A Helping Hand : On Innovations for Rehabilitation and Assistive Technology

• Main Author: Nilsson, Mats
• Format: Doctoral Thesis
• Language: English
• Published: KTH, Neuronik (Stängd 20130701) 2013
• Subjects: Hand function; Mechatronic system; Orthose; Neurological rehabilitation; Brain-Computer Interface; Functional Electric Stimulation
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-120142; http://nbn-resolving.de/urn:isbn:978-91-7501-703-7

This thesis focuses on assistive and rehabilitation technology for restoring the function of the hand. It presents three different approaches to assistive technology: one in the form of an orthosis, one in the form of a brain-computer interface combined with functional electrical stimulation and finally one totally aiming at rehabilitating the nervous system by restoring brain function using the concept of neuroplasticity. The thesis also includes an epidemiological study based on statistics from the Swedish Hospital Discharge Register and a review on different methods for assessment of hand function. A novel invention of an orthosis in form of a light weight glove, the SEM (Soft Extra Muscle) glove, is introduced and described in detail. The SEM glove is constructed for improving the grasping capability of a human independently of the particular task being performed. A key feature is that a controlling and strengthening effect is achieved without the need for an external mechanical structure in the form of an exoskeleton. The glove is activated by input from tactile sensors in its fingertips and palm. The sensors react when the applied force is larger than 0.2 N and feed a microcontroller of DC motors. These pull lines, which are attached to the fingers of the glove and thus work as artificial tendons. A clinical study on the feasibility of the SEM glove to improve hand function on a group of patients with varying degree of disability has been made. Assessments included passive and active range of finger motion, flexor muscle strength according to the Medical Research Council (MRC) 0-5 scale, grip strength using the Grippit hand dynamometer, fine motor skills according to the Nine Hole Peg test and hand function in common activities by use of the Sollerman test. Participants rated the potential benefit on a Visual Analogue Scale. A prototype for a system for combining BCI (Brain-Computer Interface) and FES (Functional Electrical Stimulation) is described. The system is intended to be used during the first period of recovery from a TBI (Traumatic Brain Injury) or stroke that have led to paresis in the hand, before deciding on a permanent system, thus allowing the patients to get a quick start on the motor relearning. The system contains EEG recording electrodes, a control unit and a power unit. Initially the patients will practice controlling the movement of a robotic hand and then move on to controlling pulses being sent to stimulus electrodes placed on the paretic muscle. An innovative electrophysiological device for rehabilitation of brain lesions is presented, consisting of a portable headset with electrodes on both sides adapted on the localization of treatment area. The purpose is to receive the outgoing signal from the healthy side of the brain and transfer that signal to the injured and surrounding area of the remote side, thereby having the potential to facilitate the reactivation of the injured brain tissue. The device consists of a control unit as well as a power unit to activate the circuit electronics for amplifying, filtering, AD-converting, multiplexing and switching the outgoing electric signals to the most optimal ingoing signal for treatment of the injured and surrounding area. === <p>QC 20130403</p>