A Mechanical Hand-Tracking System With Tactile Feedback Designed for Telemanipulation.

In this paper, we present a mechanical hand-tracking system with tactile feedback designed for fine manipulation in teleoperation scenarios. Alternative tracking methods based on artificial vision and data gloves have become an asset for virtual reality interaction. Yet, occlusions, lack of precision, and the absence of effective haptic feedback beyond vibrotactile still appear as a limit for teleoperation applications. In this work, we propose a methodology to design a linkage mechanism for hand pose tracking purposes, preserving complete finger mobility. Presentation of the method is followed by design and implementation of a working prototype, and by evaluation of the tracking accuracy using optical markers. Moreover, a teleoperation experiment involving a dexterous robotic arm and hand was proposed to ten participants. It investigated the effectiveness and repeatability of the hand tracking with combined haptic feedback during a proposed pick and place manipulation tasks.

An Assistive Soft Wrist Exosuit for Flexion Movements With an Ergonomic Reinforced Glove.

Soft exosuits are a promising solution for the assistance and augmentation of human motor abilities in the industrial field, where the use of more symbiotic wearable robots can avoid excessive worker fatigue and improve the quality of the work. One of the challenges in the design of soft exosuits is the choice of the right amount of softness to balance load transfer, ergonomics, and weight. This article presents a cable-driven based soft wrist exosuit for flexion assistance with the use of an ergonomic reinforced glove. The flexible and highly compliant three-dimensional (3D)-printed plastic structure that is sewn on the glove allows an optimal force transfer from the remotely located motor to the wrist articulation and to preserve a high level of comfort for the user during assistance. The device is shown to reduce fatigue and the muscular effort required for holding and lifting loads in healthy subjects for weights up to 3 kg.

On the edge between soft and rigid: an assistive shoulder exoskeleton with hyper-redundant kinematics.

In this paper, we present a prototype of an innovative portable shoulder exoskeleton for human assistance and augmentation. The device provides torques to flexion/extension movements of the shoulder, compensating for gravitational forces, and is passively compliant along the remaining degrees of freedom letting the shoulder moving along them. The novelty of our system is a flexible link, made of a hyper-redundant passive structure, that avoids joint misalignment by adapting to the complex movements of the humerus head, similarly to a soft component. The flexible link is compliant to rotations around one axis but rigid around the other two axes, allowing transmission of flexion/extension torque but kinematically transparent along the remaining degrees of freedom. The device is light weight and allows to cover around the 82% of the shoulder flexion/extension range of motion. The exoskeleton was tested on a cohort of 5 healthy subjects, monitoring shoulder kinematics, interaction forces and acquiring the electromyography of three major muscles contributing to shoulder flexion. During both static postures and dynamic movements, assistance from the exoskeleton resulted in a significant reduction of muscular effort in the anterior (-32.2% in static, -25.3% in dynamic) and medial deltoid (56.9% in static, -49.6% in dynamic) and an average reduction of the biceps brachii.

Design Requirements of Generic Hand Exoskeletons and Survey of Hand Exoskeletons for Rehabilitation, Assistive, or Haptic Use.

Most current hand exoskeletons have been designed specifically for rehabilitation, assistive, or haptic applications to simplify the design requirements. Clinical studies on poststroke rehabilitation have shown that adapting assistive or haptic applications into physical therapy sessions significantly improves the motor learning and treatment process. The recent technology can lead to the creation of generic hand exoskeletons that are application-agnostic. In this paper, our motivation is to create guidelines and best practices for generic exoskeletons by reviewing the literature of current devices. First, we describe each application and briefly explain their design requirements, and then list the design selections to achieve these requirements. Then, we detail each selection by investigating the existing exoskeletons based on their design choices, and by highlighting their impact on application types. With the motivation of creating efficient generic exoskeletons in the future, we finally summarize the best practices in the literature.

Wearable Haptics and Immersive Virtual Reality Rehabilitation Training in Children With Neuromotor Impairments.

The past decade has seen the emergence of rehabilitation treatments using virtual reality (VR) environments although translation into clinical practice has been limited so far. In this paper, an immersive VR rehabilitation training system endowed with wearable haptics is proposed for children with neuromotor impairments: it aims to enhance involvement and engagement of patients, to provide congruent multi-sensory afferent feedback during motor exercises and to benefit from the flexibility of VR in adapting exercises to the patient's need. An experimental rehabilitation session conducted with children with cerebral palsy (CP) and developmental dyspraxia (DD) has been performed to evaluate the usability of the system and proof of concept trial of the proposed approach. We compared CP/DD performance with both typically developing children and adult control group. Results show the system was compliant with different levels of motor skills and allowed patients to complete the experimental rehabilitation session, with performance varying according to the expected motor abilities of different groups. Moreover, a kinematic assessmentbased on the presented system has been designed. Obtained results reflected different motor abilities of patients and participants, suggesting suitability of the proposed kinematic assessment as a motor function outcome.

Integration of serious games and wearable haptic interfaces for Neuro Rehabilitation of children with movement disorders: A feasibility study.

The past decade has seen the emergence of rehabilitation treatments using virtual reality environments. One of the advantages in using this technology is the potential to create positive motivation, by means of engaging environments and tasks shaped in the form of serious games. In this work, we propose a novel Neuro Rehabilitation System for children with movement disorders, that is based on serious games in immersive virtual reality with haptic feedback. The system design aims to enhance involvement and engagement of patients, to provide congruent multi-sensory afferent feedback during motor exercises, and to benefit from the flexibility of virtual reality in adapting exercises to the patient's needs. We present a feasibility study of the method conducted through an experimental rehabilitation session in a group of 4 children with Cerebral Palsy and Developmental Dyspraxia, 4 Typically Developing children and 4 healthy adults. Subjects and patients were able to accomplish the proposed rehabilitation session and average performance of the motor exercises in patients were lower, although comparable, to healthy subjects. Together with positive comments reported by children after the rehabilitation session, results are encouraging for application of the method in a prolonged rehabilitation treatment.

Wearable Haptic Systems for the Fingertip and the Hand: Taxonomy, Review, and Perspectives.

In the last decade, we have witnessed a drastic change in the form factor of audio and vision technologies, from heavy and grounded machines to lightweight devices that naturally fit our bodies. However, only recently, haptic systems have started to be designed with wearability in mind. The wearability of haptic systems enables novel forms of communication, cooperation, and integration between humans and machines. Wearable haptic interfaces are capable of communicating with the human wearers during their interaction with the environment they share, in a natural and yet private way. This paper presents a taxonomy and review of wearable haptic systems for the fingertip and the hand, focusing on those systems directly addressing wearability challenges. The paper also discusses the main technological and design challenges for the development of wearable haptic interfaces, and it reports on the future perspectives of the field. Finally, the paper includes two tables summarizing the characteristics and features of the most representative wearable haptic systems for the fingertip and the hand.

A 3-RSR Haptic Wearable Device for Rendering Fingertip Contact Forces.

A novel wearable haptic device for modulating contact forces at the fingertip is presented. Rendering of forces by skin deformation in three degrees of freedom (DoF), with contact-no contact capabilities, was implemented through rigid parallel kinematics. The novel asymmetrical three revolute-spherical-revolute (3-RSR) configuration allowed compact dimensions with minimum encumbrance of the hand workspace. The device was designed to render constant to low frequency deformation of the fingerpad in three DoF, combining light weight with relatively high output forces. A differential method for solving the non-trivial inverse kinematics is proposed and implemented in real time for controlling the device. The first experimental activity evaluated discrimination of different fingerpad stretch directions in a group of five subjects. The second experiment, enrolling 19 subjects, evaluated cutaneous feedback provided in a virtual pick-and-place manipulation task. Stiffness of the fingerpad plus device was measured and used to calibrate the physics of the virtual environment. The third experiment with 10 subjects evaluated interaction forces in a virtual lift-and-hold task. Although with different performance in the two manipulation experiments, overall results show that participants better controlled interaction forces when the cutaneous feedback was active, with significant differences between the visual and visuo-haptic experimental conditions.

New generation emerging technologies for neurorehabilitation and motor assistance.

This paper illustrates the application of emerging technologies and human-machine interfaces to the neurorehabilitation and motor assistance fields. The contribution focuses on wearable technologies and in particular on robotic exoskeleton as tools for increasing freedom to move and performing Activities of Daily Living (ADLs). This would result in a deep improvement in quality of life, also in terms of improved function of internal organs and general health status. Furthermore, the integration of these robotic systems with advanced bio-signal driven human-machine interface can increase the degree of participation of patient in robotic training allowing to recognize user's intention and assisting the patient in rehabilitation tasks, thus representing a fundamental aspect to elicit motor learning.

An EMG-Controlled Robotic Hand Exoskeleton for Bilateral Rehabilitation.

This paper presents a novel electromyography (EMG)-driven hand exoskeleton for bilateral rehabilitation of grasping in stroke. The developed hand exoskeleton was designed with two distinctive features: (a) kinematics with intrinsic adaptability to patient's hand size, and (b) free-palm and free-fingertip design, preserving the residual sensory perceptual capability of touch during assistance in grasping of real objects. In the envisaged bilateral training strategy, the patient's non paretic hand acted as guidance for the paretic hand in grasping tasks. Grasping force exerted by the non paretic hand was estimated in real-time from EMG signals, and then replicated as robotic assistance for the paretic hand by means of the hand-exoskeleton. Estimation of the grasping force through EMG allowed to perform rehabilitation exercises with any, non sensorized, graspable objects. This paper presents the system design, development, and experimental evaluation. Experiments were performed within a group of six healthy subjects and two chronic stroke patients, executing robotic-assisted grasping tasks. Results related to performance in estimation and modulation of the robotic assistance, and to the outcomes of the pilot rehabilitation sessions with stroke patients, positively support validity of the proposed approach for application in stroke rehabilitation.

A fully immersive set-up for remote interaction and neurorehabilitation based on virtual body ownership.

Although telerehabilitation systems represent one of the most technologically appealing clinical solutions for the immediate future, they still present limitations that prevent their standardization. Here we propose an integrated approach that includes three key and novel factors: (a) fully immersive virtual environments, including virtual body representation and ownership; (b) multimodal interaction with remote people and virtual objects including haptic interaction; and (c) a physical representation of the patient at the hospital through embodiment agents (e.g., as a physical robot). The importance of secure and rapid communication between the nodes is also stressed and an example implemented solution is described. Finally, we discuss the proposed approach with reference to the existing literature and systems.

Beaming: an asymmetric telepresence system.

The Beaming project recreates, virtually, a real environment; using immersive VR, remote participants can visit the virtual model and interact with the people in the real environment. The real environment doesn't need extensive equipment and can be a space such as an office or meeting room, domestic environment, or social space.

The contribution of cutaneous and kinesthetic sensory modalities in haptic perception of orientation.

The aim of this study was to understand the integration of cutaneous and kinesthetic sensory modalities in haptic perception of shape orientation. A specific robotic apparatus was employed to simulate the exploration of virtual surfaces by active touch with two fingers, with kinesthetic only, cutaneous only and combined sensory feedback. The cutaneous feedback was capable of displaying the local surface orientation at the contact point, through a small plate indenting the fingerpad at contact. A psychophysics test was conducted with SDT methodology on 6 subjects to assess the discrimination threshold of angle perception between two parallel surfaces, with three sensory modalities and two shape sizes. Results show that the cutaneous sensor modality is not affected by size of shape, but kinesthetic performance is decreasing with smaller size. Cutaneous and kinesthetic sensory cues are integrated according to a Bayesian model, so that the combined sensory stimulation always performs better than single modalities alone.