Search Results (33)

The flexible upper-limb exoskeleton robot (exosuit) is composed of fabrics, soft actuators and compliant force-transmitting structures, which provides assistance or rehabilitation training for the shoulders, elbows, wrists and hands. By realizing human–robot collaboration, this kind of system has the advantages of comfort, light weight and portability, thus promoting motor function recovery and neural plasticity. This review establishes a classification and comparison framework for flexible upper-limb exoskeletons based on the actuation modalities and systematically summarizes the research progress under different actuation modalities. The relevant literature published from 2015 to 2025 was retrieved from the EI, IEEE Xplore, PubMed and Web of Science databases. After screening according to the preset inclusion and exclusion criteria, a total of 64 original research papers meeting the criteria were finally included for analysis. According to the actuation modalities, the flexible upper-limb exoskeleton robot is classified, and all kinds of systems are summarized and compared. Motor–cable/tendon actuation and pneumatic/hydraulic actuation have advanced substantially and are approaching technical maturity for flexible upper-limb exoskeletons. Meanwhile, designs based on passive/hybrid mechanisms (e.g., elastic energy storage elements and clutches) and new intelligent material actuations are showing a diversified development trend. In the future, the development is expected to further focus on lightweight and compliance, and by integrating multimodal sensing and feedback control, motion intention recognition and human–robot interaction theories, actuation systems will be developed towards modularization, intelligence and high-power density, in order to achieve more comfortable, lighter and more effective flexible upper-limb exoskeleton systems. Full article

The translation of knowledge and methodologies across disciplines represents a valuable source of innovation, particularly in user-centered design approaches that have become essential in medical device development. This study explores the use of the PICO (Population, Intervention, Comparison, and Outcome) framework, a cornerstone of evidence-based medicine for formulating clinical questions, as a conceptual structure to support the alignment between clinical needs and engineering design consideration in robotic rehabilitation devices, with a focus on hand exoskeletons. Through a conceptual reinterpretation and application-oriented exploration supported by illustrative case studies involving both rigid and soft robotic glove prototypes, this study shows how each PICO component can inform engineering parameters, from defining user impairments and intervention strategies to benchmarking and outcome measurements. The analysis highlights the potential of PICO in fostering a user-centered design perspective and bridging clinical and engineering domains while also identifying its structural limitations when applied to device design contexts. This study concludes that while the PICO framework offers a valuable foundational structure, it requires customization to fully address the multifactorial requirements of effective, patient-specific robotic rehabilitation device design. Full article

Osteoarthritis (OA) is a progressive musculoskeletal disorder that affects not only older adults but also younger populations, often leading to chronic pain, joint stiffness, functional impairment, and a decline in quality of life. Non-invasive physical rehabilitation plays a critical role in slowing disease progression, alleviating symptoms, and maintaining joint mobility. However, rehabilitation tools such as compression gloves and manual exercise aids are typically passive and provide minimal real-time feedback to patients or clinicians. Others, such as exoskeletons and soft-actuated devices, can be costly or complex to use. This study presents the design and development of an electrically actuated glove integrated with force and flex sensors, intended to assist individuals diagnosed with Stage 2 OA in performing guided finger exercises. The system integrates a digital front-end application that offers real-time feedback and data visualization, enabling more personalized and trackable therapy sessions for both patients and healthcare providers. Preliminary results from an initial human trial with healthy participants demonstrate that the glove enables naturalistic movement without imposing excessive restriction or augmentation of motion. These findings support the glove’s potential in preserving hand coordination and dexterity, key objectives in early-stage OA intervention, and suggest its suitability for integration into home-based or clinical rehabilitation protocols. Full article

This study presents a soft exoskeleton system designed to enhance the safety of electrical maintenance personnel during tower climbing by augmenting the hand grip and providing fall prevention assistance. Inspired by biological principles, a compact, stroke-amplified, and fast-response actuator based on a spring energy storage–release mechanism was developed and evaluated through tensile and speed tests, demonstrating sufficient locking force and a fast response time of 37.5 ms. A dual-sensing module integrating pressure and flexible bending sensors was designed to detect grasping states in real time. System effectiveness was further validated through functional electrical stimulation (FES) and simulated climbing experiments. FES tests confirmed the system’s ability to maintain grasp posture under involuntary hand extension, while climbing experiments verified consistent and reliable transitions between locking and unlocking during movement. Although preliminary, these results suggest that integrating soft exoskeletons with rapid-response actuators offers a promising solution for improving grip stability and operational safety in high-risk vertical environments. Full article

Soft–rigid interfaces in exoskeletons are key to balancing flexibility and structural support, providing both comfort and function. In our experience, combining Bioflex material with a rigid filament improves mechanical properties while allowing the exoskeleton to adapt to complex hand movements. Flexible components provide adaptability, reducing pressure points and discomfort during prolonged use. At the same time, rigid components provide the stability and force transfer necessary to support weakened grip strength. A key challenge in this integration is achieving a smooth transition between materials to prevent stress concentrations that can lead to material failure. Techniques for providing adhesion and mechanical locking are essential to ensure the durability and longevity of soft and rigid interfaces. One issue we have observed is that rigid filaments can restrict movement if not strategically placed, potentially leading to unnatural hand movement. On the other hand, excessive softness can reduce the force output needed for effective rehabilitation or assistance. Optimizing the interface design requires iterative testing to find the perfect balance between flexibility and mechanical support. In some prototypes, material fatigue in soft sections led to early failure, requiring reinforced hybrid structures. Addressing these issues through better material bonding and geometric optimization can significantly improve the performance and comfort of hand exoskeletons. The aim of this study was to investigate the transition between rigid and soft materials for exoskeletons. Full article

Background: Cerebrovascular accident, commonly known as stroke, Parkinson’s disease, and multiple sclerosis represent significant neurological conditions affecting millions globally. Stroke remains the third leading cause of death worldwide and significantly impacts patients’ hand functionality, making hand rehabilitation crucial for improving quality of life. Methods: A comprehensive literature review was conducted analyzing over 300 papers, and categorizing them based on mechanical design, mobility, and actuation systems. To evaluate each device, a database with 45 distinct criteria was developed to systematically assess their characteristics. Results: The analysis revealed three main categories of devices: rigid exoskeletons, soft exoskeletons, and hybrid devices. Electric actuation represents the most common source of power. The dorsal placement of the mechanism is predominant, followed by glove-based, lateral, and palmar configurations. A correlation between mass and functionality was observed during the analysis; an increase in the number of actuated fingers or in functionality automatically increases the mass of the device. The research shows significant technological evolution with considerable variation in design complexity, with 29.4% of devices using five or more actuators while 24.8% employ one or two actuators. Conclusions: While substantial progress has been made in recent years, several challenges persist, including missing information or incomplete data from source papers and a limited number of clinical studies to evaluate device effectiveness. Significant opportunities remain to improve device functionality, usability, and therapeutic effectiveness, as well as to implement advanced power systems for portable devices. Full article

Background/Objectives: Spasticity commonly occurs in individuals after experiencing a stroke, impairing their hand function and limiting activities of daily living (ADLs). In this paper, we introduce an exoskeletal aid, combined with a set of augmented reality (AR) games consisting of the Rehabotics rehabilitation solution, designed for individuals with upper limb spasticity following stroke. Methods: Our study, involving 60 post-stroke patients (mean ± SD age: 70.97  ±  4.89 years), demonstrates significant improvements in Ashworth Scale (AS) scores and Box and Block test (BBT) scores when the Rehabotics solution is employed. Results: The intervention group showed slightly greater improvement compared to the control group in terms of the AS (−0.23, with a confidence interval of −0.53 to 0.07) and BBT (1.67, with a confidence interval of 1.18 to 2.16). Additionally, the Rehabotics solution was particularly effective for patients with more severe deficits. Patients with an AS score of 3 showed more substantial improvements, with their AS scores increasing by −1.17 ± 0.39 and BBT scores increasing by −4.83 ± 0.72. Conclusions: These findings underscore the potential of wearable hand robotics in enhancing stroke survivors’ hand rehabilitation, emphasizing the need for further investigations into its broader applications. Full article

The widespread application of exoskeletons driven by soft actuators in motion assistance and medical rehabilitation has proven effective for patients who struggle with precise object grasping and suffer from insufficient hand strength due to strokes or other conditions. Repetitive passive flexion/extension exercises and active grasp training are known to aid in the restoration of motor nerve function. However, conventional pneumatic artificial muscles (PAMs) used for hand rehabilitation typically allow for bending in only one direction, thereby limiting multi-degree-of-freedom movements. Moreover, establishing precise models for PAMs is challenging, making accurate control difficult to achieve. To address these challenges, we explored the design and fabrication of a bidirectionally bending PAM. The design parameters were optimized based on actual rehabilitation needs and a finite element analysis. Additionally, a dynamic model for the PAM was established using elastic strain energy and the Lagrange equation. Building on this, an adaptive position control method employing a radial basis function neural network, optimized for parameters and hidden layer nodes, was developed to enhance the accuracy of these soft PAMs in assisting patients with hand grasping. Finally, a wearable soft hand rehabilitation exoskeleton was designed, offering two modes, passive training and active grasp, aimed at helping patients regain their grasp ability. Full article

Robotic exoskeletons are being actively applied to support the activities of daily living (ADL) for patients with hand motion impairments. In terms of actuation, soft materials and sensors have opened new alternatives to conventional rigid body structures. In this arena, biomimetic soft systems play an important role in modeling and controlling human hand kinematics without the restrictions of rigid mechanical joints while having an entirely deformable body with limitless points of actuation. In this paper, we address the computational limitations of modeling large-scale articulated systems for soft robotic exoskeletons by integrating a parallel algorithm to compute the exoskeleton’s dynamics equations of motion (EoM), achieving a computation with $O\left(lo{g}_{2}n\right)$ complexity for the highly articulated n degrees of freedom (DoF) running on p processing cores. The proposed parallel algorithm achieves an exponential speedup for $n=p=64$ DoF while achieving a $0.96$ degree of parallelism for $n=p=256$, which demonstrates the required scalability for controlling highly articulated soft exoskeletons in real time. However, scalability will be bounded by the $n=p$ fraction. Full article

Soft pneumatic actuators/robotics have received significant interest in the medical and health fields, due to their intrinsic elasticity and simple control strategies for enabling desired interactions. However, current soft hand pneumatic exoskeletons often exhibit uniform deformation, mismatch the profile of the interacting objects, and seldom quantify the assistive effects during activities of daily life (ADL), such as extension angle and predicted joint stiffness. The lack of quantification poses challenges to the effective and sustainable advancement of rehabilitation technology. This paper introduces the design, modeling, and testing of pneumatic bioinspired segmented composite proprioceptive bending actuators (SCPBAs) for hand rehabilitation in ADL tasks. Inspired by human finger anatomy, the actuator’s soft-joint–rigid-bone segmented structure provides a superior fit compared to continuous structures in traditional fiber-reinforced actuators (FRAs). A quasi-static model is established to predict the bending angles based on geometric parameters. Quantitative evaluations of predicted joint stiffness and extension angle utilizing proprioceptive bending are performed. Additionally, a soft under-actuated hand exoskeleton equipped with SCPBAs demonstrates their potential in ADL rehabilitation scenarios. Full article

Exoskeletons are being explored for assisting motion therapy for neurological impairment-related rehabilitation. Soft robotic exoskeletons are gaining more attention for upper-extremity applications due to their simplistic actuation mechanisms and compliant nature. To regain fine motor hand functions, it is desired to have both hand and wrist motions in a coordinated fashion, as most daily living tasks require a combination of both hand and wrist joint motions. However, a soft robotic exoskeleton with hand and wrist motion together is an underdeveloped area. This paper presents a pneumatically actuated soft robotic exoskeleton designed to provide coordinated assistive motion to the hand and wrist joints using PD-based feedback control. The results showed the potential of the exoskeleton to provide flexion/extension rehabilitation exercises and task-oriented rehabilitation practices. Additionally, the results have confirmed that the implemented PD control ensures that the exoskeleton reaches the targeted angular trajectories and velocities. Two modes, full and partial assistance, were successfully tested to verify the ability of the exoskeleton to accommodate varying levels of impairment. Full article

Upper limb functionality is essential to perform activities of daily living. It is critical to investigate neurorehabilitation therapies in order to improve upper limb functionality in post-stroke patients. This paper presents a soft-robotic bilateral system to provide rehabilitation therapy for hand and wrist joints. A sensorized glove that tracks finger and wrist joint movements is worn on the healthy limb, which guides the movement of the paretic limb. The input of sensors from the healthy limb is provided to the soft robotic exoskeleton attached to the paretic limb to mimic the motion. A proportional derivative flow-based control algorithm is used to perform bilateral therapy. To test the feasibility of the developed system, two different applications are performed experimentally: (1) Wrist exercise with a dumbbell, and (2) Object pick-and-place task. The initial tests of the developed system verified its capability to perform bilateral therapy. Full article

Hand exoskeletons are potential solutions for enhancing upper extremity function after stroke, yet achieving intuitive control remains challenging. We recently showed that isometric grip force tracking is preserved after stroke, providing a possible control source for a hand exoskeleton. In this study, we developed a hand exoskeleton with a soft compliant mechanism and novel force control strategy that leverages isometric grip force control of digits 3–5 to control an index–thumb pinch grip. We first present characterization of the compliant mechanisms output impedance (34.77 N/m), and output force (2.3 ± 0.57 N). We then present results of a study that assessed the intuitiveness of the strategy during a grip–lift–move task in ten unimpaired individuals. From four unimpaired individuals we also gathered user preferences on force sensitivity and operating mode, where in one mode flexion force from digits 3–5 caused index finger closing, while in the other mode it caused index finger opening. The strategy proved intuitive, improving movement frequency on the grip–lift–move task by 30%. Users preferred greater force sensitivity and using flexion force from digits 3–5 to drive index finger extension. The force control strategy incorporated into the exoskeleton shows promise warranting further investigation in neurologically impaired participants. Full article

Stroke, the third leading cause of global disability, poses significant challenges to healthcare systems worldwide. Addressing the restoration of impaired hand functions is crucial, especially amid healthcare workforce shortages. While robotic-assisted therapy shows promise, cost and healthcare community concerns hinder the adoption of hand exoskeletons. However, recent advancements in soft robotics and digital fabrication, particularly 3D printing, have sparked renewed interest in this area. This review article offers a thorough exploration of the current landscape of soft hand exoskeletons, emphasizing recent advancements and alternative designs. It surveys previous reviews in the field and examines relevant aspects of hand anatomy pertinent to wearable rehabilitation devices. Furthermore, the article investigates the design requirements for soft hand exoskeletons and provides a detailed review of various soft exoskeleton gloves, categorized based on their design principles. The discussion encompasses simulation-supported methods, affordability considerations, and future research directions. This review aims to benefit researchers, clinicians, and stakeholders by disseminating the latest advances in soft hand exoskeleton technology, ultimately enhancing stroke rehabilitation outcomes and patient care. Full article

Manual handling tasks, both in daily activities and at work, require high dexterity and the ability to move objects of different shapes and sizes. However, musculoskeletal disorders that can arise due to aging, disabilities, overloading, or strenuous work can impact the natural capabilities of the hand with serious repercussions both in working and daily activities. To address this, researchers have been developing and proving the benefits of wrist exoskeletons. This paper, which is Part II of a study on wrist exoskeletons, presents and summarizes wearable wrist exoskeleton devices intended for use in rehabilitation, assistance, and occupational fields. Exoskeletons considered within the study are those available either in a prototyping phase or on the market. These devices can support the human wrist by relieving pain or mitigating fatigue while allowing for at least one movement. Most of them have been designed to be active (80%) for higher force/torque transmission, and soft for better kinematic compliance, ergonomics, and safety (13 devices out of 24, more than 50%). Electric motors and cable transmission (respectively 11 and 9 devices, out of 24, i.e., almost 50% and 40%) are the most common due to their simplicity, controllability, safety, power-to-weight ratio, and the possibility of remote actuation. As sensing technologies, position and force sensors are widely used in all devices (almost 90%). The control strategy depends mainly on the application domain: for rehabilitation, CPM (control passive motion) is preferred (35% of devices), while for assistance and occupational purposes, AAN (assistance-as-needed) is more suitable (38% of the devices). What emerges from this analysis is that, while rehabilitation and training are fields in which exoskeletons have grown more easily and gained some user acceptance (almost 18 devices, of which 4 are available on the market), relatively few devices have been designed for occupational purposes (5, with only 2 available on the market) due to difficulties in meeting the acceptance and needs of users. In this perspective, as a result of the state-of-the-art analysis, the authors propose a conceptual idea for a portable soft wrist exoskeleton for occupational assistance. Full article