Hand Exoskeleton Design for the Rehabilitation of Patients with Rheumatoid Arthritis

Abstract

Starting in 2015, various exoskeleton designs have been developed to facilitate interventions in the rehabilitation of patients with movement disabilities aimed primarily at flexing and extending the finger joints. This article covers the review and generation of a device for the physical rehabilitation of people diagnosed with rheumatoid arthritis (RA). Among the determining aspects for its manufacture, it has been detected that most have been designed with different technological tools with limited degrees of freedom (GDL) and the application of mechanical systems without studies of interaction with the user. The applied methodological framework for the development of exoskeletons of the hand includes a systematic review of the devices, referring to their mechanical, electronic and functional attributes according to the technological trends of the last five years. The information analyzed in this article allows the generation of an exoskeleton with the use of rapid prototyping techniques within user-centered digital manufacturing processes.

Design and Validation of an Exoskeleton for Hand Rehabilitation in Adult Patients with Rheumatoid Arthritis

“…For the first phase of the validation methodology, the validation experience from previous research was taken as a starting point and the following recommended principles for validation with users were taken into account [11]:…”

“…The interest in exoskeletons for healthcare has been increasing, and particularly the interest of satisfying the concerns of the growing aging society [3,13]. A deeper understanding of the hand as a life tool has been the trigger to carry out an intensive investigation into this field and has evidenced the need to reliably manage the symptoms presented in older adults with RA, using a methodology center in the patients [6,11,12].…”

“…Additionally, in more recent reviews [4], there has been a considerable focus on glove-based devices, as they have been extensively investigated in medical practice. However, in the lack of evidence from well-controlled projects with conclusive results regarding the effectiveness of the proposed interventions [6], it is imperative to focus rehabilitation techniques on training adapted to the patient's needs in terms of the exercises they perform to reduce the symptoms of the disease [10,11]. All this requires that from the beginning, the exoskeleton must be designed with the user's real requirements in mind.…”

“…In this regard, it is pointed out that, in current hand rehabilitation therapies, there are external factors that are not so favorable for this process. These include the low number of available specialists, assistants and equipment [11,14], which makes the recovery process more difficult for patients; however, with the use of different RP technologies, it is possible to get closer to a model that can be scaled up to self-fabrication.…”

“…Against this background, the previous research was intensified in order to create a functional prototype that aligns with the expectations of improvement in the quality life of patients and that allows to evaluate the improvement of joint movement in a dynamic and systematic way. Taking in consideration the last results with some prototypes made, it is possible to say that the application of the methodology used next to the RP technologies for hand rehabilitation [2,7,11] improves the joint arc of movement considerably, increases the muscle stretching, and shows a reduction in pain during finger movement. Figure 1 shows three functional prototypes that have been tested in patients with early RA, all of them were designed using the same methodology that is going to be described in this article.…”