Journal of Rehabilitation Medicine 51-4inkOmslag | Page 64

J Rehabil Med 2019; 51: 298–306 ORIGINAL REPORT QUANTIFYING UPPER EXTREMITY PERFORMANCE WITH AND WITHOUT ASSISTANCE OF A SOFT-ROBOTIC GLOVE IN ELDERLY PATIENTS: A KINEMATIC ANALYSIS Anne VAN OMMEREN, MSc 1,2 *, Bob RADDER, MSc 1,2 *, Anke KOTTINK, PhD 1,3 , Jaap BUURKE, PhD, PT PRANGE-LASONDER, PhD 1,2 and Johan RIETMAN, PhD, MD 1,2 From the 1 Roessingh Research and Development, 2 Department of Biomechanical Engineering, and 3 Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands *These authors contributed equally to this article. Objective: To explore the direct influence of a soft- robotic glove on movement duration and movement execution in elderly people with decreased hand func­tion during a reach-and-grasp task. Design: Cross-sectional study. Patients: Eight subjects, aged 55+ years, with de- creased hand function. Methods: The direct effect of the glove was explored using kinematic analysis during a reach-and-grasp task with a light (100 g) and heavy (1,000/2,500 g) cylindrical object, performed with and without the soft-robotic glove. Results: There was no difference in total movement time between performance with and without the glo- ve. With the glove, the relative time needed to trans- port the heavy object was shorter, while the relative time needed to grasp the heavy object was longer. In addition, transporting light objects involved a lo- wer peak velocity and larger elbow extension, and grasping the object involved a larger hand opening compared with without glove. Conclusion: As expected, no positive influence of the soft-robotic glove was found on total movement du- ration in elderly subjects. The influence of the glove on movement execution varied with movement pha- se. The positive and negative effects found may be due to a perceived confidence while carrying hea- vy objects with the glove, or compensation for loss of sensation, respectively. This information can be used to improve the glove design. Key words: soft-robotic glove; assistive technology; elderly; hand; movement analysis; wearable devices; activities of daily living; upper extremity. Accepted Feb 4, 2019; Epub ahead of print Feb 15, 2019 J Rehabil Med 2019; 51: 298–306 Correspondence address: Anne van Ommeren, Roessingh Research and Development, Roessinghsbleekweg 33b, PO Box 310, NL-7500 AH Enschede, The Netherlands. E-mail: [email protected] T , Gerdienke 1,3 he function of the ageing hand decreases as result of loss of muscle mass (i.e. sarcopaenia) (1), rheumatoid arthritis or age-related diseases (2, 3). Symptoms of a decrease in hand function in the elderly population often include loss of grip/pinch strength, joint stiffness, decreased range of motion and LAY ABSTRACT The function of the ageing hand decreases as result of loss of muscle mass or age-related diseases, such as osteoarthritis or rheumatoid arthritis. This loss of func­ tion results in limitations in performing activities of dai- ly living, such as carrying heavy objects, drinking and eating. A wearable soft-robot glove (the ironHand) has been developed to support grip strength during daily life. This study assessed the effect of the ironHand on movement execution in 8 elderly people with decreased hand function due to age-related diseases. The influence of the glove on movement execution in elderly subjects varied with movement phase. Grasping of a heavy ob- ject took relatively longer, while its transport phase was relatively shorter, with the glove, compared with without the glove. These results provide insight into how a soft- robotic glove influences movement, both in a positive and a negative sense. This information could be used to improve the design of wearable robots for the hand. increased fatigue or pain (4–7). This loss of function results in limitations in performing activities of daily living (ADL), such as carrying heavy objects (4, 8, 9). An effective approach to improving hand function in daily life is exercise training. Exercise training for older adults with reduced hand strength should consist of components that contain progressive resistance and functional exercise (10). Another approach to impro- ving functional independence is the use of assistive devices (11), especially when exercise treatment does not solve all physical problems and people are left with, or experience, diminished hand function. These assistive devices are available in different shapes and sizes, ranging from simple aids (e.g. a jar opener) that support a specific task, to technological innovations that allow more functionality in daily life. Most of these robotic assistive devices consist of complex, bulky and expensive equipment, while often substituting upper limb movement of the user by robotic action (12). Wearable assistive devices are focused less on substituting the user and more on assisting use of the hand, where needed, during ADL. An example is the soft-robotic ironHand glove, developed to support grip strength during ADL (13). The soft-robotic ironHand glove has been evaluated regarding feasibility (in terms This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm doi: 10.2340/16501977-2535 Journal Compilation © 2019 Foundation of Rehabilitation Information. ISSN 1650-1977