Changes in Movement Profile Related to Use of a Soft-robotic Glove During High-demand Tasks
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 发起方
- 入组人数
- 6
- 试验地点
- 2
- 主要终点
- Kinematic movement profile during performance of strenuous ADL task
研究概览
简要总结
The hand is important to perform activities of daily living (ADL). However, many people experience a loss of hand function as result of a traumatic brain injury, spinal cord injury, stroke or orthopedic problems, or due to ageing. To improve hand function, or reduce its decline, one can benefit from exercise therapy or use of assistive aids to improve ADL independence. A promising innovative approach combining both is a wearable soft-robotic glove that supports hand grip. With this glove, performance of functional activities can be supported directly, while also facilitating repeated use of the affected arm and hand during functional daily activities. One of our previous studies showed that besides a direct support effect, a therapeutic effect on performance was found after several weeks of using the soft-robotic glove as support during ADL. However, several participants reported complaints of increased pain and/or overload, mainly at the beginning of the trial. Clinicians suspect that a (too) high intensity of hand use compared to normal is contributing to this observation. This might be related to more fatigue experienced when using the glove in high-demand tasks, due to a larger movement capacity (faster, further, more repetitions) and can be associated with decreased blood perfusion/lower saturation levels at muscular level and altered muscle activation and movement coordination.
Therefore, the primary objective is to examine the effect of use of the assistive soft-robotic glove during strenuous ADL tasks on the kinematic movement profile, compared to not using the soft-robotic glove. Secondary objectives are to examine whether pain or discomfort is experienced in strenuous activities with the soft-robotic glove as well as the characteristics and locations of such pain/discomfort, and to examine whether use of the glove is associated with increased handgrip strength, larger number of ADL task repetitions, diminished blood perfusion / reduced tissue saturation at the muscle and/or changes in muscle activity.
详细描述
A promising innovative approach to improve hand function is to integrate exercise therapy with support of activities of daily life using an assistive device. This is possible using a wearable soft-robotic glove that supports hand grip. With this glove, performance of functional activities can be supported directly, while also facilitating repeated use of the affected arm and hand during functional daily activities. One of our previous studies showed that besides a direct support effect, a therapeutic effect on performance was found after several weeks of using the soft-robotic glove as support during ADL. However, several participants reported complaints of increased pain and/or overload, mainly at the beginning of the trial. Clinicians suspect that a (too) high intensity of hand use compared to normal is contributing to this observation. This might be related to more fatigue experienced when using the glove in high-demand tasks, due to a larger movement capacity (faster, further, more repetitions) and can be associated with decreased blood perfusion/lower saturation levels at muscular level and altered muscle activation and movement coordination.
The primary objective is to examine the effect of use of the assistive soft-robotic glove during strenuous ADL tasks on the kinematic movement profile, compared to not using the soft-robotic glove. Secondary objectives are to examine whether pain or discomfort is experienced in strenuous activities with the soft-robotic glove as well as the characteristics and locations of such pain/discomfort, and to examine whether use of the glove is associated with increased handgrip strength, larger number of ADL task repetitions, diminished blood perfusion / reduced tissue saturation at the muscle and/or changes in muscle activity.
The study is set-up as a cross-sectional intervention study with one measurement session, where participants will perform maximum handgrip strength tests and high-demand ADL-tasks with and without the soft-robotic glove. The aim is to include 20 participants in total, 10 of which will be frail elderly and the other 10 will be neuromuscular patients, all suffering from reduced hand function.
All participants will perform each movement task with and without the soft-robotic glove. The soft-robotic glove used in the study is the Carbonhand system (Bioservo Technologies, Sweden). It is a CE-marked medical device and it consists of a glove that supports finger flexion via sewn-in tendons and a control unit housing the actuators that pull on the tendons and the batteries. The grip support is activated by applying very light pressure on sensors in the fingertips of the glove, and de-activated by releasing the pressure on the sensors. After execution of all tasks with and without glove, differences in outcome measures will be compared between glove conditions.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 90 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Frail elderly with reduced hand function:
- •Age between 65 and 90 years
- •Experience difficulties in performing ADL due to a decline in hand function
- •Able to make a pinch grip between thumb and middle or ring finger
- •Sufficient cognitive status to understand two-step instructions
- •Having (corrected to) normal vision
- •Able to provide written informed consent
- •Neuromuscular patients:
- •Age between 18 and 80 years
- •Experience difficulties in performing ADL due to a decline in hand function that can be attributed to a diagnosed neuromuscular disease
- •Being in a chronic and stable phase of disease
- •Able to make a pinch grip between thumb and middle or ring finger
- •Sufficient cognitive status to understand two-step instructions
- •Having (corrected to) normal vision
- •Able to provide written informed consent
排除标准
- •Frail elderly with reduced hand function:
- •Currently receiving treatment for a disease affecting arm/hand function
- •Used the CarbonHand system in the past 3 months
- •Severe sensory problems of the most-affected hand
- •Severe acute pain of the most-affected hand
- •Wounds on the hands that can provide a problem when using the glove
- •Severe contractures limiting passive range of motion
- •Severe spasticity of the hand (≥2 points on Ashworth Scale)
- •Insufficient knowledge of the Dutch language to understand the purpose or methods of the study
- •Neuromuscular patients:
- •Severe sensory problems of the most-affected hand
研究组 & 干预措施
Study group
All participants in the study will perform arm/hand movement tasks in both of two conditions (with and without soft-robotic glove), so they constitute 1 study arm, but all receiving both intervention conditions (experimental - with glove and control - without glove).
干预措施: Soft robotic glove (Device)
结局指标
主要结局
Kinematic movement profile during performance of strenuous ADL task
时间窗: 1-2 hours during the measurement session
The kinematic movement profile during performance of strenuous ADL task, characterized by the following parameters as assessed using 3D marker-based motion capture: • Total movement duration * Duration of movement phases * Movement smoothness * Trunk displacement * Peak hand velocity * Time to peak velocity of reach phase * Hand opening * Joint excursion of the elbow * Joint excursion of the wrist * Endpoint straightness * Endpoint error
次要结局
- Maximal handgrip strength(1-2 hours during the measurement session)
- Perceived exertion and confidence in grip rating(Twice during the measurement session, after completion of both conditions, with a duration of 5-10 minutes.)
- Handgrip endurance(1-2 hours during the measurement session)
- Experienced pain/discomfort rating + description(Twice during the measurement session, after completion of both conditions, with a duration of 5-10 minutes.)
- Number of repetitions achieved during ADL task(1-2 hours during the measurement session)
- Muscle tissue oxygen saturation(1-2 hours during the measurement session)
- Amplitude, on/off times and median frequency of muscle activity(1-2 hours during the measurement session)