{"title":"主动,驱动和辅助:手和手腕外骨骼的范围审查。","authors":"A Galbert, A Buis","doi":"10.33137/cpoj.v7i1.43827","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Assistive technology is often incorporated into rehabilitation and support for those impacted by upper limb impairments. When powered, these devices provide additional force to the joints of users with muscle weakness. Actuated devices allow dynamic movement compared to splints, therefore improving the ability to complete activities of daily living. However, these devices are not often prescribed and are underrepresented in research and clinical settings.</p><p><strong>Objective: </strong>This review examined the existing literature on devices developed to support hand and wrist functionality in daily activities. Focusing on active, powered, and actuated devices, to gain a clearer understanding of the current limitations in their design and prescription.</p><p><strong>Methodology: </strong>The scoping review was conducted using the PRISMA-ScR guidelines. A systematic search was done on MEDLINE, EMBASE, Scopus, Web of Science, and NHS the Knowledge Network from inception to May 2023. Articles were included if the device was portable; supported the hands and wrist actively using an actuator; and could be used for assistive living during or post-rehabilitation period.</p><p><strong>Findings: </strong>A total of 135 studies were included in the analysis of which 34 were clinical trials. The design and control methods of 121 devices were analyzed. Electrical stimulation and direct mechanical transmission were popular actuation methods. Electromyography (EMG) and joint movement detection were highly used control methods to translate user intentions to device actuation. A total of 226 validation methods were reported, of which 44% were clinically validated. Studies were often not conducted in operational environments with 69% at technology readiness levels ≤ 6, indicating that further development and testing is required.</p><p><strong>Conclusion: </strong>The existing literature on hand and wrist exoskeletons presents large variations in validation methods and technical requirements for user-specific characteristics. This suggests a need for well-defined testing protocols and refined reporting of device designs. This would improve the significance of clinical outcomes and new assistive technology.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 1","pages":"43827"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609922/pdf/","citationCount":"0","resultStr":"{\"title\":\"Active, Actuated, and Assistive: a Scoping Review of Exoskeletons for the Hands and Wrists.\",\"authors\":\"A Galbert, A Buis\",\"doi\":\"10.33137/cpoj.v7i1.43827\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Assistive technology is often incorporated into rehabilitation and support for those impacted by upper limb impairments. When powered, these devices provide additional force to the joints of users with muscle weakness. Actuated devices allow dynamic movement compared to splints, therefore improving the ability to complete activities of daily living. However, these devices are not often prescribed and are underrepresented in research and clinical settings.</p><p><strong>Objective: </strong>This review examined the existing literature on devices developed to support hand and wrist functionality in daily activities. Focusing on active, powered, and actuated devices, to gain a clearer understanding of the current limitations in their design and prescription.</p><p><strong>Methodology: </strong>The scoping review was conducted using the PRISMA-ScR guidelines. A systematic search was done on MEDLINE, EMBASE, Scopus, Web of Science, and NHS the Knowledge Network from inception to May 2023. Articles were included if the device was portable; supported the hands and wrist actively using an actuator; and could be used for assistive living during or post-rehabilitation period.</p><p><strong>Findings: </strong>A total of 135 studies were included in the analysis of which 34 were clinical trials. The design and control methods of 121 devices were analyzed. Electrical stimulation and direct mechanical transmission were popular actuation methods. Electromyography (EMG) and joint movement detection were highly used control methods to translate user intentions to device actuation. A total of 226 validation methods were reported, of which 44% were clinically validated. 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引用次数: 0
摘要
背景:辅助技术经常被纳入到上肢损伤患者的康复和支持中。当通电时,这些设备为肌肉无力的用户的关节提供额外的力量。与夹板相比,驱动装置允许动态运动,因此提高了完成日常生活活动的能力。然而,这些设备并不经常被处方,并且在研究和临床环境中代表性不足。目的:本综述回顾了现有文献中用于支持日常活动中手和手腕功能的设备。重点关注有源、动力和驱动设备,以更清楚地了解其设计和处方的当前局限性。方法:使用PRISMA-ScR指南进行范围审查。系统检索了MEDLINE、EMBASE、Scopus、Web of Science和NHS知识网络,检索时间从成立到2023年5月。如果设备是便携式的,则包括物品;使用致动器主动支撑手和手腕;可用于康复期间或康复后的辅助生活。结果:共纳入135项研究,其中34项为临床试验。分析了121个装置的设计和控制方法。电刺激和直接机械传动是常用的驱动方式。肌电图(EMG)和关节运动检测是高度使用的控制方法,将用户意图转化为设备驱动。共报道226种验证方法,其中44%得到临床验证。研究通常没有在操作环境中进行,69%的技术准备水平≤6,这表明需要进一步的开发和测试。结论:现有关于手腕部外骨骼的文献在验证方法和用户特定特性的技术要求方面存在很大差异。这表明需要定义良好的测试协议和完善的设备设计报告。这将提高临床结果和新的辅助技术的意义。
Active, Actuated, and Assistive: a Scoping Review of Exoskeletons for the Hands and Wrists.
Background: Assistive technology is often incorporated into rehabilitation and support for those impacted by upper limb impairments. When powered, these devices provide additional force to the joints of users with muscle weakness. Actuated devices allow dynamic movement compared to splints, therefore improving the ability to complete activities of daily living. However, these devices are not often prescribed and are underrepresented in research and clinical settings.
Objective: This review examined the existing literature on devices developed to support hand and wrist functionality in daily activities. Focusing on active, powered, and actuated devices, to gain a clearer understanding of the current limitations in their design and prescription.
Methodology: The scoping review was conducted using the PRISMA-ScR guidelines. A systematic search was done on MEDLINE, EMBASE, Scopus, Web of Science, and NHS the Knowledge Network from inception to May 2023. Articles were included if the device was portable; supported the hands and wrist actively using an actuator; and could be used for assistive living during or post-rehabilitation period.
Findings: A total of 135 studies were included in the analysis of which 34 were clinical trials. The design and control methods of 121 devices were analyzed. Electrical stimulation and direct mechanical transmission were popular actuation methods. Electromyography (EMG) and joint movement detection were highly used control methods to translate user intentions to device actuation. A total of 226 validation methods were reported, of which 44% were clinically validated. Studies were often not conducted in operational environments with 69% at technology readiness levels ≤ 6, indicating that further development and testing is required.
Conclusion: The existing literature on hand and wrist exoskeletons presents large variations in validation methods and technical requirements for user-specific characteristics. This suggests a need for well-defined testing protocols and refined reporting of device designs. This would improve the significance of clinical outcomes and new assistive technology.