Author ORCID Identifier
0000-0002-2062-6663
Document Type
Dissertation
Date of Award
8-31-2022
Degree Name
Doctor of Philosophy in Biomedical Engineering - (Ph.D.)
Department
Biomedical Engineering
First Advisor
Sergei Adamovich
Second Advisor
Xianlian Alex Zhou
Third Advisor
Max Roman
Fourth Advisor
Alma S. Merians
Fifth Advisor
Gerard G. Fluet
Abstract
Stroke affects approximately 800,000 people in the United States each year, and due to its chronic effects, it is one of the leading causes of disability. Many individuals with stroke suffer the loss of motor function in their paretic upper extremity, and longitudinal studies show that 30 — 66% of individuals with hemiplegia fail to regain arm function six months post stroke. After a stroke, the brain undergoes neuroplasticity which will promote recovery of function. Investigators and clinicians are trying to develop rehabilitation interventions that can be designed to promote neuroplasticity, enhancing the recovery outcomes of therapy.
For individuals with all levels of impairment, robot-mediated therapy can assist with repetitive movements at a high dosage which is a crucial component of recovery. These control paradigms can be passive, moving an individual's limb through a preprogrammed trajectory, or active, requiring the individual to provide an intentional movement prior to receiving assistance from the robot. Another method that is used for enhancing neuroplasticity is priming. Motor priming preceding therapeutic interventions such as task-specific training may enhance the effects of the intervention facilitating better recovery. An exoskeleton is developed during this project that has the capabilities to perform motor priming with individuals with stroke.
The NJIT Gripper is designed as a low-cost lightweight, easy-to-use robotic exoskeleton that assists with flexion and extension of the fingers or opening and closing of the hand. For individuals with stroke, extending the fingers to open the hand is often a challenging task. Evaluations with healthy individuals and individuals with stroke demonstrate that the exoskeleton is well tolerated. The control schemes of the NJIT Gripper allow it to be used to provide movement-based motor priming in the form of stretching for individuals with stroke. The objective of this pilot study is to determine which method of stretching is the most effective. Individuals with chronic stroke participate in movement-based motor priming for 30 minutes of stretching the hand muscles, and kinematic and neurophysiological outcome measures are evaluated.
The NJIT Gripper is designed to be used in combination with the Home based Virtual Rehabilitation System (HoVRS) previously developed by our laboratory. To establish perceived acceptance, a usability study was performed, and HoVRS is evaluated by individuals with chronic stroke as well as physical and occupational therapists.
Finally, the NJIT Gripper is used in conjunction with HoVRS for a case study with one participant. The participant attends nine in-person training sessions where they receive 30 minutes of movement-based priming as well as therapeutic game play. The participant uses HoVRS at home unsupervised for two additional months. Clinical and kinematic outcomes are evaluated and demonstrate that even at —6 years post stroke, the individual was able to make improvements.
Recommended Citation
Mont, Ashley Joyce, "Development and evaluation of a hand exoskeleton for neurorehabilitation post stroke" (2022). Dissertations. 1788.
https://digitalcommons.njit.edu/dissertations/1788
Included in
Biomedical Engineering and Bioengineering Commons, Neuroscience and Neurobiology Commons, Robotics Commons
