Neurorehabilitation research suggests that not only high training intensity, but also somatosensory information plays a fundamental role in the recovery of stroke patients. Yet, there is currently a lack of easy-to-use robotic solutions for sensorimotor hand rehabilitation. We addressed this shortcoming by developing a novel clinical-driven robotic hand rehabilitation device, which is capable of fine haptic rendering, and that supports physiological full flexion/extension of the fingers while offering an effortless setup. Our palmar design, based on a parallelogram coupled to a principal revolute joint, introduces the following novelties: (1) While allowing for an effortless installation of the user's hand, it offers large range of motion of the fingers (full extension to 180° flexion). (2) The kinematic design ensures that all fingers are supported through the full range of motion and that the little finger does not lose contact with the finger support in extension. (3) We took into consideration that a handle is usually comfortably grasped such that its longitudinal axis runs obliquely from the metacarpophalangeal joint of the index finger to the base of the hypothenar eminence. (4) The fingertip path was optimized to guarantee physiologically correct finger movements for a large variety of hand sizes. Moreover, the device possesses a high mechanical transparency, which was achieved using a backdrivable cable transmission. The transparency was further improved with the implementation of friction and gravity compensation. In a test with six healthy participants, the root mean square of the human-robot interaction force was found to remain as low as 1.37 N in a dynamic task. With its clinical-driven design and easy-to-use setup, our robotic device for hand sensorimotor rehabilitation has the potential for high clinical acceptance, applicability and effectiveness.@en

Sensorimotor impairments of the hand after stroke can drastically reduce the ability to perform activities of daily living. Recently, there has been an increased interest in minimally supervised and unsupervised rehabilitation to increase therapy dosage and to complement conventional therapy. Several devices have been developed that are simple to use and portable. Yet, they do not incorporate diversified somatosensory feedback, which has been suggested to promote sensorimotor recovery. Here we present the prototype of a portable one-degree-of-freedom hand trainer based on a novel compliant shell mechanism. Our solution is safe, intuitive, and can be used for various hand sizes. Importantly, it also provides rich sensory feedback through haptic rendering. We complement our device with a rehabilitation game, where we leverage interactive tangible game elements with diverse haptic characteristics to provide somatosensory training and foster recovery.

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Currently, there is a lack of easy-to-use hand rehabilitation devices which not only retrain motor functions, but also include somatosensory information of the interaction with tangible virtual objects to also regain sensory function. To overcome these shortcomings, we are developing a novel haptic rehabilitation device that focuses on usability, enforces physiological movements and provides haptic rendering capabilities.

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Whole-hand haptic rendering could lead to more naturalistic and intuitive virtual hand-object interactions, which could be especially beneficial for applications such as sensorimotor robotic neurorehabilitation. However, the majority of previously proposed whole-hand haptic rendering algorithms rely on effortful custom implementations or are not suited for the grounded haptic devices often used in neurorehabilitation. Therefore, we suggest a framework for whole-hand haptic rendering based on a readily available physics engine. We employ a bilateral position-position teleoperation framework between a haptic rehabilitation device and a simulated hand avatar with added exercise-specific haptic rendering. Moreover, in consideration of the needs of neurological patients, we introduce an adaptive damping of the haptic device during hand-object interactions for increased stabilization of the patient's limb. We present the first results of the feasibility of the proposed framework in a haptic rehabilitation exercise. In an ongoing clinical study, the practical application of the presented framework is currently investigated.

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In order to identify the clinical requirements for a novel upper-limb robotic device for sensorimotor neurorehabilitation, a survey with 33 participants (including physiotherapists, occupational therapists, speech therapists, nurses and physicians) was conducted. The results show that grasping, eating and personal hygiene are amongst the most important activities of daily living to be exercised. Hand/finger extension were reported as crucial movements. In serious games for neurorehabilitation, adjustable quantity of virtual objects as well as adjustable game difficulty are highly demanded features. The majority of the participants would like to spend less than 10 min for the setup of a robotic device.

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