scholarly journals A Plug-and-Train Robot (PLUTO) for Hand Rehabilitation: Design and Preliminary Evaluation

2020 ◽  
Author(s):  
Aravind Nehrujee ◽  
Hallel Andrew ◽  
Ann Patricia ◽  
ReethaJannetSurekha ◽  
SamuelKamaleshKumar Selvaraj ◽  
...  
Keyword(s):  
Computer Games ◽  
Preliminary Evaluation ◽  
Wrist Flexion ◽  
Single Session ◽  
Hand Rehabilitation ◽  
System Usability Scale ◽  
Flexion Extension ◽  
Minimally Supervised ◽  
Experience Questionnaire ◽  
Hand Opening

Abstract Hand neurorehabilitation involves the training of movements at various joints of the forearm, wrist, fingers, and thumb. Assisted training of all these joints either requires either one complex multiple degree-of-freedom (DOF) robot or a set of simple robots with one or two DOF. Both of these are not economically or clinically viable solutions. The paper presents work that addresses this problem with a single DOF robot that can train multiple joints one at a time – the plug and train robot (PLUTO). PLUTO has a single actuator with a set of passive attachments/mechanisms that can be easily attached/detached to train for wrist flexion-extension, wrist ulnar-radial deviation, forearm pronation-supination, and gross hand opening-closings. The robot can provide training in active and assisted regimes. PLUTO is linked to performance adaptive computer games to provide feedback to the patients and motivate them during training. As the first step toward clinical validation, the device's usability was evaluated in 45 potential stakeholders/end-users of the device, including 15 patients, 15 caregivers, and 15 clinicians with standardized questionnaires: System Usability Scale (SUS) and User Experience Questionnaire (UEQ). Patients and caregivers were administered the questionnaire after a two-session training. Clinicians, on the other hand, had a single session demo after which feedback was obtained. The total SUS score obtained from the patients, clinicians, and healthy subjects was 73.3 ± 14.6 (n = 45), indicating good usability. The UEQ score was rated positively in all subscales by both the patients and clinicians, indicating that the features of PLUTO match their expectations. The positive response from the preliminary testing and the feedback from the stakeholders indicates that with additional passive mechanisms, assessment features, and optimized ergonomics, PLUTO will be a versatile, affordable, and useful system for routine use in clinics and also patients’ homes for delivering minimally supervised hand therapy.

scholarly journals Towards a platform for robot-assisted minimally-supervised therapy of hand function: design and pilot usability evaluation

2021 ◽  
Author(s):  
Raffaele Ranzani ◽  
Lucas Eicher ◽  
Federica Viggiano ◽  
Bernadette Engelbrecht ◽  
Jeremia P.O. Held ◽  
...  
Keyword(s):  
Real World ◽  
Motor Coordination ◽  
Hand Function ◽  
Usability Evaluation ◽  
Therapy Session ◽  
Preliminary Evaluation ◽  
Hand Rehabilitation ◽  
Robot Assisted ◽  
Perceived Workload ◽  
Minimally Supervised

AbstractBackgroundRobot-assisted therapy can increase therapy dose after stroke, which is often considered insufficient in clinical practice and after discharge, especially with respect to hand function. Thus far, there has been a focus on rather complex systems that require therapist supervision. To better exploit the potential of robot-assisted therapy, we propose a platform designed for minimal therapist supervision, and present the preliminary evaluation of its immediate usability, one of the main and frequently neglected challenges for real-world application. Such an approach could help increase therapy dose by allowing the training of multiple patients in parallel by a single therapist, as well as independent training in the clinic or at home.MethodsWe implemented design changes on a hand rehabilitation robot, considering aspects relevant to enabling minimally-supervised therapy, such as new physical/graphical user interfaces and two functional therapy exercises to train hand motor coordination, somatosensation and memory. Ten participants with chronic stroke assessed the usability of the platform and reported the perceived workload during a single therapy session with minimal supervision. The ability to independently use the platform was evaluated with a checklist.ResultsParticipants were able to independently perform the therapy session after a short familiarization period, requiring assistance in only 13.46(7.69-19.23)% of the tasks. They assigned good-to-excellent scores on the SUS to the user-interface and the exercises (85.00(75.63-86.88) and 73.75(63.13-83.75) out of 100, respectively). Nine participants stated that they would use the platform frequently. Perceived workloads lay within desired workload bands. Object grasping with simultaneous control of forearm pronosupination and stiffness discrimination were identified as the most difficult tasks.DiscussionOur findings demonstrate that a robot-assisted therapy device can be rendered safely and intuitively usable upon first exposure with minimal supervision through compliance with usability and perceived workload requirements. The preliminary usability evaluation identified usability challenges that should be solved to allow real-world minimally-supervised use. Such a platformcould complement conventional therapy, allowing to provide increased dose with the available resources, and establish a continuum of care that progressively increases therapy lead of the patient from the clinic to the home.

scholarly journals Towards a Platform for Robot-Assisted Minimally-Supervised Therapy of Hand Function: Design and Pilot Usability Evaluation

2021 ◽  
Vol 9 ◽  
Author(s):  
Raffaele Ranzani ◽  
Lucas Eicher ◽  
Federica Viggiano ◽  
Bernadette Engelbrecht ◽  
Jeremia P. O. Held ◽  
...  
Keyword(s):  
Real World ◽  
Motor Coordination ◽  
Hand Function ◽  
Usability Evaluation ◽  
Therapy Session ◽  
Preliminary Evaluation ◽  
Robot Assisted ◽  
System Usability Scale ◽  
Perceived Workload ◽  
Minimally Supervised

BackgroundRobot-assisted therapy can increase therapy dose after stroke, which is often considered insufficient in clinical practice and after discharge, especially with respect to hand function. Thus far, there has been a focus on rather complex systems that require therapist supervision. To better exploit the potential of robot-assisted therapy, we propose a platform designed for minimal therapist supervision, and present the preliminary evaluation of its immediate usability, one of the main and frequently neglected challenges for real-world application. Such an approach could help increase therapy dose by allowing the training of multiple patients in parallel by a single therapist, as well as independent training in the clinic or at home.MethodsWe implemented design changes on a hand rehabilitation robot, considering aspects relevant to enabling minimally-supervised therapy, such as new physical/graphical user interfaces and two functional therapy exercises to train hand motor coordination, somatosensation and memory. Ten participants with chronic stroke assessed the usability of the platform and reported the perceived workload during a single therapy session with minimal supervision. The ability to independently use the platform was evaluated with a checklist.ResultsParticipants were able to independently perform the therapy session after a short familiarization period, requiring assistance in only 13.46 (7.69–19.23)% of the tasks. They assigned good-to-excellent scores on the System Usability Scale to the user-interface and the exercises [85.00 (75.63–86.88) and 73.75 (63.13–83.75) out of 100, respectively]. Nine participants stated that they would use the platform frequently. Perceived workloads lay within desired workload bands. Object grasping with simultaneous control of forearm pronosupination and stiffness discrimination were identified as the most difficult tasks.DiscussionOur findings demonstrate that a robot-assisted therapy device can be rendered safely and intuitively usable upon first exposure with minimal supervision through compliance with usability and perceived workload requirements. The preliminary usability evaluation identified usability challenges that should be solved to allow real-world minimally-supervised use. Such a platform could complement conventional therapy, allowing to provide increased dose with the available resources, and establish a continuum of care that progressively increases therapy lead of the patient from the clinic to the home.

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

2021 ◽  
Vol 11 (2) ◽  
pp. 815
Author(s):  
Husam Almusawi ◽  
Géza Husi
Keyword(s):  
Experimental Testing ◽  
Hand Movement ◽  
Evaluation Process ◽  
Continuous Passive Motion ◽  
Wrist Flexion ◽  
Design And Development ◽  
Passive Motion ◽  
Assistive Robots ◽  
Flexion Extension ◽  
Design Characteristics

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.

scholarly journals Joint-Specific Play Controller for Upper Extremity Therapy: Feasibility Study in Children With Wrist Impairment

2016 ◽  
Vol 96 (11) ◽  
pp. 1773-1781
Author(s):  
Bethany J. Wilcox ◽  
Megan M. Wilkins ◽  
Benjamin Basseches ◽  
Joel B. Schwartz ◽  
Karen Kerman ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Computer Games ◽  
Average Frequency ◽  
Cross Sectional Study ◽  
Wrist Flexion ◽  
Motor Impairments ◽  
Cross Sectional ◽  
Play Activity ◽  
Play Session ◽  
Flexion And Extension

Abstract Background Challenges with any therapeutic program for children include the level of the child's engagement or adherence. Capitalizing on one of the primary learning avenues of children, play, the approach described in this article is to develop therapeutic toy and game controllers that require specific and repetitive joint movements to trigger toy/game activation. Objective The goal of this study was to evaluate a specially designed wrist flexion and extension play controller in a cohort of children with upper extremity motor impairments (UEMIs). The aim was to understand the relationship among controller play activity, measures of wrist and forearm range of motion (ROM) and spasticity, and ratings of fun and difficulty. Design This was a cross-sectional study of 21 children (12 male, 9 female; 4–12 years of age) with UEMIs. Methods All children participated in a structured in-clinic play session during which measurements of spasticity and ROM were collected. The children were fitted with the controller and played with 2 toys and 2 computer games for 5 minutes each. Wrist flexion and extension motion during play was recorded and analyzed. In addition, children rated the fun and difficulty of play. Results Flexion and extension goal movements were repeatedly achieved by children during the play session at an average frequency of 0.27 Hz. At this frequency, 15 minutes of play per day would result in approximately 1,700 targeted joint motions per week. Play activity was associated with ROM measures, specifically supination, but toy perception ratings of enjoyment and difficulty were not correlated with clinical measures. Limitations The reported results may not be representative of children with more severe UEMIs. Conclusions These outcomes indicate that the therapeutic controllers elicited repetitive goal movements and were adaptable, enjoyable, and challenging for children of varying ages and UEMIs.

Quantification of Hand Grip Force under Dynamic Conditions

1993 ◽  
Vol 37 (10) ◽  
pp. 715-719 ◽  
Author(s):  
Katherine R. Lehman ◽  
W. Gary Allread ◽  
P. Lawrence Wright ◽  
William S. Marras
Keyword(s):  
Grip Force ◽  
Wrist Flexion ◽  
Range Of Movement ◽  
Ulnar Deviation ◽  
Dynamic Conditions ◽  
Radial Deviation ◽  
Hand Grip ◽  
Flexion Extension ◽  
Maximum Grip ◽  
Lower Grip

A laboratory experiment was conducted to determine whether grip force capabilities are lower when the wrist is moved than in a static position. The purpose was to determine the wrist velocity levels and wrist postures that had the most significant effect on grip force. Maximum grip forces of five male and five female subjects were determined under both static and dynamic conditions. The dominant wrist of each subject was secured to a CYBEX II dynamometer and grip force was collected during isokinetic wrist deviations for four directions of motion (flexion to extension, extension to flexion, radial to ulnar, and ulnar to radial). Six different velocity levels were analyzed and grip forces were recorded at specific wrist positions throughout each range of movement. For flexion-extension motions, wrist positions from 45 degrees flexion to 45 degrees extension were analyzed whereas positions from 20 degrees radial deviation to 20 degrees ulnar deviation were studied for radial-ulnar activity. Isometric exertions were also performed at each desired wrist position. Results showed that, for all directions of motion, grip forces for all isokinetic conditions were significantly lower than for the isometric exertions. Lower grip forces were exhibited at extreme wrist flexion and extreme radial and ulnar positions for both static and dynamic conditions. The direction of motion was also found to affect grip strength; extension to flexion exertions produced larger grip forces than flexion to extension exertions and radial to ulnar motion showed larger grip forces than ulnar to radial deviation. Although, males produced larger grip forces than females in all exertions, significant interactions between gender and velocity were noted.

Pengembangan Front-End Website Perpustakaan Politeknik Negeri Jakarta dengan menggunakan Metode User Centered Design

2020 ◽  
Vol 6 (2) ◽  
pp. 89-95
Author(s):  
Cerah Ayunda Prawastiyo ◽  
Indra Hermawan
Keyword(s):  
User Interface ◽  
User Experience ◽  
Black Box ◽  
User Centered Design ◽  
Front End ◽  
System Usability Scale ◽  
System Usability ◽  
Experience Questionnaire ◽  
User Centered

Penggunaan internet di Indonesia khususnya di instansi pendidikan terutama perguruan tinggi yaitu mengandalkan internet untuk mencari kumpulan informasi dan referensi terkait dengan mata kuliah. Salah satu unit di sebuah perguruan tinggi yang menggunakan internet dengan memanfaatkan sistem informasi berbasis website adalah perpustakaan Politeknik Negeri Jakarta (PNJ). Website berperan penting untuk instansi sebagai acuan website yang baik salah satunya dapat dinilai dari sisi User Interface (UI) yang memiliki tampilan menarik dan User Experience (UX) untuk meningkatkan kenyamanan pengguna website. Dalam pengembangan front end website perpustakaan menggunakan metode User Centered Design (UCD), framework bootstrap, bahasa pemrograman HTML5, CSS dan Javascript. Pada tahap evaluasi design dalam bentuk wireframe menggunakan metode System Usability Scale (SUS) mendapatkan skor 83, pengujian black box untuk mengukur fungsionalitas website mendapatkan hasil sesuai dengan skenario, pengujian User Experience Questionnaire (UEQ) untuk mengukur tingkat kenyamanan pengguna website mendapatkan hasil positif.

Arthroscopic ligament-specific repair for triangular fibrocartilage complex foveal avulsions: a minimum 2-year follow-up study

2020 ◽  
pp. 175319342095790
Author(s):  
Bo Liu ◽  
Margareta Arianni ◽  
Feiran Wu
Keyword(s):  
Patient Reported Outcomes ◽  
Triangular Fibrocartilage Complex ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Flexion Extension ◽  
Patient Reported ◽  
Triangular Fibrocartilage ◽  
The Mean ◽  
Viable Method

This study reports the arthroscopic ligament-specific repair of the triangular fibrocartilage complex (TFCC) that anatomically restores both the volar and dorsal radioulnar ligaments into their individual foveal footprints. Twenty-five patients underwent arthroscopic ligament-specific repair with clinical and radiological diagnoses of TFCC foveal avulsions. The mean age was 28 years (range 14–47) and the mean follow-up was 31 months (range 24–47). Following arthroscopic assessment, 20 patients underwent double limb radioulnar ligament repairs and five had single limb repairs. At final follow-up, there were significant improvements in wrist flexion–extension, forearm pronation–supination and grip strength. There were also significant improvements in pain and patient-reported outcomes as assessed by the patient-rated wrist evaluation, Disabilities of the Arm, Shoulder and Hand score and modified Mayo wrist scores. Arthroscopic ligament-specific repair of the TFCC does not require specialist dedicated equipment or consumables and offers a viable method of treating these injuries. Level of evidence: IV

Outcomes of Supplementary Spring Wire Fixation With Volar Plating for Volar Lunate Facet Fragments in Distal Radius Fractures

Hand ◽  
2020 ◽  
pp. 155894472097640
Author(s):  
Nathaniel Fogel ◽  
Lauren M. Shapiro ◽  
Allison Roe ◽  
Sahitya Denduluri ◽  
Marc J. Richard ◽  
...  
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Wrist Flexion ◽  
Volar Plating ◽  
Radius Fractures ◽  
Locked Plating ◽  
Spring Wire ◽  
Flexion Extension ◽  
Wire Fixation ◽  
The Mean

Background Intra-articular distal radius fractures with small volar lunate facet fragments can be challenging to address with volar plate fixation alone. Volar locked plating with supplementary spring wire fixation has been previously described in a small series but has not been further described in the literature. We hypothesized that this technique can provide adequate fixation for volar lunate facet fragments smaller than 15 mm in length, which are at risk of displacement. Methods We completed a retrospective chart review (2015-2019) of patients who underwent volar locked plating with the addition of supplementary spring wire fixation for intra-articular distal radius fractures with a volar lunate facet fragment (<15 mm). Postoperative radiographs were assessed to evaluate union, evidence of hardware failure, escape of the volar lunate facet fragment, and postoperative volar tilt. Clinical outcome was assessed with wrist flexion/extension, arc of pronosupination, and Quick Disabilities of the Arm, Shoulder, and Hand Score ( QuickDASH) scores. Results Fifteen patients were identified, of which all went on to fracture union. There were no hardware failures or escape of the volar lunate facet fragment at final follow-up. One patient underwent hardware removal for symptoms of flexor tendon irritation. The mean wrist flexion was 59°, wrist extension was 70°, pronation was 81°, and supination was 76°. The mean QuickDASH score was 18.5. The mean postoperative volar tilt was 3.6°. Conclusions Supplementary spring wire fixation with standard volar plating provides stable fixation for lunate facet fragments less than 15 mm. This technique is a safe and reliable alternative to commercially available fragment-specific implants.

Re-motion total wrist arthroplasty: 39 non-rheumatoid cases with a mean follow-up of 7 years

2019 ◽  
Vol 44 (9) ◽  
pp. 946-950 ◽  
Author(s):  
Stefan M. Froschauer ◽  
Maximilian Zaussinger ◽  
Dietmar Hager ◽  
Manfred Behawy ◽  
Oskar Kwasny ◽  
...  
Keyword(s):  
Radial Component ◽  
Visual Analogue Scale Pain ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Analogue Scale Pain ◽  
Wrist Arthroplasty

We evaluated the outcomes of the Re-motion total wrist arthroplasty in 39 non-rheumatoid patients. The mean follow-up was 7 years (range 3–12). Postoperative wrist flexion-extension and radial-ulnar deviation as well as the scores of the Disability of Arm Shoulder and Hand questionnaire and the visual analogue scale pain scores improved significantly. Complications occurred in 13 wrists, five of which required further surgery. The most frequent complication was impingement between the scaphoid and the radial implant (n = 5), which can be avoided by complete or almost complete scaphoid resection. Periprosthetic radiolucency developed around the radial component in three cases and three radial screws loosened. Despite the incidence of high implant survival in 38 of 39 wrists over 7 years (97%), the complication rate is not satisfying. Knowledge of the risk of complications and patient selection are essential when making the decision to choose wrist arthroplasty over arthrodesis. Level of evidence: IV

Cerebellar nuclear cell activity during antagonist cocontraction and reciprocal inhibition of forearm muscles

1985 ◽  
Vol 54 (2) ◽  
pp. 231-244 ◽  
Author(s):  
R. Wetts ◽  
J. F. Kalaska ◽  
A. M. Smith
Keyword(s):  
Activity Patterns ◽  
Cell Activity ◽  
Reciprocal Inhibition ◽  
Discharge Frequency ◽  
Wrist Flexion ◽  
Wrist Movement ◽  
Forearm Muscles ◽  
Flexion Extension ◽  
Nuclear Cell ◽  
Low Order

Monkeys were trained to exert a maintained isometric pinch with the thumb and forefinger. This task reliably elicited a simultaneous cocontraction of the forearm muscles. The same monkeys were also taught to insert the open hand into a manipulandum, flex and extend the wrist 35 and 15 degrees, respectively, and maintain an isometric wrist position against a mechanical stop for 1 s. This second task comprised two conditions: a dynamic or movement phase and a static or isometric phase. Movement always involved a wrist displacement of 50 degrees. Although some forearm muscles demonstrated bidirectional activity during the wrist displacement phase, all the wrist and finger muscles were alternatively active in isometric flexion or extension. Of the neurons in the dentate and interposed nuclei that consistently changed discharge during repeated isometric prehension, over 90% (61/67) of the neurons increased activity during this cocontraction of forearm muscles. About 70% (47/67) of these same nuclear cells discharged with a reciprocal pattern of firing during alternating wrist flexion-extension movements. Forty-six neurons had sustained and reciprocal discharge during the maintained isometric wrist postures. No differences were seen between the activity patterns of dentate and interposed cells with respect to either the prehension task or the reciprocal wrist-movement task. The discharge frequency of some dentate and interpositus neurons could be correlated with prehensile force as well as velocity of wrist movement and torque developed by wrist muscles. Correlation coefficients were calculated between nuclear cell discharge and the amplitude of the surface EMGs of the flexors and extensors of the wrist and fingers during the wrist-movement task. Sixteen nuclear cells showed low-order, but reliably positive, correlations with one of the two forearm muscle groups (mean r = 0.33). In contrast, a sample of seven Purkinje cells recorded during the same task demonstrated low-order correlations that were negative in sign (mean r = -0.30) between discharge frequency and one of the two forearm EMGs.

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