Hand Extension Robot Orthosis (HERO) Grip Glove: enabling independence amongst persons with severe hand impairments after stroke

Abstract

Background: The Hand Extension Robot Orthosis (HERO) Grip Glove was iteratively designed to meet requests from therapists and persons after a stroke who have severe hand impairment to create a device that extends all five fingers, enhances grip strength and is portable, lightweight, easy to put on, comfortable and affordable. Methods: Eleven persons who have minimal or no active finger extension (Chedoke McMaster Stage of Hand 1-4) post-stroke were recruited to evaluate how well they could perform activities of daily living and finger function assessments with and without wearing the HERO Grip Glove. Results: The 11 participants showed statistically significant improvements (p < 0.01), while wearing the HERO Grip Glove, in the water bottle grasp and manipulation task (increase of 2.3 points, SD 1.2, scored using the Chedoke Hand and Arm Inventory scale from 1 to 7) and in index finger extension (increase of 147 o , SD 44) and range of motion (increase of 145 o , SD 36). The HERO Grip Glove provided 12.7 N (SD 8.9 N) of grip force and 11.0 N (SD 4.8) of pinch force to their affected hands, which enabled those without grip strength to grasp and manipulate blocks, a fork and a water bottle, as well as write with a pen. The participants were 'more or less satisfied' with the HERO Grip Glove as an assistive device (average of 3.3 out of 5 on the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 Scale). The highest satisfaction scores were given for safety and security (4.6) and ease of use (3.8) and the lowest satisfaction scores were given for ease of donning (2.3), which required under 5 min with assistance. The most common requests were for greater grip strength and a smaller glove size for small hands. Conclusions: The HERO Grip Glove is a safe and effective tool for enabling persons with a stroke that have severe hand impairment to incorporate their affected hand into activities of daily living, which may motivate greater use of the affected upper extremity in daily life to stimulate neuromuscular recovery.

3-Dimensional Printing in Rehabilitation: Feasibility of Printing an Upper Extremity Gross Motor Function Assessment Tool

“…Individuals greater than seven days post-stroke and with mmoderate to severe impairment of hand function were recruited for this pilot study [34]. The inclusion criteria were: (a)stroke survivors greater than seven days post-stroke…”

Myoelectric untethered robotic glove enhances hand function and performance on daily living tasks after stroke

“…Recently, untethered robotic gloves with soft and rigid components have been found to enhance performance on a small set of grasping and lifting daily living tasks for people after stroke, even if the user has high tone and spasticity and no finger extension. [9][10][11] However, the effectiveness of the assistance provided by wearable robots needs further evaluation with people with varying levels of hand impairment after stroke using a standardized set of daily living tasks.…”

“…3 A wrist brace and a linear actuator on the palmar side of the forearm were added for the second version, the HERO Grip Glove, which enabled people after stroke to extend their fingers fully and then grip a water bottle, wooden block, a fork and a pen more securely. 9 Assessments showed participants were 'more or less satisfied' with the HERO Grip Glove's usability. The most requested improvements were for a more accurate control mode that did not require use of the unaffected hand, flexion assistance for all five fingers and stronger grip force, especially for small diameter objects like pens and forks.…”

“…• Adding wire tendons for ring and little finger flexion and thumb adduction to provide palm curvature and greater grip force • Integrating an untethered EMG recording device and a myoelectric calibration and control algorithm with the robotic glove for muscle-initiated assistance My-HERO uses the same foldable wrist brace design as the HERO Grip Glove, so that the wrist is supported and the same donning technique of inserting the thumb and then each individual finger can be used for flaccid and clenched hands. 9 The battery pack (9 V Energizer Lithium battery) and Bluetooth-enabled microcontroller (tinyTILE Intel Curie) are relocated to the proximal end of the wrist brace for improved aesthetics and to reduce the arm torque required to lift the glove. A size medium glove is used to provide better fit on the thumb.…”

Clinical Trial of HEXORR II for Robotic Hand Movement Therapy After Stroke

“…Wearable devices can be used during whole upper extremity tasks, such as reach and grasp tasks, and can take the form of active [11][12][13][14][15][16][17][18] or passive exoskeletons. [19][20][21][22] However, because of space and weight constraints in wearable devices, movement kinematics and control algorithms can often be more precise and sophisticated with desktop devices that isolate nger movements, but don't allow use of the hand with objects or in conjunction with proximal arm joints.…”