A HERO for Stroke Patients: a new hand exoskeleton 3D printed on textiles for rehabilitation

Abstract

Background: Stroke survivors can be affected by motor deficits in the hand. Robotic equipment associated with brain-machine interfaces (BMI) may aid the motor rehabilitation of these patients. BMIs involving orthotic control by motor imagery practices have been successful in restoring stroke patients' movements. However, there is still little acceptance of the robotic devices available, either by patients and clinicians, mainly because of the high costs involved. Motivated by this context, the present work aims to design and construct the Hand Exoskeleton for Rehabilitation Objectives (HERO) to recover extension and flexion movements of the fingers. Methods: 3D printing technique in association with textiles was used to produce a lightweight and wearable device. 3D-printed actuators have also been designed to reduce equipment costs. The actuator transforms the torque of DC motors into linear force transmitted by Bowden cables to move the fingers passively. The exoskeleton was controlled by neuroelectric signal --- electroencephalography (EEG). Concept tests were performed to evaluate control performance. A healthy volunteer was submitted to a training block with the exoskeleton, according to the Graz-BCI protocol. Ergonomy was evaluated with a 2D tracking software. Results: The outcome of the applied manufacturing technique was aesthetically pleasing. HERO's glove can be compared to ordinary clothing. The weight over the hand was around 102 g. The volunteer was able to control the exoskeleton with 91.5\% accuracy. Conclusions: HERO's project resulted in a lightweight, simple, portable, ergonomic, and low-cost device. Its use is not restricted to a clinical setting. Thus, users will be able to execute motor training with the HERO at hospitals, rehabilitation clinics, and home, increasing the rehabilitation intervention time. This may favor motor rehabilitation and improve the life quality of stroke survivors.

Feasibility of Robot-Assistance Hand Physiotherapy in Post-Stroke Patients

“…Physiotherapy exercises are considered the most important approach to restoring hand functions [5] since the conventional methods of phys-iotherapy have some drawbacks, as follows: 1) the therapist needs to do many physical works, leading to fatigue and lack of carefulness in training the patients, 2) patients also become tired due to repetitive exercises, resulting in stopping treatment, and 3) a long time is needed for the patient's recovery, leading to increased treatment costs [6][7][8]. Different designed robots fabricated performing physiotherapy exercises on the hand, considered exoskeleton, such as soft exoskeleton robotic systems [9], Multi-Sensorial Immersive Dynamic Autonomous Systems (MIDAS) [10], and Hand Exoskeleton for Rehabilitation Objectives (HERO) [11]. In this field, other categories also work on devices with passive movements, such as a portable exoskeleton [12], a multi degree of freedom device for fingers [13], SPO (Script Passive Orthosis) [14], and an interactive rehabilitation robot [15], mostly fabricated for finger rehabilitation, including café [16], assist-on-fingers [17], ExoSkeleton for Index Finger [18], and IOTA (Isolated Orthosis for Thumb Actuation) [19].…”