Multimodal Feedback-Enhanced Soft Hand Rehabilitation Robot: System Development and Preliminary Clinical Evaluation

Soft robotic systems have attracted increasing attention for hand rehabilitation because of their compliance, adaptability, and potential for comfortable human-robot interaction. However, the clinical translation of soft hand rehabilitation robots remains limited by insufficient integration of interactive training, user feedback, and practical wearability. This study presents a multimodal feedback-enhanced soft hand rehabilitation robot based on lattice-structured soft pneumatic actuators (LSPAs), together with a preliminary clinical evaluation. The system integrates a fabric-based soft glove, pneumatic actuation, fingertip force sensing, hand-motion tracking, and interactive virtual rehabilitation tasks to provide coordinated visual, auditory, force-related, and mirror-visual feedback. Material characterization was first conducted to compare three TPU materials with different mechanical properties, followed by system-level evaluation of usability, wearability, and actuator durability. A four-week robot-assisted rehabilitation intervention was then conducted in nine stroke survivors. Participants completed five one-hour sessions per week, including passive training and multimodal interactive training. Clinical outcomes were evaluated using the Brunnstrom motor recovery stage, Fugl-Meyer Assessment of the upper extremity (FMA-UE), National Institutes of Health Stroke Scale (NIHSS), and Activities of Daily Living (ADL) scale, while usability was assessed using the System Usability Scale (SUS). After four weeks, the mean Brunnstrom stage increased from 2.44±2.07 to 3.67±2.12, FMA-UE increased from 18.33±25.63 to 32.67±23.11, NIHSS decreased from 5.67±4.36 to 3.22±2.99, and ADL increased from 49.78±39.53 to 66.67±22.50. The mean SUS score was 74.4. TPU420D provided the best durability among the tested configurations, with more than 30 h of recorded use without failure during the experimental period. These findings support the feasibility and usability of the proposed system and provide preliminary evidence for its application in stroke hand rehabilitation. Because of the small sample size, heterogeneous post-stroke status, short intervention period, and absence of a control group, the clinical findings should be interpreted as preliminary rather than confirmatory evidence of therapeutic efficacy.