ABSTRACT
ObjectiveTo apply pneumatic hand rehabilitation equipment in comprehensive rehabilitation training to improve hand function in children with spastic hemiplegic cerebral palsy. MethodsFrom Januray, 2020 to September, 2021, 58 children with spastic hemiplegia cerebral palsy in Maternity and Child Health Care Hospital of Nantong University were randomly divided into control group (n = 29) and experimental group (n = 29). Both groups accepted comprehensive rehabilitation training, while the experimental group accepted pneumatic hand rehabilitation equipment training in addition, for six months. They were assessed with Peabody Developmental Motor Scales-Fine Motor (PDMS-FM), Fine Motor Function Measurement (FMFM) and Wee-Function Independence Measure (Wee-FIM) before and after training. ResultsThe scores of PDMS-FM, FMFM and Wee-FIM improved in both groups after training (|t| > 16.310, P < 0.001), and improved more in the experimental group than in the control group (t > 2.795, P < 0.01). ConclusionApplication of pneumatic hand rehabilitation equipment in comprehensive rehabilitation training can effectively promote the recovery of hand function for children with spastic hemiplegic cerebral palsy.
ABSTRACT
Objective To improve the clinical application of using rehabilitation robot for hand rehabilitation and solve the current shortcomings of rigid hand rehabilitation robot, such as complex structure, heavy weight, potential safety hazard, a new soft and wearable robotic glove was proposed. Methods The robotic glove was driven by McKibben pneumatic artificial muscles (PAMs). The tendon drive system was designed based on simulation of human hand anatomy and physiology structure, which could transmit forces and torques through the user’s own skeleton and joints. The normal hand movement could be simulated and this design pattern highly reduced the weight of the robotic glove. Meanwhile a surface electromyogrphy (sEMG) collecting circuit was developed to acquire sEMG signals from the forearm. User intent could be detected by measuring the sEMG of flexor digitorum superficialis and extensor digitorum communis on the forearm. Results The results of the experiment investigation on characteristics of the soft robotic glove showed that the robotic glove could effectively assist people completing daily activities and grasping daily necessities. The feasibility and scientificity of the robotic glove was validated. Conclusions The soft and wearable robotic glove has an advantage of light weight, easy operation and high comfortableness, and it can provide references for the study and design of similar hand rehabilitation devices.
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Abstract: In the last years, a considerable number of patients with hand mobility problems has been reported; in most of these cases, the patients must spend time in a specialized center to carry out a therapy to rehabilitate damaged parts. This paper presents the design of an orthosis for finger rehabilitation. The novelty of this proposal is that the design is formed by rigid links and three semicircular sliders with a center of rotation coincident with the finger joints; moreover, the synthesis of these sliders is realized in a new and simple way. The mechanism is designed to be compact enough to be used by a person during a whole day; it is formed by twelve links and allows the three finger phalanxes to be flexed simultaneously. The mechanism is coupled only to the dorsal side of the hand and has no interference when grasping objects, in such a way that the orthosis presented in this paper enables the patient to perform the Activities of Daily Living. The synthesis of the mechanism presented in this paper focuses on the middle finger, nevertheless, it is possible to use the same configuration for the others fingers only by scaling.
Resumen: En los últimos años un considerable número de pacientes con problemas de movilidad en las manos ha sido reportado; en la mayoría de los casos, los pacientes deben pasar un tiempo determinado en un centro especializado para llevar a cabo una terapia para rehabilitar las partes afectadas. En este artículo se presenta el diseño de una ortesis para rehabilitación de un dedo. La novedad de esta propuesta es que el diseño está formado por eslabones rígidos y tres correderas semicirculares, cuyo centro de rotación coincide con el centro de rotación de los dedos; además, la síntesis de estas correderas se realizó de una manera sencilla y nueva. El mecanismo diseñado es suficientemente compacto para ser utilizado por una persona durante un día entero; está formado por doce eslabones y permite que las tres falanges se muevan simultáneamente. El mecanismo es acoplado al dorso de la mano para no interferir con la sujeción de objetos, y por tanto permitir el desarrollo de las actividades de la vida diaria. La síntesis del mecanismo presentada en este artículo se enfoca en el dedo medio, sin embargo es posible usar la misma configuración para los otros dedos, solo escalando el mecanismo.
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Objective To study the effects of active and passive movement of the affected hand after ischemic stroke on brain activity patterns using blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) and to explore the central mechanism of movement treatment for hand disability.Methods Five pa-tients with subcortical cerebral infarction in Brunnstrom stages 1 to 3 (both upper limb and hand affected) were investigated using BOLD-fMRI during active and passive clenching and relaxing of the affected hand.Statistical parametric mapping software (SPM5) was used to integrate the activity data and display them in one standard brain map.The activated areas were then compared.Results The BOLD-fMRI signals aroused by both active and passive move-ment were enhanced in the contralateral sensorimotor cortex,the contralateral premotor cortex,bilaterally in the sup-plementary motor area and in the bilateral cerebellum.Both movements also activated the ipsilateral sensorimotor cor-tex and premotor cortex,which are not normally activated during such movements in healthy people.The areas were more extensive and the activation was stronger during passive movement.Moreover,the activated brain areas induced by active movement were mainly on the contralateral side,while passive movement induced activation distributed over both hemispheres almost evenly.Conclusions Both active and passive movement significantly activate the brain areas responsible for movement of the affected hand.Both are useful for boosting brain reorganization after stroke.
ABSTRACT
Hand rehabilitation is essential to restore the maximal functional capacity of a patient after the injuries of hand or upper extremity, such as a fracture, tendon tear, crushing, or amputation. To achieve the purpose, hand rehabilitation should begin shortly after the completion of surgery. Especially after the replantation, functional recovery can be achieved by a careful inpatient evaluation providing a proper treatment, detecting problems, and updating treatment programs, and arranging discharge and follow-up cares by a hand rehabilitation team. We report our experience of a successful hand rehabilitation of patient with a replantation surgery after the complete right forearm amputation. A comprehensive approach and systematized treatment programs are important for a hand rehabilitation.