The New Jersey Institute of Technology's
Electronic Theses & Dissertations Project

Title:	Assessment of a hand exoskeleton on proximal and distal training in virtual environments for robot mediated upper extremity rehabilitation
Author:	Abbruzzese, Kevin
View Online:	njit-etd2017-001 (xix, 185 pages ~ 2.2 MB pdf)
Department:	Department of Biomedical Engineering
Degree:	Doctor of Philosophy
Program:	Biomedical Engineering
Document Type:	Dissertation
Advisory Committee:	Foulds, Richard A. (Committee chair) Adamovich, Sergei (Committee member) Narahara, Taro (Committee member) Deutsch, Judy (Committee member) Fluet, Gerard G. (Committee member)
Date:	2017-01
Keywords:	Exoskeleton Robot mediated therapy Virtual environments Stroke Rehabilitation Assistive technology
Availability:	Unrestricted
Abstract:	Stroke is the leading cause of disability in the United States with approximately 800,000 cases per year. This cerebral vascular accident results in neurological impairments that reduce limb function and limit the daily independence of the individual. Evidence suggests that therapeutic interventions with repetitive motor training can aid in functional recovery of the paretic limb. Robotic rehabilitation may present an exercise intervention that can improve training and induce motor plasticity in individuals with stroke. An active (motorized) hand exoskeleton that provides support for wrist flexion/extension, abduction/adduction, pronation/supination, and finger pinch is integrated with a pre-existing 3-Degree of Freedom (DOF) haptic robot (Haptic Master, FCS Moog) to determine the efficacy of increased DOF during proximal and distal training in Upper Extremity (UE) rehabilitation. Subjects are randomly assigned into four groups to evaluate the significance of increased DOF during virtual training: Haptic Master control group (HM), Haptic Master with Gripper (HMG), Haptic Master with Wrist (HMW), and Haptic Master with Gripper and Wrist (HMWG). Each subject group performs a Pick and Place Task in a virtual environment where the distal hand exoskeleton is mapped to the virtual representation of the hand. Subjects are instructed to transport as many virtual cubes as possible to a specified target in the allotted time period of 120s. Three cube sizes are assessed to determine efficacy of the assistive end-effector. An additional virtual task, Mailbox Task, is performed to determine the effect of training and the ability to transfer skills between virtual settings in an unfamiliar environment. The effects of viewing mediums are also investigated to determine the effect of immersion on performance using an Oculus Rift as an HMD compared to conventional projection displays. It is hypothesized that individuals with both proximal and complete distal hand control (HMWG) will see increased benefit during the Pick and Place Task than individuals without the complete distal attachment, as assisted daily living tasks are often accomplished with coordinated arm and hand movement. The purpose of this study is to investigate the additive effect of increased degrees of freedom at the hand through task-specific training of the upper arm in a virtual environment, validate the ability to transfer skills obtained in a virtual environment to an untrained task, and determine the effects of viewing mediums on performance. A feasibility study is conducted in individuals with stroke to determine if the modular gripper can assist pinch movements. These investigations represent a comprehensive investigation to assess the potential benefits of assistive devices in a virtual reality setting to retrain lost function and increase efficacy in motor control in populations with motor impairments.