PMC10073561_01
RobHand rehabilitation platform. (A) RobHand exoskeleton (B) Tab for selection and configuration therapies (C) Squeeze oranges therapy.
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F2
The RobHand (Robot for Hand Rehabilitation) is an exoskeleton-type electromechanical device, which is attached to the patient's hand and provides assistance for performing different types of finger movement rehabilitation therapies (Figure 2A). Then, the therapist must select which type of exercise to perform and configure it by specifying the number of repetitions and velocity (low, medium, and high) (Figure 2B). Four types of rehabilitation exercises are available: i) Squeeze oranges (Figure 2C):flexion and extension of the hand fingers with the aim making orange juice ii) Hand opening and closing:flexion and extension of the five hand fingers simultaneously iii) Fingers opening and closing:flexion and extension of hand fingers individually iv) Pinch grip and precision grip:flexion and extension of the thumb against the four fingers or against the index finger.
Flow diagram of the stages of the intervention and baseline and post intervention manual function tests.
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Each training session was divided into six consecutive stages (Figure 3). Technology (QUEST 2.0) questionnaire after the intervention (T1). The timestamps at which each test was performed are shown in Figure 3.
Participant performing a training session: (A) Hand opening and closing (stage 1), (B) squeeze oranges (stage 2), (C) precision grip (stage 3) and (D) pinch grip (stage 4).
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The training began when the researcher gave the start indication, at which point the RobHand performed the opening-closing actions for the participant (Figure 4A). 75 repetitions per session were completed with a two second break in between. This exercise is performed in sync with audiovisual material, showing how a hand is squeezing oranges while the RobHand is performing the movement with the hand of the patient (Figure 4B). 19 repetitions per session were completed with four seconds break in between. The instructions given by the evaluator were: "I am going to ask you to grab this cube (the instructor held the cube near the hand of the patient) using your thumb and index finger and place it in my open hand." (Figure 4C). 75 high speed repetitions were completed with two seconds break in between each closing and opening movement. In this stage, the semisoft wedge was removed and instead the evaluator moved the patient's arm from one point of the table, across their body to another point, while stacking cones (Figure 4D).
Participants performing manual function tests: (A) Grip dynamometry, (B) 9-HPT, (C) GPT and (D) BBT.
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The patient is asked to grasp the resistance of the handle, place his shoulder in abduction and with neutral rotation (Figure 5A). The test is timed, and the patient must place the nine pegs in marked holes on the board and then remove all of them, using the impaired hand (Figure 5B). If the tested person is not able to match all pegs in 5 min, the tester counts the number of matched pegs on the board (Figure 5C). Furthermore, the box on a table must be in front of the patient, oriented longitudinally and in line with the participant, with the compartment that contains the blocks, parallel to the hand to be evaluated (Figure 5D).