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Development of a Novel Task-oriented Rehabilitation Program using a Bimanual Exoskeleton Robotic Hand
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User Testing for Performance and Brain Engagement With the Hope Hand Exoskeleton for Individuals With Spasticity Due

Tess B Meier, Kehan Yang, Andrew Daudelin

    IEEE ... International Conference on Rehabilitation Robotics : [Proceedings]
    |July 11, 2025
    PubMed
    Summary

    Assistive hand exoskeletons, like the HOPE Hand, may improve neurorehabilitation for individuals with upper motor neuron injuries. These devices aid daily activities, potentially enhancing brain function and motor skills through increased use and task specificity.

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    Area of Science:

    • Neuroscience
    • Rehabilitation Engineering
    • Biomedical Engineering

    Background:

    • Hand spasticity and hypertonia are common after upper motor neuron (UMN) injuries from stroke and traumatic brain injury (TBI).
    • Rehabilitation robots and exoskeletons show promise but may limit neuroplasticity due to repetitive tasks and infrequent use.
    • Assistive hand exoskeletons can increase the frequency and specificity of functional task practice, potentially promoting neuroplasticity.

    Purpose of the Study:

    • To evaluate the neurorehabilitative potential of an assistive hand exoskeleton (HOPE Hand) for individuals with hand spasticity and hypertonia.
    • To assess the impact of the HOPE Hand on functional task performance and brain activity in individuals with UMN injuries.
    • To explore the use of functional near-infrared spectroscopy (fNIRS) in conjunction with performance metrics to understand exoskeleton-driven neurorehabilitation.

    Main Methods:

    • User testing of the HOPE Hand (hand orthosis with powered finger extension) with 3 control and 2 impaired subjects (TBI and stroke).
    • Evaluation of functional task performance (water bottle task) with and without the exoskeleton.
    • Assessment of brain engagement using functional near-infrared spectroscopy (fNIRS) during task performance.

    Main Results:

    • Impaired subjects completed the functional water bottle task significantly faster with the HOPE Hand exoskeleton compared to without it.
    • fNIRS data indicated activation in the motor cortex and speech centers of the brain in impaired subjects, even with existing damage.
    • The combination of performance metrics and neuroimaging provides a method for evaluating assistive exoskeleton benefits.

    Conclusions:

    • Assistive hand exoskeletons like the HOPE Hand may offer neurorehabilitative benefits by improving functional task performance and engaging brain activity.
    • Increased frequency and specificity of functional task practice facilitated by assistive exoskeletons can leverage neuroplasticity principles.
    • Further research combining performance data and neuroimaging is crucial for understanding and optimizing the neurorehabilitative potential of assistive exoskeletons.