Quantifying upper extremity performance with and without assistance of a soft-robotic glove in elderly patients: A kinematic analysis.

OBJECTIVE: To explore the direct influence of a soft-robotic glove on movement duration and movement execution in elderly people with decreased hand function during a reach-and-grasp task. DESIGN: Cross-sectional study. PATIENTS: Eight subjects, aged 55+ years, with decreased hand function. METHODS: The direct effect of the glove was explored using kinematic analysis during a reach-and-grasp task with a light (100 g) and heavy (1,000/2,500 g) cylindrical object, performed with and without the soft-robotic glove. RESULTS: There was no difference in total movement time between performance with and without the glove. With the glove, the relative time needed to transport the heavy object was shorter, while the relative time needed to grasp the heavy object was longer. In addition, transporting light objects involved a lower peak velocity and larger elbow extension, and grasping the object involved a larger hand opening compared with without glove. CONCLUSION: As expected, no positive influence of the soft-robotic glove was found on total movement duration in elderly subjects. The influence of the glove on movement execution varied with movement phase. The positive and negative effects found may be due to a perceived confidence while carrying heavy objects with the glove, or compensation for loss of sensation, respectively. This information can be used to improve the glove design.

Assistive Technology for the Upper Extremities After Stroke: Systematic Review of Users' Needs.

BACKGROUND: Technical innovations have the potential to compensate for loss of upper-limb motor functions after stroke. However, majority of the designs do not completely meet the needs and preferences of the end users. User-centered design methods have shown that the attention to user perspectives during development of assistive technology leads to devices that better suit the needs of the users. OBJECTIVE: To get more insight into the factors that can bring the design of assistive technology to higher levels of satisfaction and acceptance, studies about user perspectives on assistive technology for the upper limb after stroke are systematically reviewed. METHODS: A database search was conducted in PubMed, EMBASE, CINAHL, PsycINFO, and Scopus from inception to August 2017, supplemented with a search of reference lists. Methodological quality of the included studies was appraised. User perspectives of stroke survivors, carers, and health care professionals were extracted. A total of 35 descriptive themes were identified, from which 5 overarching themes were derived. RESULTS: In total, 9 studies with information gathered from focus groups, questionnaires, and interviews were included. Barriers and enablers influencing the adoption of assistive technology for the upper limb after stroke emerged within 5 overarching but highly interdependent themes: (1) promoting hand and arm performance; (2) attitude toward technology; (3) decision process; (4) usability; and (5) practical applicability. CONCLUSIONS: Expected use of an assistive technology is facilitated when it has a clear therapeutic base (expected benefit in enhancing function), its users (patients and health care professionals) have a positive attitude toward technology, sufficient information about the assistive technology is available, and usability and practical applicability have been addressed successfully in its design. The interdependency of the identified themes implies that all aspects influencing user perspectives of assistive technology need to be considered when developing assistive technology to enhance its chance of acceptance. The importance of each factor may vary depending on personal factors and the use context, either at home as an assistive aid or for rehabilitation at a clinic.