Search results for: hand spasticity

Authors: Mohamed A. Eid, Sobhy M. Aly

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Background: About 75% of children with spastic hemiplegic cerebral palsy walk independently, but most still show abnormal gait patterns because of contractures across the joints and muscle spasticity. Objective: The purpose of this study was to investigate and compare the effects of extracorporeal shock wave therapy (ESWT) versus functional electrical stimulation (FES) on spasticity, function, and gait parameters in children with hemiplegic cerebral palsy (CP). Methods: A randomized controlled trail was conducted for 45 children with hemiplegic CP ranging in age from 6 to 9 years. They were assigned randomly using opaque envelopes into three groups. Physical Therapy (PT) group consisted of 15 children and received the conventional physical therapy program (CPTP) in addition to ankle foot orthosis (AFO). ESWT group consisted of 15 children and received the CPTP, AFO in addition to ESWT. FES group also consisted of 15 children and received the CPTP, AFO in addition to FES. All groups received the program of treatment 3 days/week for 12 weeks. Evaluation of spasticity by using the Modified Ashworth Scale (MAS), function by using the Pediatric Evaluation Disability Inventory (PEDI) and gait parameters by using the 3-D gait analysis was conducted at baseline and after 12 weeks of the treatment program. Results: Within groups, significant improvements in spasticity, function, and gait (P = 0.05) were observed in both ESWT and FES groups after treatment. While between groups, ESWT group showed significant improvements in all measured variables compared with FES and PT groups (P ˂ 0.05) after treatment. Conclusion: ESWT induced significant improvement than FES in decreasing spasticity and improving function and gait in children with hemiplegic CP. Therefore, ESWT should be included as an adjunctive therapy in the rehabilitation program of these children.

Keywords: cerebral palsy, extracorporeal shock wave therapy, functional electrical stimulation, function, gait, spasticity

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Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

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Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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Authors: M. A. Riurean, S. Heijnen, C. A. Knott, J. Makinde, D. Gotti, J. VD. Kamp

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Objectives: The current study is done in preparation for a randomized controlled study investigating the effects of an implicit motor learning protocol implemented using an extension-supporting glove. It will explore different protocols to find out which is preferred when studying motor learn-ing in the chronic stroke population that struggles with hand spasticity. Design: This exploratory study will follow 24 individuals who have a chronic stroke (> 6 months) during their usual care journey. We will record the results of two 9-Hole Peg Tests (9HPT) done during their therapy ses-sions with a physiotherapist or in their home before and after 4 weeks of them wearing an exten-sion-supporting glove used to employ the to-be-studied protocols. The participants will wear the glove 3 times/week for one hour while performing their activities of daily living and record the times they wore it in a diary. Their experience will be monitored through telecommunication once every week. Subjects: Individuals that have had a stroke at least 6 months prior to participation, hand spasticity measured on the modified Ashworth Scale of maximum 3, and finger flexion motor control measured on the Motricity Index of at least 19/33. Exclusion criteria: extreme hemi-neglect. Methods: The participants will be randomly divided into 3 groups: one group using the glove in a pre-set way of decreasing support (implicit motor learning), one group using the glove in a self-controlled way of decreasing support (autonomous motor learning), and the third using the glove with constant support (as control). Before and after the 4-week period, there will be an intake session and a post-assessment session. Analysis: We will compare the results of the two 9HPTs to check whether the protocols were effective. Furthermore, we will compare the results between the three groups to find the preferred one. A qualitative analysis will be run of the experience of participants throughout the 4-week period. Expected results: We expect that the group using the implicit learning protocol will show superior results.

Keywords: implicit learning, hand spasticity, stroke, error minimization, motor task

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Authors: Engi E. I. Sarhan, Usama M. Rashad, Ibrahim M. I. Hamoda, Mohammed K. Mohamed

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Background: This study aimed to know the effect of nitrogen-based cryotherapy on the spasticity of calf muscle in stroke patients. Patients were selected from the outpatient clinic of Neurology, Al-Mansoura general hospital, Al-Mansoura University. Subjects and methods: Thirty Stroke Patients of both sexes ranged from 45 to 60 years old were divided randomly into two equal groups, a study group (A) received a nitrogen-based cryotherapy, a selective physical therapy program and ankle foot orthosis (AFO), while as patients in control group (B) received the same program and AFO only. The treatment duration was three times per week for four weeks for both groups. We assessed spasticity of calf muscle before and after treatment subjectively using modified Ashworth scale (MAS) and objectively via measuring H / M ratio on electromyography machine. We also assessed ankle dorsiflexion ROM objectively using two dimensions motion analysis (2D). Results: After treatment, there was a highly significant improvement in the study group compared to the control group regarding the score of MAS, no significant difference in the study group compared to the control group regarding the readings of H / M ratio, highly significant improvement in the study group compared to the control group regarding the 2D motion analysis findings. Conclusion: This modality considers effective in reducing spasticity in the calf muscle and improving ankle dorsiflexion of the affected limb.

Keywords: ankle foot orthosis, nitrogen-based cryotherapy, stroke, spasticity

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Authors: Hilal Keklicek, Baris Cetin, Yeliz Salci, Ayla Fil, Umut Altinkaynak, Kadriye Armutlu

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Objectives and Goals: Spasticity is a common symptom characterized with a velocity dependent increase in tonic stretch reflexes (muscle tone) in patient with multiple sclerosis (MS). Hypertonic muscles affect the normal plantigrade contact by disturbing accommodation of foot to the ground while walking. It is important to know the differences between healthy and neurologic foot features for management of spasticity related deformities and/or determination of rehabilitation purposes and contents. This study was planned with the aim of investigating the dynamic plantar pressure distribution in individuals with MS and determining the differences between healthy individuals (HI). Methods: Fifty-five individuals with MS (108 foot with spasticity according to Modified Ashworth Scale) and 20 HI (40 foot) were the participants of the study. The dynamic pedobarograph was utilized for evaluation of dynamic loading parameters. Participants were informed to walk at their self-selected speed for seven times to eliminate learning effect. The parameters were divided into 2 categories including; maximum loading pressure (N/cm2) and time of maximum pressure (ms) were collected from heal medial, heal lateral, mid foot, heads of first, second, third, fourth and fifth metatarsal bones. Results: There were differences between the groups in maximum loading pressure of heal medial (p < .001), heal lateral (p < .001), midfoot (p=.041) and 5th metatarsal areas (p=.036). Also, there were differences between the groups the time of maximum pressure of all metatarsal areas, midfoot, heal medial and heal lateral (p < .001) in favor of HI. Conclusions: The study provided basic data about foot pressure distribution in individuals with MS. Results of the study primarily showed that spasticity of lower extremity muscle disrupted the posteromedial foot loading. Secondarily, according to the study result, spasticity lead to inappropriate timing during load transfer from hind foot to forefoot.

Keywords: multiple sclerosis, plantar pressure distribution, gait, norm values

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Authors: Amanda Cristina da Silva Reis, Bruno Paulino Venâncio, Cristina Theada Ferreira, Andrea Fialho do Prado, Lucimara Guedes dos Santos, Aline de Souza Gravatá, Larissa Lima Gonçalves, Isabella Aparecida Ferreira Moretto, João Carlos Ferrari Corrêa, Fernanda Ishida Corrêa

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Objective: To compare two protocols of Transcranial Magnetic Stimulation (TMS) on quadriceps muscle spasticity in individuals diagnosed with Multiple Sclerosis (MS). Method: Clinical, crossover study, in which six adult individuals diagnosed with MS and spasticity in the lower limbs were randomized to receive one session of high-frequency (≥5Hz) and low-frequency (≤ 1Hz) TMS on motor cortex (M1) hotspot for quadriceps muscle, with a one-week interval between the sessions. To assess the spasticity was applied the Ashworth scale and were analyzed the latency time (ms) of the motor evoked potential (MEP) and the central motor conduction time (CMCT) of the bilateral quadriceps muscle. Assessments were performed before and after each intervention. The difference between groups was analyzed using the Friedman test, with a significance level of 0.05 adopted. Results: All statistical analyzes were performed using the SPSS Statistic version 26 programs, with a significance level established for the analyzes at p<0.05. Shapiro Wilk normality test. Parametric data were represented as mean and standard deviation for non-parametric variables, median and interquartile range, and frequency and percentage for categorical variables. There was no clinical change in quadriceps spasticity assessed using the Ashworth scale for the 1 Hz (p=0.813) and 5 Hz (p= 0.232) protocols for both limbs. Motor Evoked Potential latency time: in the 5hz protocol, there was no significant change for the contralateral side from pre to post-treatment (p>0.05), and for the ipsilateral side, there was a decrease in latency time of 0.07 seconds (p<0.05 ); for the 1Hz protocol there was an increase of 0.04 seconds in the latency time (p<0.05) for the contralateral side to the stimulus, and for the ipsilateral side there was a decrease in the latency time of 0.04 seconds (p=<0.05), with a significant difference between the contralateral (p=0.007) and ipsilateral (p=0.014) groups. Central motor conduction time in the 1Hz protocol, there was no change for the contralateral side (p>0.05) and for the ipsilateral side (p>0.05). In the 5Hz protocol for the contralateral side, there was a small decrease in latency time (p<0.05) and for the ipsilateral side, there was a decrease of 0.6 seconds in the latency time (p<0.05) with a significant difference between groups (p=0.019). Conclusion: A high or low-frequency session does not change spasticity, but it is observed that when the low-frequency protocol was performed, there was an increase in latency time on the stimulated side, and a decrease in latency time on the non-stimulated side, considering then that inhibiting the motor cortex increases cortical excitability on the opposite side.

Keywords: multiple sclerosis, spasticity, motor evoked potential, transcranial magnetic stimulation

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini, Omid Seyed Esmaeili, Rouzbeh Kezemi, Noushin Mehrbod, Nazanin Vahed, Tahereh Hajiahmad, Noureddin Nakhostin Ansari

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Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of VR beside conventional rehabilitation versus conventional rehabilitation alone on spasticity and motor function in stroke patients. Materials and Methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran, in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were modified Ashworth scale, recovery stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in the combination group (P=0.003). Only wrist extension was varied between groups and was better in the combination group. The variables generally had a statistically significant difference (P < 0.05). Conclusion: Virtual reality plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: stroke, virtual therapy, rehabilitation, treatment

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Authors: Mohd Noah A. Rahman, Afzaal H. Seyal, Norhafilah Bara

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Developing a software application using an interface with computers and peripheral devices using gestures of human body such as hand movements keeps growing in interest. A review on this hand gesture detection and recognition based on computer vision technique remains a very challenging task. This is to provide more natural, innovative and sophisticated way of non-verbal communication, such as sign language, in human computer interaction. Nevertheless, this paper explores hand detection and hand gesture recognition applying a vision based approach. The hand detection and recognition used skin color spaces such as HSV and YCrCb are applied. However, there are limitations that are needed to be considered. Almost all of skin color space models are sensitive to quickly changing or mixed lighting circumstances. There are certain restrictions in order for the hand recognition to give better results such as the distance of user’s hand to the webcam and the posture and size of the hand.

Keywords: hand detection, hand gesture, hand recognition, sign language

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Authors: Y. Y. Pang, N. A. Ismail

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The map is a powerful and convenient tool in helping us to navigate to different places, but the use of indirect devices often makes its usage cumbersome. This study intends to propose a new map navigation dialogue that uses hand gesture. A set of dialogue was developed from users’ perspective to provide users complete freedom for panning, zooming, rotate, and find direction operations. A participatory design experiment was involved here where one hand gesture and two hand gesture dialogues had been analysed in the forms of hand gestures to develop a set of usable dialogues. The major finding was that users prefer one-hand gesture compared to two-hand gesture in map navigation.

Keywords: hand gesture, map navigation, participatory design, intuitive interaction

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Authors: Cecilia Amponsem-Boateng, Timothy B. Oppong, Haiyan Yang, Guangcai Duan

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The human palm has been identified as one of the richest habitats for human microbial accommodation making hand hygiene essential to primary prevention of infection. Since the hand is in constant contact with fomites which have been proven to be mostly contaminated, building hand hygiene habits is essential for the prevention of infection. This research was conducted to assess the hand hygiene habits of Ghanaian youths in Accra. This study used a survey as a quantitative method of research. The findings of the study revealed that out of the 254 participants who fully answered the questionnaire, 22% had the habit of washing their hands after outings while only 51.6% had the habit of washing their hands after using the bathroom. However, about 60% of the participants said they sometimes ate with their hands while 28.9% had the habit of eating with the hand very often, a situation that put them at risk of infection from their hands since some participants had poor handwashing habits; prompting the need for continuous education on hand hygiene.

Keywords: hand hygiene, hand hygiene habit, hand washing, hand sanitizer use

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Authors: M. Jebali, M. Jemni

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This work is the part of vision based hand gesture recognition system for Natural Human Computer Interface. Hand tracking and segmentation are the primary steps for any hand gesture recognition system. The aim of this paper is to develop robust and efficient hand segmentation algorithm such as an input to another system which attempt to bring the HCI performance nearby the human-human interaction, by modeling an intelligent sign language recognition system based on prediction in the context of dialogue between the system (avatar) and the interlocutor. For the purpose of hand segmentation, an overcoming occlusion approach has been proposed for superior results for detection of hand from an image.

Keywords: HCI, sign language recognition, object tracking, hand segmentation

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Authors: Justin Lee, Siraj Shaikh, Alice Chu MD

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Children with cerebral palsy (CP) commonly present with upper extremity impairment, affecting one or both extremities, and are classified using the Manual Ability Classification Scale (MACS). The MACS defines bimanual hand abilities for children ages 4-18 years in everyday tasks and is a gradient scale, with I being nearly normal and V requiring total assistance. Children with more severe upper extremity impairment (MACS III-V) are often underrepresented, and relatively few effective therapies have been identified for these patients. Current orthoses are static and are only meant to prevent the progression of contractures in these patients. Other limitations include cost, comfort, accessibility, and longevity of the orthoses. Taking advantage of advances in 3D printing technology, we have created a highly customizable upper extremity orthotic that can be produced at a low cost. Iterations in our design have resulted in an orthotic that is custom fit to the patient based on scans of their arm, made of rigid polymer when needed to provide support, flexible material where appropriate to allow for comfort, and designed with a mechanical pulley system to allow for some functional use of the arm while in the orthotic. Preliminary data has shown that our orthotic can be built at a fraction of the cost of current orthoses and provide clinically significant improvement in assisting hand assessment (AHA) and pediatric quality of life scores (PedsQL).

Keywords: upper extremity orthosis, upper extremity, orthosis, 3-D printing, cerebral palsy, occupational therapy, spasticity, customizable

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Authors: Noor Ayuni Che Zakaria, Takashi Komeda, Cheng Yee Low, Kaoru Inoue, Fazah Akhtar Hanapiah

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Previous studies have shown that there are arguments regarding the reliability and validity of the Ashworth and Modified Ashworth Scale towards evaluating patients diagnosed with upper limb disorders. These evaluations depended on the raters’ experiences. This initiated us to develop an upper limb disorder part-task trainer that is able to simulate consistent upper limb disorders, such as spasticity and rigidity signs, based on the Modified Ashworth Scale to improve the variability occurring between raters and intra-raters themselves. By providing consistent signs, novice therapists would be able to increase training frequency and exposure towards various levels of signs. A total of 22 physiotherapists and occupational therapists participated in the study. The majority of the therapists agreed that with current therapy education, they still face problems with inter-raters and intra-raters variability (strongly agree 54%; n = 12/22, agree 27%; n = 6/22) in evaluating patients’ conditions. The therapists strongly agreed (72%; n = 16/22) that therapy trainees needed to increase their frequency of training; therefore believe that our initiative to develop an upper limb disorder training tool will help in improving the clinical education field (strongly agree and agree 63%; n = 14/22).

Keywords: upper limb disorder, clinical education tool, inter/intra-raters variability, spasticity, modified Ashworth scale

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Authors: Sung-Wook Shin, Sung-Taek Chung

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Hand grip strength has been utilized as an indicator to evaluate the motor ability of hands, responsible for performing multiple body functions. It is, however, difficult to evaluate other factors (other than hand muscular strength) utilizing the hand grip strength only. In this study, we analyzed the motor ability of hands using EMG and the hand grip strength, simultaneously in order to evaluate concentration, muscular strength reaction time, instantaneous muscular strength change, and agility in response to visual reaction. In results, the average time (and their standard deviations) of muscular strength reaction EMG signal and hand grip strength was found to be 209.6 ± 56.2 ms and 354.3 ± 54.6 ms, respectively. In addition, the onset time which represents acceleration time to reach 90% of maximum hand grip strength, was 382.9 ± 129.9 ms.

Keywords: hand grip strength, EMG, visual reaction, endurance

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Authors: Keyi Wang

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Similar to the touchscreen, hand gesture based human-computer interaction (HCI) is a technology that could allow people to perform a variety of tasks faster and more conveniently. This paper proposes a training method of an image-based hand gesture image and video clip recognition system using a CNN (Convolutional Neural Network) with a dataset. A dataset containing 6 hand gesture images is used to train a 2D CNN model. ~98% accuracy is achieved. Furthermore, a 3D CNN model is trained on a dataset containing 4 hand gesture video clips resulting in ~83% accuracy. It is demonstrated that a Cozmo robot loaded with pre-trained models is able to recognize static and dynamic hand gestures.

Keywords: deep learning, hand gesture recognition, computer vision, image processing

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Authors: Tamara Grujic, Mirjana Bonkovic

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Measurements and quantitative analysis of kinematic parameters of human hand movements have an important role in different areas such as hand function rehabilitation, modeling of multi-digits robotic hands, and the development of machine-man interfaces. In this paper the assessment and evaluation of the reach-to-grasp movement by using computerized and robot-assisted method is described. Experiment involved the measurements of hand positions of seven healthy subjects during grasping three objects of different shapes and sizes. Results showed that three dominant phases of reach-to-grasp movements could be clearly identified.

Keywords: human hand, kinematics, measurement and analysis, reach-to-grasp movement

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Authors: Mogeeb A. El-Sheikh

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The study has developed the previous design of an artificial anthropomorphic humanoid hand and accustomed it as a prosthetic hand. The main specifications of this design are determined. The development of our previous design involves the main artificial hand’s parts and subassemblies, palm, fingers, and thumb. In addition, the study presents an adaptable socket design for a transradial amputee. This hand has 3 fingers and thumb. It is more reliable, cosmetics, modularity, and ease of assembly. Its size and weight are almost as a natural hand. The socket cavity has the capability for different sizes of a transradial amputee. The study implements the developed design by using rapid prototype and specifies its main specifications by using a data glove and finite element method.

Keywords: adaptable socket, prosthetic hand, transradial amputee, data glove

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Authors: Reut Lanyado, David Mendlovic

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Most biological methods for authentication require special equipment and, some of them are easy to fake. We proposed a method for authentication based on hand movement while typing a sentence with a regular camera. This technique uses the full video of the hand, which is harder to fake. In the first phase, we tracked the hand joints in each frame. Next, we represented a single frame for each individual using our Pose Agnostic Rotation and Movement (PARM) dimensional space. Then, we indicated a full video of hand movement in a fixed low dimensional space using this method: Fixed Dimension Video by Interpolation Statistics (FDVIS). Finally, we identified each individual in the FDVIS representation using unsupervised clustering and supervised methods. Accuracy exceeds 96% for 80 individuals by using supervised KNN.

Keywords: authentication, feature extraction, hand recognition, security, signal processing

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Authors: Samar Mousa, Rebecca Shirley

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Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

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Authors: Idahosa Osagie Ojo

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The paper analyses the right hand in indigenous African economic thought using the Benin people of Southern Nigeria as a case study. The Benin people esteemed handiwork and industriousness and embodied it with the right hand, which was regarded as the ultimate bringer of material wellbeing and societal status. The paper aims to contribute to African economic thought by analysing the conception of the hand in pre-colonial Benin society as the source of material wherewithal and to reveal how the hand was epitomised as the ultimate purveyor of economic providence and class status. The study adopts the historical method, and the interpretive design was used. Primary and secondary sources were utilised, and the findings confirm that the conception of the hand as the giver of material wellbeing was calculatingly done to recompense an industrious and productive lifestyle worthy of accolades and emulations. Findings also show that the people of Benin thought that the right hand is the ultimate bringer of material prosperity and therefore placed tremendous value on it up to the point of veneration. The paper also reveals that the Benin people thought that the fruits of one’s labour outvalued other possessions like an inheritance. The paper also shows that the Benin economic thought, on the hand, as signifying productiveness, intensely encouraged productivity and disdained indolence in the society.

Keywords: Benin, economic thought, hand, industriousness

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Authors: Chen-Sheng Chen, Tsung-Yi Huang, Pi-Chang Sun

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Chronic stroke patients often have complaints about hand dysfunction due to flexor hypertonia and extensor weakness, which makes it difficult to open their affected hand for functional grasp. Hand rehabilitation after stroke is essential for restoring functional independence. Constraint-induced movement therapy has shown to be a successful treatment for patients who have acquired certain level of wrist and finger extension. The goal of this study was to investigate the feasibility of task-oriented approach incorporating 3D-printed dynamic hand device by evaluating hand functional performance. This study manufactured a hand device using 3d printer for chronic stroke. The experimental group engaged task-oriented approach with dynamic hand device, but the control group only received task-oriented approach. Outcome measurements include palmar pinch force (PPF), lateral pinch force (LPF), grip force (GF), and Box and Blocks Test (BBT). The results of study revealed the improvement of PPF in experimental group but not in control group. Meanwhile, improvement in LPF, GF and BBT can be found in both groups. This study demonstrates that the 3D-printed dynamic hand device is an effective therapeutic assistive device to improve pinch force, grasp force, and dexterity and facilitate motivation during home program in individuals with chronic stroke.

Keywords: 3D printing, biomechanics, hand orthosis, stroke

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Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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Authors: Daleesha M. Viswanathan, Sumam Mary Idicula

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Dynamic hand gestures are an intrinsic component in sign language communication. Extracting spatial temporal features of the hand gesture trajectory plays an important role in a dynamic gesture recognition system. Finding a discrete feature descriptor for the motion trajectory based on the orientation feature is the main concern of this paper. Kalman filter algorithm and Hidden Markov Models (HMM) models are incorporated with this recognition system for hand trajectory tracking and for spatial temporal classification, respectively.

Keywords: orientation features, discrete feature vector, HMM., Indian sign language

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Authors: Christopher Spiewak, M. R. Islam, Mohammad Arifur Rahaman, Mohammad H. Rahman, Roger Smith, Maarouf Saad

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For those who have lost the ability to move their hand, going through repetitious motions with the assistance of a therapist is the main method of recovery. We have been developed a robotic assistive device to rehabilitate the hand motions in place of the traditional therapy. The developed assistive device (RAD-HR) is comprised of four degrees of freedom enabling basic movements, hand function, and assists in supporting the hand during rehabilitation. We used a nonlinear computed torque control technique to control the RAD-HR. The accuracy of the controller was evaluated in simulations (MATLAB/Simulink environment). To see the robustness of the controller external disturbance as modelling uncertainty (±10% of joint torques) were added in each joints.

Keywords: biorobotics, rehabilitation, robotic assistive device, exoskeleton, nonlinear control

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Authors: Mohua Chatterjee, Rajib De

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Introduction: Bone Marrow Transplant (BMT) is often performed to treat patients with various types of leukemia. A majority of these patients develop complications like chronic musculoskeletal GVHD post-BMT where patients get scleroderma, pain and restricted range of motion of joints of hand. If not treated early, it may cause permanent deformity of hand. This study was done to find the effectiveness of physiotherapy in hand dysfunction caused due to chronic musculoskeletal GVHD of leukemia patients after BMT. Methodology: 23 patients diagnosed with leukemia and having musculoskeletal GVHD were treated with a set of exercises including active exercises and stretching. The outcome was measured by Cochin Hand Function Scale (CHFS) at baseline and after four weeks of intervention. Results: Two patients were not able to carry out exercises beyond two weeks due to relapse of disease and one patient defaulted. It was found that all the patients who received physiotherapy had significant improvement in hand function. Mean CHFS decreased from 63.67 to 27.43 (P value < 0.001) indicating improvement in hand function after four weeks of physiotherapy. Conclusion: Early intervention of physiotherapy is effective in reducing hand dysfunction of leukemia patients with musculoskeletal GVHD post-BMT.

Keywords: bone marrow transplant, hand dysfunction, leukemia, musculoskeletal graft versus host disease, physiotherapy

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Authors: Yang-Keun Ahn, Kwang-Soon Choi, Young-Choong Park, Kwang-Mo Jung

Abstract:

Vision based user interfaces to control TVs and PCs have the advantage of being able to perform natural control without being limited to a specific device. Accordingly, various studies on hand gesture recognition using RGB cameras or depth cameras have been conducted. However, such cameras have the disadvantage of lacking in accuracy or the construction cost being large. The proposed method uses a low cost IR camera to accurately differentiate between the hand and the background. Also, complicated learning and template matching methodologies are not used, and the correlation between the fingertips extracted through curvatures is utilized to recognize Click and Move gestures.

Keywords: recognition, hand gestures, infrared camera, RGB cameras

Procedia PDF Downloads 375

Authors: Naoki Saito, Daisuke Kon, Toshiyuki Sato

Abstract:

This paper describes an underactuated robot hand operated by low-power actuators. It can grasp objects of various shapes using easy operations. This hand is suitable for use as a lightweight prosthetic hand that can grasp various objects using few input channels. To realize operations using a low-power actuator, a cross section deformation spring is proposed. The design procedure of the underactuated robot finger is proposed to realize an adaptive grasping movement. The validity of this mechanism and design procedure are confirmed through an object grasping experiment. Results demonstrate the effectiveness of a cross section deformation spring in reducing the actuator power. Moreover, adaptive grasping movement is realized by an easy operation.

Keywords: robot hand, underactuated mechanism, cross-section deformation spring, prosthetic hand

Procedia PDF Downloads 342

Authors: Hamid Falaki, Roya Kelkanlo, Mojtaba Tabatabaei

Abstract:

The present study aimed at distinguishing the effects of work type on hand dimensions and investigating the relationship between anthropometric dimensions and occupation. The anthropometric data used in study were collected on 12 hand anthropometric dimensions. The participants included 91 males in two groups, namely manual labor job and office workers. All the data were analyzed using SPSS version 16. All measurements were significantly greater than those of office jobs except for the grip diameter obtained from the manual workers. The hand perimeter was the greatest value among the 12 measured dimensions, while the thickness of the side little finger was the smallest one. In four dimensions, namely width of four fingers together from the central hinge; diameter of thumb to face; diameter of index finger to face; hand thickness from index finger revealed the availability of a significant difference between manual labor jobs and office workers. Moreover, no significant relation was observed between weight and stature with hand dimension, which represents the correlation between occupation and the four dimensions. The results of this study showed that the difference between the two occupational groups was significant in terms of the four dimensions. Therefore, it is suggested that tool designers should consider this finding in their designing process.

Keywords: hand dimensions, occupation, tool design, anthropometry

Procedia PDF Downloads 169

Authors: Okewu E. Jonathan

Abstract:

There are several techniques of production in the field of ceramics. These different techniques overtime have been categorised under three methods of production which includes; casting, throwing and hand building. Hand building method of production is further broken down into other techniques and they include coiling, slabbing and pinching. Ceramic artists find the different hand building techniques to be very interesting, practicable and rewarding. This has encouraged ceramic artist in their various studios at different levels to experiment for further hand building techniques that could be unique and unusual. The art of “Clay Palm Press” is a development from studio experiment in a quest for uniqueness in conceptual ceramic practise. Clay palm press is a technique that requires no formal tutelage but at the same time, it is not easily comprehensible when viewed. It is a practice of putting semi-solid clay in the palm and inserting a closed fist pressure so as to take the imprint of the human palm. This clay production from the palm when dried, fired and explored into an art, work reveals an absolute awesomeness of what the palm imprint could result in.

Keywords: ceramics, clay palm press, conceptual forms, hand building, technique

Procedia PDF Downloads 244

Authors: Saad M. Darwish, Magda M. Madbouly, Murad B. Khorsheed

Abstract:

Sign Languages (SL) are the most accomplished forms of gestural communication. Therefore, their automatic analysis is a real challenge, which is interestingly implied to their lexical and syntactic organization levels. Hidden Markov models (HMM’s) have been used prominently and successfully in speech recognition and, more recently, in handwriting recognition. Consequently, they seem ideal for visual recognition of complex, structured hand gestures such as are found in sign language. In this paper, several results concerning static hand gesture recognition using an algorithm based on Type-2 Fuzzy HMM (T2FHMM) are presented. The features used as observables in the training as well as in the recognition phases are based on Singular Value Decomposition (SVD). SVD is an extension of Eigen decomposition to suit non-square matrices to reduce multi attribute hand gesture data to feature vectors. SVD optimally exposes the geometric structure of a matrix. In our approach, we replace the basic HMM arithmetic operators by some adequate Type-2 fuzzy operators that permits us to relax the additive constraint of probability measures. Therefore, T2FHMMs are able to handle both random and fuzzy uncertainties existing universally in the sequential data. Experimental results show that T2FHMMs can effectively handle noise and dialect uncertainties in hand signals besides a better classification performance than the classical HMMs. The recognition rate of the proposed system is 100% for uniform hand images and 86.21% for cluttered hand images.

Keywords: hand gesture recognition, hand detection, type-2 fuzzy logic, hidden Markov Model

Procedia PDF Downloads 429