Skip to main content
Log in

A Wearable Soft Robot for Stroke Patients’ Finger Occupational Therapy and Quantitative Measures on the Joint Paralysis

  • Regular Paper
  • Published:
International Journal of Precision Engineering and Manufacturing Aims and scope Submit manuscript

Abstract

We suggest a wearable soft robot for post-stroke, hemiplegic patients’ finger rehabilitation and quantitative evaluations on the joint paralysis. The device consists of a pair of gloves. One measures finger positions of the normal side, and the other induces symmetric movements on the affected side by pneumatic force. Ten patients at Brunnstrom stage 3 and 4 from a local hospital participated in this study. They performed Rolyan Stacking Cones 10 times with and without the support of the soft robot. We measured subjects’ proximal interphalangeal angles and air pressures in the pneumatic glove during the exercise to monitor grab/release patterns. The soft robot helped open their paralyzed finger joints by more than 50 degrees on average regardless of Brunnstrom stages. We applied pattern recognition methods on the measurement to quantitatively evaluate the subjects. A support vector machine revealed a misclassification rate of 20%, implying that there were a considerable number of overlapping data sets near the boundary between Brunnstrom stages. K-means method with three clusters suggested a new subject group near the support vector machine border. Thus, we conclude that our wearable soft robot not only provides grab/release guides to post-stroke patients but also provides quantitative information on their finger paralysis supplementary to the existing qualitative assessments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Jørgensen, H. S., et al. (1996). Acute stroke with atrial fibrillation: the Copenhagen Stroke Study. Stroke, 27(10), 1765–1769.

    Article  Google Scholar 

  2. Cramer, S. C., et al. (1997). A functional MRI study of subjects recovered from hemiparetic stroke. Stroke, 28(12), 2518–2527.

    Article  Google Scholar 

  3. Hefter, H., et al. (2012). Classification of posture in poststroke upper limb spasticity: A potential decision tool for botulinum toxin A treatment? International Journal of Rehabilitation Research, 35(3), 227–233.

    Article  Google Scholar 

  4. Marciniak, C. (2011). Poststroke hypertonicity: upper limb assessment and treatment. Topics in stroke rehabilitation, 18(3), 179–194.

    Article  Google Scholar 

  5. Li, Z., et al. (2014). The joint coordination in reach-to-grasp movements. In 2014 IEEE/RSJ international conference on intelligent robots and systems. IEEE.

  6. Park, J.-Y., et al. (2015). The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients. Journal of Physical Therapy Science, 27(6), 1681–1683.

    Article  Google Scholar 

  7. Timmermans, A. A., et al. (2009). Technology-assisted training of arm-hand skills in stroke: Concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design. Journal of Neuroengineering and Rehabilitation, 6(1), 1.

    Article  Google Scholar 

  8. Hatem, S. M., et al. (2016). Rehabilitation of motor function after stroke: A multiple systematic review focused on techniques to stimulate upper extremity recovery. Frontiers in Human Neuroscience, 10, 442.

    Article  Google Scholar 

  9. Broeks, G., et al. (1999). The long-term outcome of arm function after stroke: Results of a follow-up study. Disability and Rehabilitation, 21(8), 357–364.

    Article  Google Scholar 

  10. Feys, H. M., et al. (1998). Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke: A single-blind, randomized, controlled multicenter trial. Stroke, 29(4), 785–792.

    Article  Google Scholar 

  11. Corbyn, Z. (2014). A growing global burden. Nature, 510(7506), S2–S2.

    Article  Google Scholar 

  12. World Health Organization. (2014). Global status report on noncommunicable diseases 2014. No. WHO/NMH/NVI/15.1. World Health Organization.

  13. Fugl-Meyer, A. R., et al. (1975). The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scandinavian Journal of Rehabilitation Medicine, 7(1), 13–31.

    Google Scholar 

  14. Duncan, P. W., et al. (1994). Similar motor recovery of upper and lower extremities after stroke. Stroke, 25(6), 1181–1188.

    Article  Google Scholar 

  15. Bohannon, R. W., & Williams Andrews, A. (1987). Interrater reliability of hand-held dynamometry. Physical Therapy, 67(6), 931–933.

    Article  Google Scholar 

  16. Brunnstrom, S. (1966). Motor testing procedures in hemiplegia: based on sequential recovery stages. Physical Therapy, 46(4), 357–375.

    Article  Google Scholar 

  17. Thibaut, A., et al. (2013). Spasticity after stroke: physiology, assessment and treatment. Brain Injury, 27(10), 1093–1105.

    Article  Google Scholar 

  18. Katz, R. T., et al. (1992). Objective quantification of spastic hypertonia: Correlation with clinical findings. Archives of Physical Medicine and Rehabilitation, 73(4), 339–347.

    Article  Google Scholar 

  19. Fu-Mei, L., & Mohamed, S. (1999). Correlation of spasticity with hyperactive stretch reflexes and motor dysfunction in hemiplegia. Archives of Physical Medicine and Rehabilitation, 80(5), 526–530.

    Article  Google Scholar 

  20. Naghdi, S., et al. (2010). A neurophysiological and clinical study of Brunnstrom recovery stages in the upper limb following stroke. Brain Injury, 24(11), 1372–1378.

    Article  Google Scholar 

  21. Gladstone, D. J., Danells, C. J., & Black, S. E. (2002). The Fugl-Meyer assessment of motor recovery after stroke: A critical review of its measurement properties. Neurorehabilitation and Neural Repair, 16(3), 232–240.

    Article  Google Scholar 

  22. Jutai, J. W., & Teasell, R. W. (2003). The necessity and limitations of evidence-based practice in stroke rehabilitation. Topics in Stroke Rehabilitation, 10(1), 71–78.

    Article  Google Scholar 

  23. Langhorne, P., Coupar, F., & Pollock, A. (2009). Motor recovery after stroke: A systematic review. The Lancet Neurology, 8(8), 741–754.

    Article  Google Scholar 

  24. Aisen, M. L., et al. (1997). The effect of robot-assisted therapy and rehabilitative training on motor recovery following stroke. Archives of Neurology, 54(4), 443–446.

    Article  Google Scholar 

  25. Grosmaire, A.-G., Duret, C., & Krebs, H. I. (2019). Robot-assisted therapy in upper extremity hemiparesis: Overview of an evidence-based approach. Frontiers in Neurology, 10, 412.

    Article  Google Scholar 

  26. Lum, P. S., et al. (2002). Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. Archives of Physical Medicine and Rehabilitation, 83(7), 952–959.

    Article  Google Scholar 

  27. Norouzi-Gheidari, N., Archambault, P. S., & Fung, J. (2012). Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: Systematic review and meta-analysis of the literature. Journal of Rehabilitation Research & Development, 49, 4.

    Article  Google Scholar 

  28. Reinkensmeyer, D. J., & Boninger, M. L. (2012). Technologies and combination therapies for enhancing movement training for people with a disability. Journal of Neuroengineering and Rehabilitation, 9(1), 17.

    Article  Google Scholar 

  29. Burgar, C. G., et al. (2011). Robot-assisted upper-limb therapy in acute rehabilitation setting following stroke: Department of Veterans Affairs multisite clinical trial. J Rehabil Res Dev, 48(4), 445–458.

    Article  Google Scholar 

  30. Mehrholz, J. et al. (2012). Electromechanical and robot-assisted arm training for improving generic activities of daily living, arm function, and arm muscle strength after stroke. Cochrane Database of Systematic Reviews, 6.

  31. Islam, M. R., et al. (2017). A brief review on robotic exoskeletons for upper extremity rehabilitation to find the gap between research porotype and commercial type. Adv Robot Autom, 6(3), 2.

    Article  Google Scholar 

  32. Feix, T., et al. (2015). The grasp taxonomy of human grasp types. IEEE Transactions on Human-Machine Systems, 46(1), 66–77.

    Article  Google Scholar 

  33. Yue, Z., Zhang, X., & Wang, J. (2017). Hand rehabilitation robotics on poststroke motor recovery. Behavioural Neurology.

  34. Sarac, M., Solazzi, M., & Frisoli, A. (2019). Design requirements of generic hand exoskeletons and survey of hand exoskeletons for rehabilitation, assistive, or haptic use. IEEE Transactions on Haptics, 12(4), 400–413.

    Article  Google Scholar 

  35. Gull, M. A., Bai, S., & Bak, T. (2020). A review on design of upper limb exoskeletons. Robotics, 9(1), 16.

    Article  Google Scholar 

  36. Chu, C.-Y., & Patterson, R. M. (2018). Soft robotic devices for hand rehabilitation and assistance: A narrative review. Journal of Neuroengineering and Rehabilitation, 15(1), 9.

    Article  Google Scholar 

  37. Connelly, L., et al. (2010). A pneumatic glove and immersive virtual reality environment for hand rehabilitative training after stroke. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 18(5), 551–559.

    Article  Google Scholar 

  38. In, H., et al. (2015). Exo-glove: A wearable robot for the hand with a soft tendon routing system. IEEE Robotics & Automation Magazine, 22(1), 97–105.

    Article  Google Scholar 

  39. Polygerinos, P., et al. (2015). Soft robotic glove for combined assistance and at-home rehabilitation. Robotics and Autonomous Systems, 73, 135–143.

    Article  Google Scholar 

  40. Yoon, J.-S., et al. (2018). An air pocket glove for finger rehabilitation and quantitative assessment of hemiplegic patients. Journal of the Korean Society for Precision Engineering, 35(8), 817–823.

    Article  Google Scholar 

  41. McCluskey, A., Lannin, N. A., Schurr, K., & Dorsch, S. Chapter 40: Optimizing motor performance and sensation after brain impairment. Occupational therapy for people experiencing illness, injury or impairment: Promoting occupation and participation.

  42. Boomkamp-Koppen, H. G. M., et al. (2005). Poststroke hand swelling and oedema: Prevalence and relationship with impairment and disability. Clinical Rehabilitation, 19(5), 552–559.

    Article  Google Scholar 

Download references

Funding

This work was supported by Korea National Research Foundation (KNRF) Grant funded by Korea government (MOE) (No. 2020R1I1A3A04038203).

Author information

Authors and Affiliations

Authors

Contributions

Conceptualization, J.K., G.L. and H.J.; methodology, J.K., G.L., H.J. and W.P.; software, W.P.; validation, J.K., G.L. and H.J.; formal analysis, J.K.; investigation, J.K., G.L., H.J., W.P., YS.J. and HD.K.; resources, YS.J. and HD.K.; data curation, J.K., G.L., H.J. and W.P.; writing—original draft preparation, J.K., G.L. and H.J.; writing—review and editing, J.K., G.L. and H.J.; visualization, J.K., G.L. and H.J.; supervision, Jaehyo.K.; project administration, Jaehyo.K.; funding acquisition, Jaehyo.K. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Jaehyo Kim.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Availability of Data and Material

Data are fully available through the corresponding author.

Code Availability

Codes are fully available through the corresponding author.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, J., Lee, G., Jo, H. et al. A Wearable Soft Robot for Stroke Patients’ Finger Occupational Therapy and Quantitative Measures on the Joint Paralysis. Int. J. Precis. Eng. Manuf. 21, 2419–2426 (2020). https://doi.org/10.1007/s12541-020-00418-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12541-020-00418-5

Keywords

Navigation