WO2010140984A1 - Dispositif de rehabilitation des fonctions du doigt - Google Patents

Dispositif de rehabilitation des fonctions du doigt Download PDF

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Publication number
WO2010140984A1
WO2010140984A1 PCT/SG2010/000209 SG2010000209W WO2010140984A1 WO 2010140984 A1 WO2010140984 A1 WO 2010140984A1 SG 2010000209 W SG2010000209 W SG 2010000209W WO 2010140984 A1 WO2010140984 A1 WO 2010140984A1
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WO
WIPO (PCT)
Prior art keywords
finger
force
cable
shaft
movement
Prior art date
Application number
PCT/SG2010/000209
Other languages
English (en)
Inventor
Ludovic Dovat
Olivier Lambercy
Chee Leong Teo
Roger Gassert
Etienne Burdet
Original Assignee
National University Of Singapore
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Filing date
Publication date
Application filed by National University Of Singapore filed Critical National University Of Singapore
Publication of WO2010140984A1 publication Critical patent/WO2010140984A1/fr

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    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/12—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles
    • A63B23/16—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles for hands or fingers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0274—Stretching or bending or torsioning apparatus for exercising for the upper limbs
    • A61H1/0285—Hand
    • A61H1/0288—Fingers
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/00178—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices for active exercising, the apparatus being also usable for passive exercising
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/002—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices isometric or isokinetic, i.e. substantial force variation without substantial muscle motion or wherein the speed of the motion is independent of the force applied by the user
    • A63B21/0023—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices isometric or isokinetic, i.e. substantial force variation without substantial muscle motion or wherein the speed of the motion is independent of the force applied by the user for isometric exercising, i.e. substantial force variation without substantial muscle motion
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/15—Arrangements for force transmissions
    • A63B21/157—Ratchet-wheel links; Overrunning clutches; One-way clutches
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
    • A63B71/06—Indicating or scoring devices for games or players, or for other sports activities
    • A63B71/0619—Displays, user interfaces and indicating devices, specially adapted for sport equipment, e.g. display mounted on treadmills
    • A63B71/0622—Visual, audio or audio-visual systems for entertaining, instructing or motivating the user
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5064—Position sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5069—Angle sensors
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
    • A63B71/0054—Features for injury prevention on an apparatus, e.g. shock absorbers
    • A63B2071/0072—Limiting the applied force, torque, movement or speed
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
    • A63B71/0054—Features for injury prevention on an apparatus, e.g. shock absorbers
    • A63B2071/0081—Stopping the operation of the apparatus
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
    • A63B71/06—Indicating or scoring devices for games or players, or for other sports activities
    • A63B71/0619—Displays, user interfaces and indicating devices, specially adapted for sport equipment, e.g. display mounted on treadmills
    • A63B71/0622—Visual, audio or audio-visual systems for entertaining, instructing or motivating the user
    • A63B2071/0625—Emitting sound, noise or music
    • A63B2071/0627—Emitting sound, noise or music when used improperly, e.g. by giving a warning
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
    • A63B71/06—Indicating or scoring devices for games or players, or for other sports activities
    • A63B71/0619—Displays, user interfaces and indicating devices, specially adapted for sport equipment, e.g. display mounted on treadmills
    • A63B2071/0655—Tactile feedback
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/005—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using electromagnetic or electric force-resisters
    • A63B21/0058—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using electromagnetic or electric force-resisters using motors
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/02—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using resilient force-resisters
    • A63B21/026—Bars; Tubes; Leaf springs
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2220/00—Measuring of physical parameters relating to sporting activity
    • A63B2220/20—Distances or displacements
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2220/00—Measuring of physical parameters relating to sporting activity
    • A63B2220/20—Distances or displacements
    • A63B2220/24—Angular displacement
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2220/00—Measuring of physical parameters relating to sporting activity
    • A63B2220/50—Force related parameters
    • A63B2220/51—Force

Definitions

  • the present invention relates to the physical rehabilitation of finger function, and more particularly, devices for said rehabilitation.
  • Stroke is one of the leading causes of adult disabilities in the world, with more than 15 millions cases every year.
  • a major part of stroke survivors suffer from hemiparesis, i.e. a paralysis of one side of the body, resulting in a severe decrease in their ability to perform typical activities of daily living (manipulating objects, handwriting, eating, driving, etc.).
  • Impaired finger function resulting from stroke can be summarized as failure to extend fingers, poor finger coordination, loss of finger independence, poor explorative movements, slow and clumsy object manipulation and grasping, and inability to control and maintain constant grip force.
  • the plasticity of the brain can help reorganize the neural connections damaged by the stroke, and thus to slowly partially recover the impaired functions.
  • Rehabilitation is performed after stroke in order to stimulate the recovery, typically by performing intense movement repetition involving the impaired limb.
  • Studies have shown that the rehabilitation program has to be task-oriented, focused on activities of daily living and repetitive movement oriented to provide an efficient therapy. It is also known that rehabilitation is also critical to other neuropathology injuries (Parkinson disease, spinal cord injuries, traumatic brain injuries, cerebral palsy) and physical rehabilitation.
  • Devices such as soft balls used in rehabilitation centers are used to train finger function.
  • soft balls are incapable of measuring patients' performances and provide them accurate feedback of their performance.
  • the invention provides a device for finger function training or rehabilitation comprising: fixations for engaging each finger; an actuator for selectively applying an active force to said fixations, and; a force transfer assembly connecting each of said fixations to the actuator.
  • the invention provides a method for training or rehabilitating finger function, the method comprising the steps of: engaging each finger with a fixation assembly; applying an active force to each finger through the fixation.
  • the invention provides for an actuator applying an active force to the fingers, rather than relying on a passive/reactive force of the prior art, which depends on the fingers to provide the applied active force in order to function.
  • the device may include means for taking measurements for the purpose of monitoring the patient's instantaneous treatment and/or objective assessment of longer term rehabilitation.
  • the device may include one or more load sensors, such as load cells, in communication with the force transfer assembly. This may provide a measure of the force applied by the device to any one or all of the patient's fingers.
  • the load sensors may also measure the load applied by the patient's fingers.
  • the cables are restrained from movement, and accordingly there will be no displacement measured.
  • the load sensor may be used to measure the force applied by the finger, or fingers, which are connected to the actuator in mode 3, that is, disconnected from both motors.
  • a displacement sensor For treatment involving flexing or extending the fingers, a displacement sensor may be used.
  • a displacement sensor may include an encoder mounted to a pulley or spindle of known diameter within the device, across which cables connected to the patient's fingers move.
  • Such an encoder may record the rotation of said pulley or spindle, and so be able to record the displacement of the cable and consequently the movement of the finger.
  • the load and displacement may be recordable, whereby the displacement and load sensors are in communication with a data acquisition system recording to memory, a chart recorder and/or a visual display for the patient and therapist to view the instantaneous results.
  • the sensors may be in communication with a control system having control of the actuators.
  • a threshold load may be pre-determined and stored within the control system. On exceeding the threshold, the control system may stop operation of the actuator to prevent injury to the patient. Further, the control system may also determine when the load is approaching the threshold load, and provide a warning to the patient/therapist. The control system may slow the rate of load application when proximate to the threshold load.
  • the control system may also have a pre-determined threshold displacement, such that on reaching the threshold, the control system stops the actuator to prevent over extension of the fingers.
  • the control system may also provide a warning and/or slowing of the actuator on being proximate to the threshold
  • the pre-determined load and/or displacement threshold may be determined on a case by case basis, depending on the condition of the patient. There may also be an absolute maximum threshold for the load and/or displacement, for which the control system prevents the device from exceeding.
  • control system may control the motor so as to emulate a linear or nonlinear relationship based on the application of force by the finger. For instance, for a linear relationship between input data from the sensors, the control system may control the motor to output a linear relation between force and position, and thus acting as a virtual spring. Similarly, a nonlinear relationship may be output, such as varying the applied force from the motor based on finger position to, say, maintain a uniform load on the finger during its full range of movement, which otherwise may not occur because of variation in the position of the finger through flexing.
  • the finger rehabilitation device may offer an automatic system that is portable and can be used at home, in rehabilitation centres, hospitals, etc to help stroke patients recover finger function.
  • it may be used as an independent module or, alternatively, it may be fixed to a structure (e.g. non-actuated structure) or to a robotic device.
  • the present invention may provide the advantage of offering a large range of movement to allow an efficient and complete training, from assisted finger extension to resisted grasp movement with the five fingers together.
  • An interface may provide the possibility for training independently several parts of the hand, e.g. the jaw of thumb and index fingers, or thumb against index and middle fingers.
  • the interface may be able to train the right or left hand and to adapt the position of the wrist for an improved comfort.
  • rehabilitation systems include non-actuated devices such as soft balls used in rehabilitation centers, which do not measure patients' performances, and robotic devices, which may be large, complex or expensive, limiting private use in the home.
  • the finger rehabilitation device may permit each fingertip freedom to move in at least three degrees-of-freedom (DOF), with a large range of movement from the fingers closing together to full extension.
  • DOF degrees-of-freedom
  • the device may comprise a cable driven system actuated by one or several motors.
  • the rehabilitation device may offer several combinations of movement by means of a clutch system that allows engaging or disengaging of each finger to the motor(s).
  • the finger rehabilitation device may comprise a cable system to train the five fingers of either hand by means of at least one motor and five clutch systems to combine the action of these motors.
  • each finger is attached to a cable linked to a clutch that can be automatically switched between three modes:
  • each finger and the thumb may operate under a different mode, such that the first motor may be under resistive load conditions and the second motor applying an active load.
  • the treatment may then require the active load applied to the thumb and index finger whilst the remaining fingers are under a resistive load, blocked from movement (mode 3) or disconnected from the device altogether.
  • the thumb may be connected to one motor and the index finger connected to another motor, with the remaining fingers blocked through connection in mode 3.
  • the arrangement would allow for training of pinching tasks.
  • the device according to the present invention includes embodiments having any combination of the three modes applied in any combination to the fingers.
  • the two motors may be engaged in different gear ratios.
  • different loading rates or load application may be available for selection between the first and second motors.
  • the actuator may include a "slip interface" between components.
  • the motor may be connected to the force transfer assembly in a friction wheel arrangement rather than toothed gears. Hence, a maximum applied load may be limited to the friction between the wheels, providing a safety aspect.
  • the fingers actuation let the fingertip free to move in space.
  • the clutch is actuated by one of the motors, the related cable is pulled by the motor, which generates a force that extends the finger.
  • the finger fixation may include an assembly, which in one embodiment may include a cable tensioning device.
  • the cable tensioning device such as a bow spring
  • the bow spring is also used to generate small forces in direction of finger flexion.
  • An alternative cable tensioning device may include a compression spring concentric with the cable.
  • a plurality of finger fixation assemblies may be adjusted to fit any hand, a particular trapezoidal shape of the structure allows rotating the device and thus adjusting the orientation of the wrist, and the rehabilitation device offers the possibility to train either right or left hand.
  • a flexible arm support can be adapted to any subject.
  • finger fixation assembly For clarity, the thumb will be included in the description of "fingers” unless specifically identified as being distinct, such as for the mounting of the associated finger fixation assembly on the frame.
  • Figure 1 is an isometric view of one embodiment of a finger rehabilitation device according to present invention.
  • Figure 2 is a close up view of the finger rehabilitation device according to Figure 1.
  • Figures 3A and 3B are isometric views of a finger rehabilitation device according to a further embodiment of the present invention.
  • Figure 4 is an alternative isometric view of the finger rehabilitation device according to Figure 1.
  • Figures 5A to 5C are various views of a finger fixation assembly according to a preferred embodiment of the present invention.
  • Figures 6A to 6E are various views of a force transfer assembly according to a further embodiment of the present invention.
  • Figures 7A to 7C are various views of an actuator according to one embodiment of the present invention.
  • Figure 8 is an exploded view of a clutch lever according to one embodiment of the present invention.
  • Figure 9 shows a visual feedback of the finger rehabilitation device according to present invention.
  • Figure 10 is an elevation view of a clutch engagement according to a further embodiment of the present invention.
  • Figure 11 is an elevation view of a clutch engagement according to a further embodiment of the present invention.
  • Figure 12 is an elevation view of a clutch engagement according to a further embodiment of the present invention.
  • Figure 13 shows an example of results of a pilot study to train finger independence.
  • Figure 14 shows an example of exercise scheme known as Isometric exercise.
  • Figure 15 shows an example of exercise scheme known as Elastic exercise.
  • Figures 16A to 16C are various views of the kinematic chain of mechanism of the finger rehabilitation device according to present invention.
  • Figures 17A to 17D are various views of the mounting of the finger rehabilitation device on different types of structures.
  • FIGS. 1 to 4 show the general assembly of a finger rehabilitation device 100 according to one embodiment of the present invention.
  • the arm 110 of a subject 115 stroke patient
  • the actuation system is enclosed in a box to prevent any harm to the subject. Due to the trapezoidal shape of the box 135, it can be placed 130 at several orientations 135 and thus be adapted for a comfortable wrist position.
  • the subject 115 places each finger 125 inside a finger strap 155.
  • the finger strap is actuated by means of a cable pulling in one direction and a bow spring in the other.
  • the device 100 is composed of five subsystems, one for each finger, each subsystem being composed of a finger fixation and a clutch system 140.
  • the finger fixation consists of a finger strap 1 (Velcro) to attach the finger.
  • the finger can be attached at any finger joint, like DIP, PIP or MCP.
  • the finger strap 1 is fixed on a support 2.
  • a load cell 3, measuring compression and traction forces, is also mounted on this support 2.
  • This force sensor 3 is thus placed between the finger and the actuating system (cable driven system and bow spring) and measures the interaction forces between the subject and the device.
  • the component 4 links the force sensor 3, the cable 5 and the bow spring 6 together.
  • the bow spring 6 has two purposes: the first objective is to maintain a certain tension in the cable system and the second one is to provide forces in the other direction, as the cable can pull in only one direction.
  • the bow spring can be made of steel, or plastic depending on the desired force amplitude.
  • the cable 5 is guided into the box through a pulley 7.
  • the pulley 7 is mounted on a shaft 8 rotating around two ball bearings 9.
  • An encoder (composed of a disk 10 and an encoder 11) is also mounted on the shaft 8 and measures the angular position of the pulley and thus the position of the finger.
  • a ball bearing 12 is mounted on a shaft 13 and pushes the cable inside the groove.
  • the pulley 7 and the encoder 10 are enclosed and protected within the part 14.
  • the support 15 can be rotated around the ball bearing 16 to provide more flexibility.
  • the whole subsystem "finger fixation" can be shifted along the profile 16 to provide a comfortable movement adapted to the subject's hand.
  • FIGS 6A to 6E show how the finger fixation can be shifted along the profile 16 and how the cable is guided from the finger fixation to the actuation system.
  • the cable is guided through the pulleys 17 and 18.
  • the pulley 17 is mounted on a quick fastener 19 and can be easily shifted according to the displacement of the finger fixation.
  • the pulley 18 remains aligned with the actuation system.
  • An important feature of the system is the possibility to train either the right or the left hand.
  • the finger fixations of the four fingers index, middle, ring and little
  • the thumb fixation needs to be switched from one side of the device to the other one.
  • the cable path is thus different for the thumb.
  • Figure 6A to 6E further show the displacement of the thumb fixation from a right hand (Fig 6D) to a left hand (Fig 6E).
  • the cable is guided through the four pulleys 20, 21 , 22 and 23.
  • the pulley 20 is mounted on a quick fastener and can be easily shifted to be aligned with the thumb fixation while the pulley 23 is aligned with the actuation system.
  • the pulleys 21 and 22 allow the large displacement of the thumb fixation.
  • FIGS 7A to 7C show one embodiment of an actuation system with two motors allowing three modes: (i) actuation by the first motor 160,; (ii) actuation by the second motor 170; and (iii) blocked 165, to prevent movement of the fingers and so permit isometric training.
  • the actuation system is composed of five clutch systems, one for each finger, and two motors.
  • the motors actuate two shafts by means of timing belts, the motor 24 actuates the shaft 27 and the motor 25 actuates the shaft 26, respectively.
  • Five gears 28 are mounted on both shafts to provide the torque when the corresponding clutch gear is engaged. Therefore, each of the five clutch systems can be engaged to one or the other shafts corresponding to the modes (i) and (ii) previously mentioned.
  • a pin 29 supported by the profile 30 provides the third mode (iii) by blocking any rotation of the clutch gear when it is engaged.
  • FIG 8 shows an exploded view of a lever, or clutch lever, system that is used to switch between the three modes.
  • the basis of the clutch system is the servomotor 31 that automatically rotates a lever in order to engage the clutch gear 32 with one of the gears 28 mounted on the motor shafts 26 and 27 (modes (i) and (ii)) or the pin 29 (mode (iii)).
  • the servomotor actuates the lever that is composed of two parts 33 and 34.
  • the two parts 33 and 34 are linked together with the component 35.
  • These levers are mounted on two ball bearings 36 and rotate around the shaft 37.
  • the clutch gear 32 and the pulley 38 are mounted on the shaft 39 at the extremity of the levers. This shaft 39 is also mounted on two ball bearings 40.
  • the clutch gear 32 provides the torque to the pulley 38 when it is engaged in one of the three modes.
  • the cable 5 is wound up the pulley 38 and transmits the force to the subject's finger.
  • the conic shape of the pulley 38 avoids the cable to cross and tie a knot.
  • the pulley 41 is mounted on a ball bearing and guides the cable toward the cone-shape pulley 38.
  • the components 42 and 43 support the levers, the component 44 supports the servomotor, the components 45 support the actuation shafts 26 and 27 and the components 46 support the two motors.
  • the exercise consists of isometric forces generated by individual fingers.
  • the exercise has been designed to keep the subject motivated and the principle is based on the game Hangman (a game in which one player tries to guess the letters of a word 190, and failed attempts are recorded by drawing a gallows and a stick figure of someone hanging on it, stroke by stroke).
  • the subject is instructed to select different letters in order to compose a word (e.g. the subject has to select one by one S-Y-D-N-E-Y 190 to form the word "Sydney").
  • To select a letter 180 the subject has to apply a certain amount of force (between 5% and 25% MVC) with a specific finger 185.
  • any force applied by another finger has a negative effect to encourage the subject to control each finger individually.
  • the placement 175 of each letter is important: the letters that are most often used (especially vowels) are placed so that the subject has to apply a large force.
  • the letters are also distributed to emphasize the thumb- index pair, required in many ADL. The words have been selected to capture the subject's interest. This is why it has been decided to use names of cities or countries that interest the subject.
  • the implemented virtual environment consists of three different feedbacks and informs the subject on his performances: (i) visual, (ii), audio and (iii) tactile feedbacks.
  • the fingers under training are connected to the actuator in mode 3, that is, disconnected from both the first and second motors, with the respective gear engaged with the pin 29 to prevent movement of the cables, and consequently, the fingers being trained.
  • a trial was conducted using the preferred embodiment of the rehabilitation device.
  • These subjects 65-83 y with right hemiplegia, right-handed) were representative of the population for which the interface has been initially designed, capable of minimal movement of the hand and fingers.
  • the two patients had similar hand function impairment preventing them from using their right hand for typical ADL such as key pinch, combing, and handwriting.
  • the objectives of this exercise are to: (i) strengthen muscles of individual fingers in order to improve finger independence and, (ii) improve the ability to control the force applied by each finger.
  • the exercise consists of isometric forces generated by individual fingers.
  • the exercise has been designed to keep the subject motivated and the principle is based on the game Hangman
  • the subject is instructed to select different letters in order to compose a word.
  • To select a letter the subject has to apply a certain amount of force, such as between 5% and 25% MVC (Maximal Voluntary Contraction), to avoid fatigue with a specific finger. Any force applied by another finger has a negative effect to encourage the subject to control each finger individually.
  • MVC Maximum Voluntary Contraction
  • Figure 13 shows that the number of successful tasks performed by individual fingers increases with the training. As reported by the subject, it was much easier in the end of the training to accomplish a specific task with individual fingers.
  • Figure 14 shows the evolution during the training while the subject has to apply a certain amount of force with the middle finger and then maintain this force. Evolution of force from the beginning (A), the middle (B) and the end (C) of the training while the subject has to reach and maintain a target force (between dotted lines) with a specific finger (middle finger in this case).
  • P1 is the section before the subject reaches the target force for the first time and P2 is the section while the subject tries to maintain the target force.
  • Subject 2 Elastic exercise In this exercise, the subject has to move the five fingers against a load (resistive load for the closing movement and assistive load for the opening movement) generated by the robotic interface (between 5% and 25% MVC). Moreover, during the movement, the fingers must be coordinated such that they have forces of identical amplitude. Visual feedback informs the subject on his performance during the training.
  • the benefits of training with this exercise may be to: (i) enhance finger coordination, (ii) strengthen the finger muscles, and (iii) increase dexterity of the five fingers.
  • Figure 15 shows the evolution during the training while the subject performs a closing movement (improvement is similar for the opening movement). Evolution of position, velocity and force from the beginning (A), the middle (B) and the end (C) of the training while the subject has to close the hand while applying the same force with each of the four fingers (the subject was not able to perform the exercise with the thumb).
  • Figure 10 shows a clutch system 195 switching between four shafts 200A to D actuated by four motors (not shown).
  • the gear ratio 205, 210 can also be modified to provide a torque adapted to any subject or exercise as shown in Figure 11.
  • Figure 12 shows another modification to transmit the torque by friction. Indeed, the gears are replaced by two pulleys 215, 220 with high coefficients of friction.
  • the actuation of the fingers is critical in rehabilitation of hand function. Considering that the complete finger movement is composed of four degrees-of- freedom (DOF), i.e. three flexion/extension (at the three joints: MCP (metacarpophalangeal), PIP (proximal interphalangeal) and DIP (distal interphalangeal)) and one abduction/adduction at the MCP joint, the actuation mechanism should also have at least four DOFs.
  • DOF degrees-of- freedom
  • a linear guide system mounted on a ball joint or (ii) as shown on Figure 16B a cable-based system.
  • Another advantage of the mechanism is that it can be very compact and can be placed on a specific frame (Figure 16C) to train the five fingers together. The frame can then be placed on a fixed structure (Fig. 17B) if we want to train hand function individually, or on a mobile structure, if we want to combine it with another system, e.g. the mechanism could be mounted on a robotic arm 245 (Fig. 17C) or an exoskeleton 250 (Fig. 17D) used to train arm movements.

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Abstract

La présente invention concerne un dispositif de réhabilitation des fonctions du doigt comportant : des éléments de fixation destinés à être en prise avec chaque doigt; un actionneur pour l'application sélective d'une force active aux dits éléments de fixation; et un ensemble de transfert de force reliant chacun desdits éléments de fixation à l'actionneur.
PCT/SG2010/000209 2009-06-03 2010-06-03 Dispositif de rehabilitation des fonctions du doigt WO2010140984A1 (fr)

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ITTO20100997A1 (it) * 2010-12-14 2012-06-15 Poli Tiziano Dispositivo di riabilitazione.
KR101281754B1 (ko) * 2011-06-17 2013-07-08 경상대학교산학협력단 손가락 재활 장치
KR101359747B1 (ko) 2012-05-17 2014-02-11 영남대학교 산학협력단 수부 자동 운동기구
TWI469774B (zh) * 2012-10-11 2015-01-21 Univ Chang Gung 觸覺運動刺激裝置
WO2015024852A1 (fr) * 2013-08-21 2015-02-26 Hocoma Ag Dispositif d'exercice du mouvement de la main
CN104784005A (zh) * 2015-03-26 2015-07-22 东南大学 柔性牵引式手指康复训练装置
WO2015144705A1 (fr) * 2014-03-27 2015-10-01 Institut Für Technische Informatik Universität Zu Lübeck Dispositif permettant d'assister les fonctions de préhension d'une main et d'entraîner les fonctions de préhension
CN105496725A (zh) * 2015-12-09 2016-04-20 东南大学 一种三自由度拇指康复训练机构
RU170210U1 (ru) * 2016-07-22 2017-04-18 Леонид Евгеньевич Селявко Устройство-тренажер для самостоятельных занятий по восстановлению амплитуды движений руки больных с неврологическими заболеваниями
KR101745563B1 (ko) 2015-06-23 2017-06-09 경북대학교 산학협력단 손 재활 운동 장치
RU172815U1 (ru) * 2016-09-05 2017-07-25 Леонид Евгеньевич Селявко Устройство-тренажер для самостоятельных занятий по разработке нарушенных движений рук больных с неврологическими заболеваниями
EP3199136A1 (fr) 2016-01-29 2017-08-02 Fundacíon Tecnalia Research & Innovation Dispositif de rééducation de la main
EP3199137A1 (fr) 2016-01-29 2017-08-02 Fundacíon Tecnalia Research & Innovation Dispositif de rééducation de main avec mécanisme de fixation
JP2018069036A (ja) * 2016-11-03 2018-05-10 明根股▲ふん▼有限公司Ｂ．Ｇｒｅｅｎ Ｔｅｃｈｎｏｌｏｇｙ Ｃｏ．，Ｌｔｄ． 他動式筋力訓練機及びその作動方法
WO2018152322A1 (fr) 2017-02-16 2018-08-23 The Johns Hopkins University Système de rééducation de la main
CN109045624A (zh) * 2018-08-07 2018-12-21 东南大学 手指主被动康复训练装置及其训练方法
CN109674483A (zh) * 2018-12-24 2019-04-26 上海大学 一种可调节的单手指匀速被动运动装置及单手指肌张力检测方法
CN109718051A (zh) * 2017-06-20 2019-05-07 孙静洁 一种手指训练器
CN109893403A (zh) * 2019-04-22 2019-06-18 燕山大学 一种绳驱动手部训练装置
CN111228750A (zh) * 2020-02-28 2020-06-05 王纯 一种神经科用手指训练器
EP3895679A1 (fr) 2020-04-15 2021-10-20 MCI Management Center Innsbruck - Internationale Hochschule GmbH Dispositif de rééducation portable
US11400010B2 (en) * 2011-07-29 2022-08-02 Leonis Medical Corporation Method and system for control and operation of motorized orthotic exoskeleton joints

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4875469A (en) * 1988-06-13 1989-10-24 Innovative Medical Engineering, Inc. Continuous passive motion devices and methods
US5697892A (en) * 1995-09-13 1997-12-16 Sutter Corporation Continuous passive motion device for the hand and a method of using the same

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4875469A (en) * 1988-06-13 1989-10-24 Innovative Medical Engineering, Inc. Continuous passive motion devices and methods
US5697892A (en) * 1995-09-13 1997-12-16 Sutter Corporation Continuous passive motion device for the hand and a method of using the same

Non-Patent Citations (3)

* Cited by examiner, † Cited by third party
Title
FU Y. ET AL: "Development of a Multi-DOF Exoskeleton Based Machine for Injured Fingers", 2008 IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS, 22 September 2008 (2008-09-22) - 26 September 2008 (2008-09-26) *
WEGE A. ET AL: "Development and Control of a Hand Exoskeleton for Rehabilitation of Hand Injuries", 2005 IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS, 2 August 2005 (2005-08-02) - 6 August 2005 (2005-08-06) *
WORSNOPP T.T. ET AL: "An Actuated Finger Exoskeleton for Hand Rehabilitation Following Stroke", PROCEEDINGS OF THE 2007 IEEE 10TH INTERNATIONAL CONFERENCE ON REHABILITATION ROBOTICS, 12 June 2007 (2007-06-12) - 15 June 2007 (2007-06-15), pages 898 - 899 *

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ITTO20100997A1 (it) * 2010-12-14 2012-06-15 Poli Tiziano Dispositivo di riabilitazione.
WO2012080959A1 (fr) 2010-12-14 2012-06-21 Poli, Tiziano Dispositif de réhabilitation
KR101281754B1 (ko) * 2011-06-17 2013-07-08 경상대학교산학협력단 손가락 재활 장치
US11400010B2 (en) * 2011-07-29 2022-08-02 Leonis Medical Corporation Method and system for control and operation of motorized orthotic exoskeleton joints
KR101359747B1 (ko) 2012-05-17 2014-02-11 영남대학교 산학협력단 수부 자동 운동기구
TWI469774B (zh) * 2012-10-11 2015-01-21 Univ Chang Gung 觸覺運動刺激裝置
WO2015024852A1 (fr) * 2013-08-21 2015-02-26 Hocoma Ag Dispositif d'exercice du mouvement de la main
WO2015144705A1 (fr) * 2014-03-27 2015-10-01 Institut Für Technische Informatik Universität Zu Lübeck Dispositif permettant d'assister les fonctions de préhension d'une main et d'entraîner les fonctions de préhension
DE102014004508A1 (de) * 2014-03-27 2015-10-01 Institut Für Technische Informatik Universität Zu Lübeck Vorrichtung zur Unterstützung von Greiffunktionen einer Hand zum Training von Greiffunktionen
CN104784005A (zh) * 2015-03-26 2015-07-22 东南大学 柔性牵引式手指康复训练装置
KR101745563B1 (ko) 2015-06-23 2017-06-09 경북대학교 산학협력단 손 재활 운동 장치
CN105496725A (zh) * 2015-12-09 2016-04-20 东南大学 一种三自由度拇指康复训练机构
WO2017129788A1 (fr) 2016-01-29 2017-08-03 Fundación Tecnalia Research & Innovation Dispositif de rééducation de la main
EP3199136A1 (fr) 2016-01-29 2017-08-02 Fundacíon Tecnalia Research & Innovation Dispositif de rééducation de la main
EP3199137A1 (fr) 2016-01-29 2017-08-02 Fundacíon Tecnalia Research & Innovation Dispositif de rééducation de main avec mécanisme de fixation
WO2017129786A1 (fr) 2016-01-29 2017-08-03 Fundación Tecnalia Research & Innovation Dispositif de rééducation de la main avec mécanisme de fixation
US11224553B2 (en) 2016-01-29 2022-01-18 Fundación Tecnalia Research & Innovation Hand rehabilitation device
RU170210U1 (ru) * 2016-07-22 2017-04-18 Леонид Евгеньевич Селявко Устройство-тренажер для самостоятельных занятий по восстановлению амплитуды движений руки больных с неврологическими заболеваниями
RU172815U1 (ru) * 2016-09-05 2017-07-25 Леонид Евгеньевич Селявко Устройство-тренажер для самостоятельных занятий по разработке нарушенных движений рук больных с неврологическими заболеваниями
JP2018069036A (ja) * 2016-11-03 2018-05-10 明根股▲ふん▼有限公司Ｂ．Ｇｒｅｅｎ Ｔｅｃｈｎｏｌｏｇｙ Ｃｏ．，Ｌｔｄ． 他動式筋力訓練機及びその作動方法
CN110537155A (zh) * 2017-02-16 2019-12-03 约翰霍普金斯大学 用于手部康复的系统
WO2018152322A1 (fr) 2017-02-16 2018-08-23 The Johns Hopkins University Système de rééducation de la main
EP3583487A4 (fr) * 2017-02-16 2020-11-11 The Johns Hopkins University Système de rééducation de la main
CN109718051A (zh) * 2017-06-20 2019-05-07 孙静洁 一种手指训练器
CN109718051B (zh) * 2017-06-20 2021-03-26 孙静洁 一种手指训练器
CN109045624A (zh) * 2018-08-07 2018-12-21 东南大学 手指主被动康复训练装置及其训练方法
CN109674483B (zh) * 2018-12-24 2021-11-05 上海大学 一种可调节的单手指匀速被动运动装置及单手指肌张力检测方法
CN109674483A (zh) * 2018-12-24 2019-04-26 上海大学 一种可调节的单手指匀速被动运动装置及单手指肌张力检测方法
CN109893403A (zh) * 2019-04-22 2019-06-18 燕山大学 一种绳驱动手部训练装置
CN109893403B (zh) * 2019-04-22 2020-04-07 燕山大学 一种绳驱动手部训练装置
CN111228750B (zh) * 2020-02-28 2021-02-19 杨风刚 一种神经科用手指训练器
CN111228750A (zh) * 2020-02-28 2020-06-05 王纯 一种神经科用手指训练器
WO2021209538A1 (fr) 2020-04-15 2021-10-21 Mci Management Center Innsbruck - Internationale Hochschule Gmbh Dispositif de rééducation portatif
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