback score of the participants was 3.8 out of 5. The proposed device significantly increased impaired hand functionality in post-stroke patients. The subjects could complete some of the grasping tasks that they could not grasp without the device.Clinical trial registrationThe Clinical Trial Registry of India approved the work CTRI/2022/02/040495 described in this manuscript.
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Affiliation(s)
- Porkodi Jayavel
- Department of Biomedical Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, India
| | - Varshini Karthik
- Department of Biomedical Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, India
| | - Jaison Jacob Mathunny
- Department of Biomedical Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, India
| | - Suresh Jothi
- SRM College of Physiotherapy, SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, India
| | - Ashokkumar Devaraj
- Department of Biomedical Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, India
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Proietti T, Nuckols K, Grupper J, Schwerz de Lucena D, Inirio B, Porazinski K, Wagner D, Cole T, Glover C, Mendelowitz S, Herman M, Breen J, Lin D, Walsh C. Combining soft robotics and telerehabilitation for improving motor function after stroke. WEARABLE TECHNOLOGIES 2024; 5:e1. [PMID: 38510985 PMCID: PMC10952055 DOI: 10.1017/wtc.2023.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/07/2023] [Accepted: 12/02/2023] [Indexed: 03/22/2024]
Abstract
Telerehabilitation and robotics, either traditional rigid or soft, have been extensively studied and used to improve hand functionality after a stroke. However, a limited number of devices combined these two technologies to such a level of maturity that was possible to use them at the patients' home, unsupervised. Here we present a novel investigation that demonstrates the feasibility of a system that integrates a soft inflatable robotic glove, a cloud-connected software interface, and a telerehabilitation therapy. Ten chronic moderate-to-severe stroke survivors independently used the system at their home for 4 weeks, following a software-led therapy and being in touch with occupational therapists. Data from the therapy, including automatic assessments by the robot, were available to the occupational therapists in real-time, thanks to the cloud-connected capability of the system. The participants used the system intensively (about five times more movements per session than the standard care) for a total of more than 8 hr of therapy on average. We were able to observe improvements in standard clinical metrics (FMA +3.9 ± 4.0, p < .05, COPM-P + 2.5 ± 1.3, p < .05, COPM-S + 2.6 ± 1.9, p < .05, MAL-AOU +6.6 ± 6.5, p < .05) and range of motion (+88%) at the end of the intervention. Despite being small, these improvements sustained at follow-up, 2 weeks after the end of the therapy. These promising results pave the way toward further investigation for the deployment of combined soft robotic/telerehabilitive systems at-home for autonomous usage for stroke rehabilitation.
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Affiliation(s)
- Tommaso Proietti
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Kristin Nuckols
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Jesse Grupper
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Diogo Schwerz de Lucena
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Bianca Inirio
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | | | - Diana Wagner
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Tazzy Cole
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Christina Glover
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Sarah Mendelowitz
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Maxwell Herman
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Joan Breen
- Whittier Rehabilitation Hospital, Bradford, MA, USA
| | - David Lin
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- VA RR&D Center for Neurorestoration and Neurotechnology, Rehabilitation R&D Service, Department of VA Medical Center, Providence, RI, USA
| | - Conor Walsh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
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Bates M, Sunderam S. Hand-worn devices for assessment and rehabilitation of motor function and their potential use in BCI protocols: a review. Front Hum Neurosci 2023; 17:1121481. [PMID: 37484920 PMCID: PMC10357516 DOI: 10.3389/fnhum.2023.1121481] [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: 12/11/2022] [Accepted: 06/01/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Various neurological conditions can impair hand function. Affected individuals cannot fully participate in activities of daily living due to the lack of fine motor control. Neurorehabilitation emphasizes repetitive movement and subjective clinical assessments that require clinical experience to administer. Methods Here, we perform a review of literature focused on the use of hand-worn devices for rehabilitation and assessment of hand function. We paid particular attention to protocols that involve brain-computer interfaces (BCIs) since BCIs are gaining ground as a means for detecting volitional signals as the basis for interactive motor training protocols to augment recovery. All devices reviewed either monitor, assist, stimulate, or support hand and finger movement. Results A majority of studies reviewed here test or validate devices through clinical trials, especially for stroke. Even though sensor gloves are the most commonly employed type of device in this domain, they have certain limitations. Many such gloves use bend or inertial sensors to monitor the movement of individual digits, but few monitor both movement and applied pressure. The use of such devices in BCI protocols is also uncommon. Discussion We conclude that hand-worn devices that monitor both flexion and grip will benefit both clinical diagnostic assessment of function during treatment and closed-loop BCI protocols aimed at rehabilitation.
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Barria P, Riquelme M, Reppich H, Cisnal A, Fraile JC, Pérez-Turiel J, Sierra D, Aguilar R, Andrade A, Nuñez-Espinosa C. Hand rehabilitation based on the RobHand exoskeleton in stroke patients: A case series study. Front Robot AI 2023; 10:1146018. [PMID: 37033674 PMCID: PMC10073561 DOI: 10.3389/frobt.2023.1146018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction: The RobHand (Robot for Hand Rehabilitation) is a robotic neuromotor rehabilitation exoskeleton that assists in performing flexion and extension movements of the fingers. The present case study assesses changes in manual function and hand muscle strength of four selected stroke patients after completion of an established training program. In addition, safety and user satisfaction are also evaluated. Methods: The training program consisted of 16 sessions; two 60-minute training sessions per week for eight consecutive weeks. During each session, patients moved through six consecutive rehabilitation stages using the RobHand. Manual function assessments were applied before and after the training program and safety tests were carried out after each session. A user evaluation questionnaire was filled out after each patient completed the program. Results: The safety test showed the absence of significant adverse events, such as skin lesions or fatigue. An average score of 4 out of 5 was obtained on the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 Scale. Users were very satisfied with the weight, comfort, and quality of professional services. A Kruskal-Wallis test revealed that there were not statistically significant changes in the manual function tests between the beginning and the end of the training program. Discussion: It can be concluded that the RobHand is a safe rehabilitation technology and users were satisfied with the system. No statistically significant differences in manual function were found. This could be due to the high influence of the stroke stage on motor recovery since the study was performed with chronic patients. Hence, future studies should evaluate the rehabilitation effectiveness of the repetitive use of the RobHand exoskeleton on subacute patients. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05598892?id=NCT05598892&draw=2&rank=1, identifier NCT05598892.
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Affiliation(s)
- Patricio Barria
- Centro de Rehabilitación, Club de Leones Cruz del Sur, Punta Arenas, Chile
- *Correspondence: Patricio Barria,
| | - Matías Riquelme
- School of Medicine, University of Magallanes (UMAG), Punta Arenas, Chile
- Centro Asistencial Docente e Investigación (CADI), University of Magallanes (UMAG), Punta Arenas, Chile
| | - Hannah Reppich
- Centro de Rehabilitación, Club de Leones Cruz del Sur, Punta Arenas, Chile
| | - Ana Cisnal
- Instituto de las Tecnologías Avanzadas de la Producción (ITAP), University of Valladolid, Valladolid, Spain
| | - Juan-Carlos Fraile
- Instituto de las Tecnologías Avanzadas de la Producción (ITAP), University of Valladolid, Valladolid, Spain
| | - Javier Pérez-Turiel
- Instituto de las Tecnologías Avanzadas de la Producción (ITAP), University of Valladolid, Valladolid, Spain
| | - David Sierra
- Instituto de las Tecnologías Avanzadas de la Producción (ITAP), University of Valladolid, Valladolid, Spain
| | - Rolando Aguilar
- Centro de Rehabilitación, Club de Leones Cruz del Sur, Punta Arenas, Chile
| | - Asterio Andrade
- Centro de Rehabilitación, Club de Leones Cruz del Sur, Punta Arenas, Chile
| | - Cristian Nuñez-Espinosa
- School of Medicine, University of Magallanes (UMAG), Punta Arenas, Chile
- Centro Asistencial Docente e Investigación (CADI), University of Magallanes (UMAG), Punta Arenas, Chile
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Yurkewich A, Ortega S, Sanchez J, Wang RH, Burdet E. Integrating hand exoskeletons into goal-oriented clinic and home stroke and spinal cord injury rehabilitation. J Rehabil Assist Technol Eng 2022; 9:20556683221130970. [PMID: 36212185 PMCID: PMC9535266 DOI: 10.1177/20556683221130970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 09/20/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Robotic exoskeletons are emerging as rehabilitation and assistive
technologies that simultaneously restore function and enable independence
for people with disabilities. Aim We investigated the feasibility and orthotic and restorative effects of an
exoskeleton-supported goal-directed rehabilitation program for people with
hand impairments after stroke or Spinal Cord Injury (SCI). Method A single-arm case-series feasibility study was conducted using a wearable
untethered hand exoskeleton during goal-directed therapy programs with
in-clinic and at-home components. Therapists trained stroke and SCI patients
to use a hand exoskeleton during rehabilitation exercises, activities of
daily living and patient-selected goals. Each patient received a 1-hour
in-clinic training session on five consecutive days, then took the
exoskeleton home for two consecutive days to perform therapist-recommended
tasks. Goal Attainment Scaling (GAS) and the Box and Block Test (BBT) were
administered at baseline, after in-clinic
therapy and after home use, with and again without wearing
the exoskeleton. The System Usability Scale (SUS), Motor Activity Log, and
Fugl-Meyer Assessment were also administered to assess the intervention’s
acceptability, adherence, usability and effectiveness. Results Four stroke patients (Chedoke McMaster Stage of Hand 2–4) and one SCI patient
(ASIA C8 Motor Stage 1) 23 ± 19 months post-injury wore the hand exoskeleton
to perform 280 ± 23 exercise repetitions in the clinic and additional
goal-oriented tasks at home. The patients performed their own goals and the
dexterity task with higher performance following the 7-days therapy program
in comparison to baseline for both exoskeleton-assisted (ΔGAS: 18 ± 10,
ΔBBT: 1 ± 5) and unassisted (ΔGAS: 14 ± 14, ΔBBT: 3 ± 4) assessments.
Therapists and patients provided ‘good’ SUS ratings of 78 ± 6 and no harmful
events were reported. Conclusions The exoskeleton-supported stroke and SCI therapy program with in-clinic and
at-home training components was feasible.
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Affiliation(s)
- Aaron Yurkewich
- Bioengineering Department, Imperial College of Science
Technology and Medicine, London UK,Aaron Yurkewich, MESc, Institute of
Biomaterials and Biomedical Engineering, University of Toronto, Room 407,
Rosebrugh Bldg, 164 College St, Toronto, ON M5S 3G9, Canada.
| | - Sara Ortega
- Occupational Therapy, Centro Europeo de
Neurociencias, Madrid, Spain
| | - José Sanchez
- Occupational Therapy, Centro Europeo de
Neurociencias, Madrid, Spain
| | - Rosalie H Wang
- Occupational Science and
Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Etienne Burdet
- Bioengineering Department, Imperial College of Science
Technology and Medicine, London UK
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Kabir R, Sunny MSH, Ahmed HU, Rahman MH. Hand Rehabilitation Devices: A Comprehensive Systematic Review. MICROMACHINES 2022; 13:mi13071033. [PMID: 35888850 PMCID: PMC9325203 DOI: 10.3390/mi13071033] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- Ryan Kabir
- Department of Mechanical Engineering, BioRobotics Lab, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (H.U.A.); (M.H.R.)
- Correspondence:
| | - Md Samiul Haque Sunny
- Department of Computer Science, BioRobotics Lab, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
| | - Helal Uddin Ahmed
- Department of Mechanical Engineering, BioRobotics Lab, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (H.U.A.); (M.H.R.)
| | - Mohammad Habibur Rahman
- Department of Mechanical Engineering, BioRobotics Lab, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (H.U.A.); (M.H.R.)
- Department of Computer Science, BioRobotics Lab, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
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Mita M, Suzumori K, Kudo D, Saito K, Chida S, Hatakeyama K, Shimada Y, Miyakoshi N. Utility of a wearable robot for the fingers that uses pneumatic artificial muscles for patients with post-stroke spasticity. JAPANESE JOURNAL OF COMPREHENSIVE REHABILITATION SCIENCE 2022; 13:12-16. [PMID: 37859849 PMCID: PMC10545049 DOI: 10.11336/jjcrs.13.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 10/21/2023]
Abstract
Mita M, Suzumori K, Kudo D, Saito K, Chida S, Hatakeyama K, Shimada Y, Miyakoshi N. Utility of a wearable robot for the fingers that uses pneumatic artificial muscles for patients with post-stroke spasticity. Jpn J Compr Rehabil Sci 2022; 13: 12-16. Objective We investigated the utility of a wearable robot for the fingers that we developed using pneumatic artificial muscles for rehabilitation of patients with post-stroke spasticity. Methods Three patients with post-stroke finger spasticity underwent rehabilitation for 20 minutes a day, 5 days a week, for 3 weeks. Passive range of motion, Modified Ashworth Scale (MAS), and circumference of each finger were measured before and after training and compared. Results The range of motion and finger circumference increased when using a wearable robot. The MAS improved partially, and no exacerbation was observed. Conclusions The wearable robot we developed is useful for rehabilitation of post-stroke spasticity and may improve venous return.
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Affiliation(s)
- Motoki Mita
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
- Department of Orthopedic Surgery, Yuri Kumiai General Hospital, Yurihonjo, Akita, Japan
| | - Koichi Suzumori
- Department of Mechanical Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Daisuke Kudo
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Kimio Saito
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
- Department of Rehabilitation Unit, Akita University Graduate School of Medicine, Akita, Japan
| | - Satoaki Chida
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
- Department of Rehabilitation Unit, Akita University Graduate School of Medicine, Akita, Japan
| | - Kazutoshi Hatakeyama
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
- Department of Rehabilitation Unit, Akita University Graduate School of Medicine, Akita, Japan
| | - Yoichi Shimada
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
- Akita Prefectural Center on Development and Disability, Akita, Japan
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
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Effectiveness of a Soft Robotic Glove to Assist Hand Function in Stroke Patients: A Cross-Sectional Pilot Study. Rehabil Res Pract 2022; 2022:3738219. [PMID: 35509444 PMCID: PMC9061070 DOI: 10.1155/2022/3738219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/17/2022] [Accepted: 04/04/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose Stroke patients have difficulty performing tasks using their paretic hands. There are limited data on the effects of using a soft robotic glove to assist with hand function. The objective of this study was to investigate the effectiveness of a soft robotic glove in assisting hand function in stroke patients. Methods This study was a cross-sectional pilot study. Twenty stroke patients with partial or complete hand weakness were recruited from a rehabilitation centre. The Box and Block Test (BBT) and the Action Research Arm Test (ARAT) were performed under two conditions: with and without use of the soft robotic glove. The order of the conditions was randomly assigned by a computer-generated program. Results BBT scores increased 6.4 blocks when using the soft robotic glove (p < 0.001). ARAT grasp, grip, pinch, and overall scores increased by 27.08% (p < 0.01), 28.75% (p < 0.001), 15.89% (p < 0.01), and 21.15% (p < 0.001), respectively, using the glove versus not using the glove. Conclusions The findings of this study suggest that using a soft robotic glove can assist a poststroke paretic hand in executing grasp, grip, and pinch.
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Gantenbein J, Dittli J, Meyer JT, Gassert R, Lambercy O. Intention Detection Strategies for Robotic Upper-Limb Orthoses: A Scoping Review Considering Usability, Daily Life Application, and User Evaluation. Front Neurorobot 2022; 16:815693. [PMID: 35264940 PMCID: PMC8900616 DOI: 10.3389/fnbot.2022.815693] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Wearable robotic upper limb orthoses (ULO) are promising tools to assist or enhance the upper-limb function of their users. While the functionality of these devices has continuously increased, the robust and reliable detection of the user's intention to control the available degrees of freedom remains a major challenge and a barrier for acceptance. As the information interface between device and user, the intention detection strategy (IDS) has a crucial impact on the usability of the overall device. Yet, this aspect and the impact it has on the device usability is only rarely evaluated with respect to the context of use of ULO. A scoping literature review was conducted to identify non-invasive IDS applied to ULO that have been evaluated with human participants, with a specific focus on evaluation methods and findings related to functionality and usability and their appropriateness for specific contexts of use in daily life. A total of 93 studies were identified, describing 29 different IDS that are summarized and classified according to a four-level classification scheme. The predominant user input signal associated with the described IDS was electromyography (35.6%), followed by manual triggers such as buttons, touchscreens or joysticks (16.7%), as well as isometric force generated by residual movement in upper-limb segments (15.1%). We identify and discuss the strengths and weaknesses of IDS with respect to specific contexts of use and highlight a trade-off between performance and complexity in selecting an optimal IDS. Investigating evaluation practices to study the usability of IDS, the included studies revealed that, primarily, objective and quantitative usability attributes related to effectiveness or efficiency were assessed. Further, it underlined the lack of a systematic way to determine whether the usability of an IDS is sufficiently high to be appropriate for use in daily life applications. This work highlights the importance of a user- and application-specific selection and evaluation of non-invasive IDS for ULO. For technology developers in the field, it further provides recommendations on the selection process of IDS as well as to the design of corresponding evaluation protocols.
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Affiliation(s)
- Jessica Gantenbein
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Jan Dittli
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Jan Thomas Meyer
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Roger Gassert
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Olivier Lambercy
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
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11
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Secciani N, Brogi C, Pagliai M, Buonamici F, Gerli F, Vannetti F, Bianchini M, Volpe Y, Ridolfi A. Wearable Robots: An Original Mechatronic Design of a Hand Exoskeleton for Assistive and Rehabilitative Purposes. Front Neurorobot 2021; 15:750385. [PMID: 34744679 PMCID: PMC8568131 DOI: 10.3389/fnbot.2021.750385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Robotic devices are being employed in more and more sectors to enhance, streamline, and augment the outcomes of a wide variety of human activities. Wearable robots arise indeed as of-vital-importance tools for telerehabilitation or home assistance targeting people affected by motor disabilities. In particular, the field of “Robotics for Medicine and Healthcare” is attracting growing interest. The development of such devices is a primarily addressed topic since the increasing number of people in need of rehabilitation or assistive therapies (due to population aging) growingly weighs on the healthcare systems of the nation. Besides, the necessity to move to clinics represents an additional logistic burden for patients and their families. Among the various body parts, the hand is specially investigated since it most ensures the independence of an individual, and thus, the restoration of its dexterity is considered a high priority. In this study, the authors present the development of a fully wearable, portable, and tailor-made hand exoskeleton designed for both home assistance and telerehabilitation. Its purpose is either to assist patients during activities of daily living by running a real-time intention detection algorithm or to be used for remotely supervised or unsupervised rehabilitation sessions by performing exercises preset by therapists. Throughout the mechatronic design process, special attention has been paid to the complete wearability and comfort of the system to produce a user-friendly device capable of assisting people in their daily life or enabling recorded home rehabilitation sessions allowing the therapist to monitor the state evolution of the patient. Such a hand exoskeleton system has been designed, manufactured, and preliminarily tested on a subject affected by spinal muscular atrophy, and some results are reported at the end of the article.
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Affiliation(s)
- Nicola Secciani
- Department of Industrial Engineering, University of Florence, Firenze, Italy
| | - Chiara Brogi
- Department of Industrial Engineering, University of Florence, Firenze, Italy
| | - Marco Pagliai
- Department of Industrial Engineering, University of Florence, Firenze, Italy
| | - Francesco Buonamici
- Department of Industrial Engineering, University of Florence, Firenze, Italy
| | - Filippo Gerli
- IRCCS Don Gnocchi, Don Carlo Gnocchi Foundation, Firenze, Italy
| | | | - Massimo Bianchini
- Institute for Complex Systems, National Research Council, Sesto Fiorentino, Italy
| | - Yary Volpe
- Department of Industrial Engineering, University of Florence, Firenze, Italy
| | - Alessandro Ridolfi
- Department of Industrial Engineering, University of Florence, Firenze, Italy
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Akbari A, Haghverd F, Behbahani S. Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic. Front Robot AI 2021; 8:612331. [PMID: 34239898 PMCID: PMC8258116 DOI: 10.3389/frobt.2021.612331] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 06/01/2021] [Indexed: 01/24/2023] Open
Abstract
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.
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Affiliation(s)
| | | | - Saeed Behbahani
- Department of Mechanical Engineering, Isfahan University of Technology, Isfahan, Iran
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