Synergistic Torso-Muscle-Controlled Detached Robotic Hand: A Novel Approach for Post-Stroke Hand Rehabilitation.

This study aimed to develop a novel rehabilitative approach for post-stroke hand movement using a simple detached robotic hand and synergistic torso muscle activities for reaching and to perform a pilot test on its functionality and feasibility. In reference to a mental practice that does not activate hand muscles, enhanced cognitive engagement would be achieved without hand activation using the externally present, visible, and audible robotic hand by activating the non-hand muscles associated with hand function. A simple and low-cost robotic hand was developed and placed distal to the hidden resting hand as if it were a functional extended hand. The opening and closing motions of the detached robotic hand were controlled by electromyogram of the anterior and posterior torso muscles associated with reaching and retrieving while providing visual and auditory feedback. The functionality of the developed system was confirmed on the repeatability of the range of duration, excursion, and response time with low variability within an acceptable range. An able-bodied adult and five mildly impaired stroke survivors embodied the detached robotic hand by successfully controlling it with or without concurrent testing of their biological finger. In the concurrent finger tests, increased reactive force and hand muscle activity were observed in most participants. These observations confirmed that the developed approach that controls a detached robotic hand with reaching-associated torso muscles is functional and applicable to stroke survivors with and without involving the biological human hand. The robotic hand system detached from the user and controlled by the voluntary effort of their reaching-associated torso muscles has enabled future studies to examine the efficacy of synergistic muscle-robot interaction as a potential rehabilitation tool.