Design and Development of Continuous Passive Motion (CPM) for Fingers and Wrist Grounded-Exoskeleton Rehabilitation System

Abstract

Impairments of fingers, wrist, and hand forearm result in significant hand movement deficiencies and daily task performance. Most of the existing rehabilitation assistive robots mainly focus on either the wrist training or fingers, and they are limiting the natural motion; many mechanical parts associated with the patient’s arms, heavy and expensive. This paper presented the design and development of a new, cost-efficient Finger and wrist rehabilitation mechatronics system (FWRMS) suitable for either hand right or left. The proposed machine aimed to present a solution to guide individuals with severe difficulties in their everyday routines for people suffering from a stroke or other motor diseases by actuating seven joints motions and providing them repeatable Continuous Passive Motion (CPM). FWRMS approach uses a combination of; grounded-exoskeleton structure to provide the desired displacement to the hand’s four fingers flexion/extension (F/E) driven by an indirect feed drive mechanism by adopting a leading screw and nut transmission; and an end-effector structure to provide angular velocity to the wrist flexion/ extension (F/E), wrist radial/ulnar deviation (R/U), and forearm supination/pronation (S/P) driven by a rotational motion mechanism. We employed a single dual-sided actuator to power both mechanisms. Additionally, this article presents the implementation of a portable embedded controller. Moreover, this paper addressed preliminary experimental testing and evaluation process. The conducted test results of the FWRMS robot achieved the required design characteristics and executed the motion needed for the continuous passive motion rehabilitation and provide stable trajectories guidance by following the natural range of motion (ROM) and a functional workspace of the targeted joints comfortably for all trainable movements by FWRMS.

Stimulation enhancement effect of the combination of exoskeleton-assisted hand rehabilitation and fingertip haptic stimulation

“…In recent years, as a type of hand rehabilitation robot, hand exoskeleton has attracted extensive research attention. The commonly used exoskeleton-assisted rehabilitation training method, continuous passive motion (CPM) training ( Almusawi and Husi, 2021 ; Nasrallah et al, 2021 ), involving repetitive tasks such as grasping a water bottle, can provide sensorimotor feedback during the process and has been shown to be effective in hand motor function improvements ( Li et al, 2021 ).…”

Continuous Passive Motion Machine for Elbow Rehabilitation

“…A Continuous Passive Motion (CPM) focusing on the fingers and wrist joints was developed by Almusawi and Geza [19] and Almusawi et al [20]. The proposed machine was cost-efficient and can be used by both right and left arms.…”

“…Its structure is based on the grounded-exoskeleton concept, and it is able to realize the flexion and extension movements of the fingers and radial and ulnar deviation of the wrist. The mechanism was built using a lead screw and a dual-sided actuator [19]. Fu et al [21] developed a CPM machine that is portable.…”

Flexohand: A Hybrid Exoskeleton-Based Novel Hand Rehabilitation Device

“…The end-effector type devices for hand rehabilitation must remain stationary, and the patient is required to place the affected hand onto the device to receive the treatment. Endeffector/endpoint devices for hand rehabilitation [32][33][34] are mechanisms that act on the distal tip of fingers propagating motion to DIP, PIP, and MCP joints. These devices can accommodate a variety of hand sizes, but isolated finger movement cannot be achieved effectively.…”