Flexohand: A Hybrid Exoskeleton-Based Novel Hand Rehabilitation Device.

Home-based hand rehabilitation has excellent potential as it may reduce patient dropouts due to travel, transportation, and insurance constraints. Being able to perform exercises precisely, accurately, and in a repetitive manner, robot-aided portable devices have gained much traction these days in hand rehabilitation. However, existing devices fall short in allowing some key natural movements, which are crucial to achieving full potential motion in performing activities of daily living. Firstly, existing exoskeleton type devices often restrict or suffer from uncontrolled wrist and forearm movement during finger exercises due to their setup of actuation and transmission mechanism. Secondly, they restrict passive metacarpophalangeal (MCP) abduction-adduction during MCP flexion-extension motion. Lastly, though a few of them can provide isolated finger ROM, none of them can offer isolated joint motion as per therapeutic need. All these natural movements are crucial for effective robot-aided finger rehabilitation. To bridge these gaps, in this research, a novel lightweight robotic device, namely "Flexohand", has been developed for hand rehabilitation. A novel compliant mechanism has been developed and included in Flexohand to compensate for the passive movement of MCP abduction-adduction. The isolated and composite digit joint flexion-extension has been achieved by integrating a combination of sliding locks for IP joints and a wire locking system for finger MCP joints. Besides, the intuitive design of Flexohand inherently allows wrist joint movement during hand digit exercises. Experiments of passive exercises involving isolated joint motion, composite joint motions of individual fingers, and isolated joint motion of multiple fingers have been conducted to validate the functionality of the developed device. The experimental results show that Flexohand addresses the limitations of existing robot-aided hand rehabilitation devices.