Design and evaluation of an actuated exoskeleton for examining motor control in stroke thumb

Abstract

Chronic hand impairment is common following stroke. This paper presents an actuated thumb exoskeleton (ATX) to facilitate research in examining motor control and hand rehabilitation. The ATX presented in this work aims to provide independent bi-directional actuation in each of the 5 degrees-of-freedom (DOF) of the thumb using a novel flexible shaft based mechanism that has 5 active DOF and 3 passive DOF. A prototype has been built and experiments have been conducted to measure the allowable workspace at the thumb and evaluate the kinematic and kinetic performance of the ATX. The experimental results show that the ATX is able to provide individual actuation at all 5 thumb joints with high joint velocity and torque capacities. Further improvement and future work are discussed.

Sensors and Actuation Technologies in Exoskeletons: A Review

“…For this reason, particular relevance is given in documents to the possibility of multi-fingers treatments, and often particular attention is paid to the management of the thumb, independently as in the works by Agarwal et al [ 49 ] and Wang et al [ 50 ], or with other fingers (e.g., [ 51 , 52 , 53 ]). The trunk is specifically addressed in the paper by Ko et al of 2018 [ 54 ], although the stabilization of the trunk is considered in clinical practice to be a fundamental step and a pre-requisite for the enrollment in several rehabilitation training paths.…”

“…This is the case in an example in the literature [ 160 ], where a position sensor is allocated after a long yielding transmission, but before the last part of the transmission, in an exoskeleton glove. A similar solution was adopted in the work by Wang et al [ 50 ] for potentiometer and strain gauge sensors located after a flexible shaft and before the last part of the transmission, or in a similar way in the paper by Agarwal et al [ 61 ] with magneto-resistive angle sensors, or in the work by Aubin et al [ 62 ] with embedded encoders and bend sensors.…”

Development and evaluation of an efficient training program to facilitate the adoption of a novel neurorehabilitation device

“…Advances in sensorimotor neurorehabilitation research have resulted in many new devices that could improve patient outcomes. [1][2][3][4][5][6] However, even with demonstrated clinical efficacy in clinical trials, new devices are hardly adopted by therapists in neurorehabilitation practice. 7,8 Multiple barriers to adoption of new rehabilitation devices in clinical practice have been identified.…”

Determining Factors that Influence Adoption of New Post-Stroke Sensorimotor Rehabilitation Devices in the USA

“…These technologies typically focus on increasing experience-dependent neuroplasticity and restoring function [6], [7]. Some examples include: virtual reality based rehabilitation games to increase repetitions of therapeutic movements to restore function [8], [9], wearable sensory stimulation to increase cortical activation during therapy [10], wearable devices that facilitate joint movements [11], [12], biofeedback [13], smart objects [14,15], and vibratory cuing devices to remind stroke survivors to move their affected upper extremities more frequently [16], [17]. Many of these restorative rehabilitation devices have shown efficacy in enhancing motor outcomes of stroke survivors [18], [19], [20].…”