Development and Validation of Customizable, Adaptive SPring-actuated Hand EXoskeleton (CASPHEX) Designed for Home-based Training of Finger Movements Post-Stroke.

IF 5.2 2区 医学 Q2 ENGINEERING, BIOMEDICAL
Thanh Q Phan, Mada Alghamdi, Mary Egwim, Sang Wook Lee
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Abstract

Passive hand devices can provide a high-dose, home-based training to stroke survivors, while active robotic systems often present practical limitations for home use due to operational complexity and safety issues. Efficacy of current passive devices, however, is reduced by their limited functionality; while their assistance typically reinforces extrinsic hand muscle function, impairments in intrinsic muscle function cannot be addressed. Passive extension assistance can also interfere with grasping movements. Therefore, we developed a novel device, Customizable, Adaptive Spring-actuated Hand Exoskeleton (CASPHEX), which can provide targeted and adaptive assistance to hand muscles to counteract unique impairments of individual subjects. CASPHEX can also adapt to user intent to allow users to perform different hand movements (i.e., hand opening followed by grasping). A novel control algorithm was developed to (1) effectively counteract worsening flexor hypertonia during extension; and (2) allow users voluntarily to switch between modes (open/close) by detecting user intent. Its performance was first validated in an experiment with 5 healthy subjects, in which CASPHEX actuated different exotendons based on their intended joint movements, whose response times were 615±53ms (proximal) and 577±47ms (distal). In the second experiment with 11 stroke survivors, we tested if they can voluntarily control CASPHEX to perform functional tasks. CASPHEX significantly improved the range of motion of the participants during finger extension, and more importantly, their box and block test scores also significantly improved by CASPHEX assistance. CASPHEX demonstrated potential to improve efficacy of robot-assisted therapy by enabling impairment-specific, home-based training of the impaired hand.

可定制、自适应弹簧驱动手外骨骼(CASPHEX)的开发和验证,设计用于中风后手指运动的家庭训练。
被动手部设备可以为中风幸存者提供高剂量的家庭训练,而主动机器人系统由于操作复杂性和安全问题,通常在家庭使用时存在实际限制。然而,目前无源器件的功效因其有限的功能而降低;虽然他们的帮助通常会加强外在的手部肌肉功能,但内在肌肉功能的损害无法解决。被动伸展辅助也会干扰抓取动作。因此,我们开发了一种新颖的设备,可定制的自适应弹簧驱动手外骨骼(CASPHEX),它可以为手部肌肉提供针对性和适应性的帮助,以抵消个体受试者的独特损伤。CASPHEX还可以适应用户的意图,允许用户执行不同的手部动作(即手张开,然后抓握)。开发了一种新的控制算法来(1)有效地对抗伸展过程中不断恶化的屈肌过度张力;(2)通过检测用户意图,允许用户自愿在模式(开/关)之间切换。首先在5名健康受试者的实验中验证了CASPHEX的性能,在实验中,CASPHEX根据不同的关节运动目标驱动不同的外伸肌腱,其响应时间分别为615±53ms(近端)和577±47ms(远端)。在对11名中风幸存者的第二个实验中,我们测试了他们是否能自愿控制CASPHEX执行功能性任务。CASPHEX显著提高了受试者手指伸展时的活动范围,更重要的是,他们的盒子和块测试成绩也在CASPHEX辅助下显著提高。CASPHEX通过对受损手进行特定损伤的家庭训练,证明了提高机器人辅助治疗效果的潜力。
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来源期刊
CiteScore
8.60
自引率
8.20%
发文量
479
审稿时长
6-12 weeks
期刊介绍: Rehabilitative and neural aspects of biomedical engineering, including functional electrical stimulation, acoustic dynamics, human performance measurement and analysis, nerve stimulation, electromyography, motor control and stimulation; and hardware and software applications for rehabilitation engineering and assistive devices.
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