Proposal for Hemiplegic Thumb Rehabilitation Device Based on Repetitive Facilitation Exercise
Abstract
1. Introduction
2. Analysis of Manual RFE for Thumbs
2.1. Principle of RFE
2.2. Movement of Thumb
2.3. Manual RFE for Thumb Flexion/Extension
- The therapist passively flexes the hemiplegic thumb;
- The therapist finishes the passive flexion at the maximal flexion position to induce the stretch reflex of the extensor muscle. Thus, the extensor muscles become under muscle tone;
- The therapist gives a signal and taps the MP joint to induce a stretch reflex, facilitating active extension;
- The therapist continues to give slight resistance force against the active extension of the thumb to maintain the tension of the extensor muscle;
- The therapist repeats the above procedure 100 times.
2.4. Manual RFE for Thumb Palmar Adduction/Abduction
- The therapist passively performs palmar adduction on the hemiplegic thumb;
- The therapist finishes the passive palmar adduction at the maximal adduction position to induce the stretch reflex of the palmar abduction muscle; thus, the abductor muscles become under muscle tone;
- The therapist signals and taps the thenar to induce a stretch reflex, enabling active palmar abduction by the patient;
- The therapist continues to give a slight resistance force against the active palmar abduction of the thumb to maintain the tension of the abductor muscle.
- The therapist repeats the above procedure 100 times.
3. Proposed Rehabilitation Device for Hemiplegic Thumb
3.1. Device Specifications
- The device needs to induce stretch reflexes of a target muscle;
- The device needs to track the active motion facilitated by the stretch reflex; in addition, the tracking motion must force slight resistance;
- The device needs a high-sensitivity force sensing mechanism to measure the force of active motion;
- Patients can watch the target thumb;
- The device needs to support training for both the left and right hands with a single device;
- Patients need to be able to easily wear the device while ensuring safety;
- The device needs to be a single-link mechanism owing to low costs.
3.2. Proposed Device
3.3. Trajectory of Thumb
3.4. Driving Mechanism of Thumb Training
- The user places the palm vertically/horizontally on the table and aligns the rotary axis of the MP/CM joint with the rotary axis of the driving mechanism;
- The device bends the training thumb to its pre-measured maximum flexion/palmar adduction angle with the circular movement;
- After the training thumb finger reaches the maximum flexion/palmar adduction angle, the device performs extension/palmar abduction with the circular movement;
- The device performs extension/palmar abduction until the training thumb returns to its initial posture with the circular movement.
3.5. Thumb Operating Unit
3.6. The High-Sensitivity Force-Sensing Mechanism
4. Control Method
4.1. Training Method for Thumb Extension/Palmar Abduction Using Proposed Device
- The driving part of the fingertip of the device controls the flexion/palmar adduction of the thumb passively;
- The device accelerates flexion/palmar adduction before reaching the maximal position, increasing motion velocity from the first to the second speed (Figure 11);
- That acceleration facilitates the stretch reflex of the extensor muscle by supporting the MP joint/thumb root with RSF-Supporter at the same time as rapid passive flexion/adduction;
- Stretch reflex increases the excitement of the target nerve tract and facilitates voluntary active extension/palmar abduction. The device follows the active motion by measuring the intention of the active motion via the torque sensor. Moreover, the device performs extension/palmar abduction while giving slight resistance to that active motion before returning the initial posture so that the device provides kinesthesia and keeps the stretch reflex.
4.2. Proposal of Resistance-Accompanying Cooperation Control
4.3. Tuning Control for the Stretch Reflex Time Lag
5. Verification of the Proposed Device
5.1. Verification of Relations of Fingertip Velocity and EMG
5.2. Verification of Stretch Reflex Induction Using the Proposed Device
5.3. Verification of RACC Assistance
5.4. Verification Experiments of Thumb Extension/Palmar Abduction Training
6. Conclusions
7. Patents
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
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Taniguchi, K.; Tanda, Y.; Yu, Y. Proposal for Hemiplegic Thumb Rehabilitation Device Based on Repetitive Facilitation Exercise. Machines 2024, 12, 920. https://doi.org/10.3390/machines12120920
Taniguchi K, Tanda Y, Yu Y. Proposal for Hemiplegic Thumb Rehabilitation Device Based on Repetitive Facilitation Exercise. Machines. 2024; 12(12):920. https://doi.org/10.3390/machines12120920
Chicago/Turabian StyleTaniguchi, Koutaro, Yuta Tanda, and Yong Yu. 2024. "Proposal for Hemiplegic Thumb Rehabilitation Device Based on Repetitive Facilitation Exercise" Machines 12, no. 12: 920. https://doi.org/10.3390/machines12120920
APA StyleTaniguchi, K., Tanda, Y., & Yu, Y. (2024). Proposal for Hemiplegic Thumb Rehabilitation Device Based on Repetitive Facilitation Exercise. Machines, 12(12), 920. https://doi.org/10.3390/machines12120920