Development of a Novel Task-oriented Rehabilitation Program using a Bimanual Exoskeleton Robotic Hand

Summary

This study reports the development of a novel robot-assisted task-oriented program for hand rehabilitation. The developmental process consists of experiments using both healthy subjects and subjects who have had a stroke and suffered from subsequent motor control dysfunction.

Abstract

A robot-assisted hand is used for the rehabilitation of patients with impaired upper limb function, particularly for stroke patients with a loss of motor control. However, it is unclear how conventional occupational training strategies can be applied to the use of rehabilitation robots. Novel robotic technologies and occupational therapy concepts are used to develop a protocol that allows patients with impaired upper limb function to grasp objects using their affected hand through a variety of pinching and grasping functions. To conduct this appropriately, we used five types of objects: a peg, a rectangular cube, a cube, a ball, and a cylindrical bar. We also equipped the patients with a robotic hand, the Mirror Hand, an exoskeleton hand that is fitted to the subject’s affected hand and follows the movement of the sensor glove fitted to their unaffected hand (bimanual movement training (BMT)). This study had two stages. Three healthy subjects were first recruited to test the feasibility and acceptability of the training program. Three patients with hand dysfunction caused by stroke were then recruited to confirm the feasibility and acceptability of the training program, which was conducted on 3 consecutive days. On each day, the patient was monitored during 5 min of movement in a passive range of motion, 5 min of robot-assisted bimanual movement, and task-oriented training using the five objects. The results showed that both healthy subjects and subjects who had suffered a stroke in conjunction with the robotic hand could successfully grasp the objects. Both healthy subjects and those who had suffered a stroke performed well with the robot-assisted task-oriented training program in terms of feasibility and acceptability.

Introduction

Most (80%) stroke patients experience a deficit in the hand and have difficulty in independently performing manual tasks that are pertinent to daily living¹. However, the complex nature of manual tasks means that it is a significant challenge to design a task-oriented training program for hand rehabilitation². In recent years, many robotic devices have been developed for hand rehabilitation^3,4, but few training protocols assisted by robotic devices allow a patient to interact with real objects. It is unclear exactly how a task-oriented training program for hand f....

Protocol

The training protocol and informed consent document were reviewed and approved by the Institutional Review Board of the Chang Gung Medical Foundation. The details of the study and the procedures were clearly explained to each subject.

1. Recruitment of three healthy adults

1. Perform the screening process using the following inclusion criteria: (1) age 20–60 years, (2) already signed informed consent, (3) normal function in upper limbs, (4) Mini-Mental State Examination (MMSE) s.......

Discussion

The results of this study showed the following: (1) both groups could successfully grasp the objects provided with the robotic hand system. They were able to complete this task with a nearly 100% success rate, which verifies the feasibility of the proposed robot-assisted task-oriented training program. (2) There were no reports of injury or adverse events during the study period and all patients reported that the robotic hand system was helpful to manipulate objects. This confirmed the acceptability of the robotic hand s.......

Materials

Name	Company	Catalog Number	Comments
Control Box	Rehabotics Medical Technology Corporation	HB01	The control box includes a power supply, sensor glove signal receiver, motor signal transmitter, and exoskeletal hand motion mode selection unit.
Exoskeletal Hand	Rehabotics Medical Technology Corporation	HS01	It is a wearable device causing the patient's fingers to move and is driven by an external motor and mechanical assembly.
Sensor Glove	Rehabotics Medical Technology Corporation	HM01	Worn on the patient's unaffected side hand. The sensors in the sensor glove will detect flexing and extension of the hand, and this data will be used to control the exoskeletal hand when in bimanual mode.