Wearable Robots: An Original Mechatronic Design of a Hand Exoskeleton for Assistive and Rehabilitative Purposes

Exoskeleton technology in nursing practice: assessing effectiveness, usability, and impact on nurses' quality of work life, a narrative review

The use of exoskeletons in nursing practice has gained attention as a potential solution to address the physical demands and risks associated with the profession. This narrative review examines the effectiveness, usability, and impact of exoskeleton technology on nurses' quality of work life. The review focuses on the reduction of physical strain and fatigue, improved posture and body mechanics, enhanced patient care, usability and acceptance factors, and the broader impact on work life. The effectiveness of exoskeletons in reducing physical strain and fatigue among nurses is supported by evidence showing decreased muscle activation and reduced forces exerted on the body. The usability and acceptance of exoskeletons are critical considerations, including device comfort and fit, ease of use and integration into workflows, user experience and training, compatibility with the work environment, and user feedback for iterative design improvements. The implementation of exoskeletons has the potential to positively impact nurses' work life by reducing work-related injuries, improving physical well-being, enhancing job satisfaction, and promoting psychological and psychosocial benefits. Additionally, the use of exoskeletons can lead to improved patient care outcomes. Challenges and future directions in the field of exoskeleton technology for nurses include cost and accessibility, adaptability to nursing specialties and tasks, long-term durability and maintenance, integration with personal protective equipment, and ethical considerations. Addressing these challenges and considering future research and development efforts are crucial for the successful integration of exoskeleton technology in nursing practice, ultimately improving nurses' quality of work life and patient care delivery.

Hand rehabilitation based on the RobHand exoskeleton in stroke patients: A case series study

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.

Hand Exoskeleton Design and Human-Machine Interaction Strategies for Rehabilitation

Stroke and related complications such as hemiplegia and disability create huge burdens for human society in the 21st century, which leads to a great need for rehabilitation and daily life assistance. To address this issue, continuous efforts are devoted in human-machine interaction (HMI) technology, which aims to capture and recognize users' intentions and fulfil their needs via physical response. Based on the physiological structure of the human hand, a dimension-adjustable linkage-driven hand exoskeleton with 10 active degrees of freedom (DoFs) and 3 passive DoFs is proposed in this study, which grants high-level synergy with the human hand. Considering the weight of the adopted linkage design, the hand exoskeleton can be mounted on the existing up-limb exoskeleton system, which greatly diminishes the burden for users. Three rehabilitation/daily life assistance modes are developed (namely, robot-in-charge, therapist-in-charge, and patient-in-charge modes) to meet specific personal needs. To realize HMI, a thin-film force sensor matrix and Inertial Measurement Units (IMUs) are installed in both the hand exoskeleton and the corresponding controller. Outstanding sensor-machine synergy is confirmed by trigger rate evaluation, Kernel Density Estimation (KDE), and a confusion matrix. To recognize user intention, a genetic algorithm (GA) is applied to search for the optimal hyperparameters of a 1D Convolutional Neural Network (CNN), and the average intention-recognition accuracy for the eight actions/gestures examined reaches 97.1% (based on K-fold cross-validation). The hand exoskeleton system provides the possibility for people with limited exercise ability to conduct self-rehabilitation and complex daily activities.