BackgroundThis paper describes the design and preliminary testing of FINGER (Finger Individuating Grasp Exercise Robot), a device for assisting in finger rehabilitation after neurologic injury. We developed FINGER to assist stroke patients in moving their fingers individually in a naturalistic curling motion while playing a game similar to Guitar Hero®a. The goal was to make FINGER capable of assisting with motions where precise timing is important.MethodsFINGER consists of a pair of stacked single degree-of-freedom 8-bar mechanisms, one for the index and one for the middle finger. Each 8-bar mechanism was designed to control the angle and position of the proximal phalanx and the position of the middle phalanx. Target positions for the mechanism optimization were determined from trajectory data collected from 7 healthy subjects using color-based motion capture. The resulting robotic device was built to accommodate multiple finger sizes and finger-to-finger widths. For initial evaluation, we asked individuals with a stroke (n = 16) and without impairment (n = 4) to play a game similar to Guitar Hero® while connected to FINGER.ResultsPrecision design, low friction bearings, and separate high speed linear actuators allowed FINGER to individually actuate the fingers with a high bandwidth of control (−3 dB at approximately 8 Hz). During the tests, we were able to modulate the subject’s success rate at the game by automatically adjusting the controller gains of FINGER. We also used FINGER to measure subjects’ effort and finger individuation while playing the game.ConclusionsTest results demonstrate the ability of FINGER to motivate subjects with an engaging game environment that challenges individuated control of the fingers, automatically control assistance levels, and quantify finger individuation after stroke.

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Vacuum Assisted Closure (V.A.C.) Therapy has previously been shown to facilitate healing of wounds. However, the physiological mechanism(s) of this treatment modality and its systemic effects require further investigations. The goal of this porcine study was to investigate the effect of V.A.C. Therapy on the systemic distribution of the inflammatory cytokines interleukin (IL)-6, IL-8, IL-10, and transforming growth factor-beta1. Twelve pigs were each given one full-thickness excisional wound, using electrocautery. Six of the pigs were treated with V.A.C. Therapy and six with saline-moistened gauze. Serum samples were collected immediately after wound creation, and hourly for 4 hours. Samples were analyzed using commercially available enzyme-linked immunosorbent assay kits. During the initial 4 hours of treatment, V.A.C. Therapy resulted in earlier and greater peaking of IL-10 and maintenance of IL-6 levels compared with saline-moistened gauze controls, which showed decreased IL-6 values over the first hour (both at p<0.05). No other treatment-based differences were detected.

The cost for SILC did not differ significantly from that for LC when standard materials were used and the duration of the procedure was considered. Converted cases were significantly more expensive than completed SILC and LC cases.