A pneumatic glove and immersive virtual reality environment for hand rehabilitative training after stroke.

While a number of devices have recently been developed to facilitate hand rehabilitation after stroke, most place some restrictions on movement of the digits or arm. Thus, a novel glove was developed which can provide independent extension assistance to each digit while still allowing full arm movement. This pneumatic glove, the PneuGlove, can be used for training grasp-and-release movements either with real objects or with virtual objects in a virtual reality environment. Two groups of stroke survivors, with seven subjects in each group, completed a six-week rehabilitation training protocol, consisting of three 1-h sessions held each week. One group wore the PneuGlove during training, performed both within a novel virtual reality environment and outside of it with physical objects, while the other group completed the same training without the device. Across subjects, significant improvements were observed in the Fugl-Meyer Assessment for the upper extremity (p < 0.001), the hand/wrist portion of the Fugl-Meyer Assessment (p < 0.001), the Box and Blocks test (p < 0.005), and palmar pinch strength (p < 0.005). While changes in the two groups were not statistically different, the group using the PneuGlove did show greater mean improvement on each of these measures, such as gains of 3.7 versus 2.4 points on the hand/wrist portion of the Fugl-Meyer Assessment and 14 N versus 5 N in palmar pinch.

Use of a pneumatic glove for hand rehabilitation following stroke.

Hand impairment is common following stroke and is often resistant to traditional therapy methods. Successful interventions have stressed the importance of repeated practice to facilitate rehabilitation. Thus, we have developed a servo-controlled glove to assist extension of individual digits to promote practice of grasp-and-release movements with the hand. This glove, the PneuGlove, permits free movement of the arm throughout its workspace. A novel immersive virtual reality environment was created for training movement in conjunction with the device. Seven stroke survivors with chronic hand impairment participated in 18 training sessions with the PneuGlove over 6 weeks. Overall, subjects displayed a significant 6-point improvement in the upper extremity score on the Fugl-Meyer assessment and this increase was maintained at the evaluation held one month after conclusion of all training (p < 0.01). The majority of this gain came from an increase in the hand/wrist score (3.8-point increase, p < 0.01). Thus, the system shows promise for rehabilitative training of hand movements after stroke.

A low cost instrumented glove for extended monitoring and functional hand assessment.

A wearable finger flexion monitor developed to measure hand function in individuals with hand dysfunction was evaluated for feasibility, measurement repeatability and reliability, fidelity of wireless transmission, and user acceptance. Configuration of the monitor allows use in situations when a traditional measurement glove cannot be worn. Five healthy individuals participated in the study of repeatability, while 10 healthy individuals and 10 individuals with acquired brain injury participated in trials to assess feasibility and user comfort. Repeatability results showed an overall error of 3.4 degrees , compared to 5.5 degrees and 5.7 degrees reported with other sensor gloves, and to manual measurements (5-8 degrees). Intraclass coefficient of reliability (using coefficient alpha) averaged 0.95. User feedback regarding comfort of the monitor was very high. Loss of data during wireless transmission was no greater than 1.2%. Results demonstrate that the monitor has a strong potential to be used as a tool for objective hand function evaluation in the home and community for both short- and long-term monitoring.

Measuring finger flexion and activity trends over a 25 hour period using a low cost wireless device.

The goal of this research was to evaluate the usefulness of a wireless custom monitor in measuring real-time finger posture over an extended period of time as the wearer goes about daily life activities. One individual wore the device for 25 continuous hours in the research facility and at home. Initial data analysis methods have been presented to explore different aspects of hand activity over time. Evaluating mean flexion over five minute intervals reveals common hand postures assumed throughout the day, while total joint excursion over longer intervals highlights periods of inactivity associated with sleep or rest, as well as periods of higher intensity activities that can be used to evaluate compliance with physical therapy and home rehabilitation instructions.