1 Department of Mechanical Engineering, Islamic Azad University, Majlesi Branch, Isfahan, Iran

2 Department of Mechanical and Aerospace Engineering, Islamic Azad University, Science and Research Branch, Tehran, Iran


Stroke is one of the most common diseases among the elderly with high personal and societal costs. In recent years, robotic rehabilitation for stroke has become an active area of research for assistance, monitoring and qualifying the rehabilitation treatments. The key issue needed for improving rehabilitation system is that patient feedback should be taken into account by the robotic rehabilitation systems for providing rehabilitation treatment. Changes in the delivery of rehabilitation treatment are an important issue since the patient or specialist should be able to express their sense about doing things and apply the needed improvements in treatment. Therefore, in this study, a three degree-of-freedom    (3-DOF) exoskeleton design of a thumb has been investigated. Then, a control structure is provided for greater security in which the patient feedback is evaluated in order to make necessary automatic changes in method of treatment (changing speed and force). In this design, a versatile framework with high performance is offered to simultaneously control thumb force and position regarding the patients’ feedback. This may help to keep the patient in the treatment process, reduce interventions and therapist caseload, effective automatic transmission of treatment and pain relief during the course of treatment. The results of the study suggest that the force and speed on the thumb can be changed during the rehabilitation period according to the patient's needs. This advantage may be considered as an essential step for improvement of the rehabilitation efficiency.


[1]      American Heart Association, Heart and Stroke Statistical Update,Available: http://www. Americanheart. org/ statistics/ stroke. htm, 2010.
[2]      Patten, C., Christine, E, Dairaghi, A., and Lum P., “Concurrent Neuromechanical and Functional Gains Following Upper-Extremity Power Training Post-Stroke”, J Neuroeng Rehabil, Vol. 10, No. 1, 2013.
[3]      Albert, C., Lo, Peter, D., Guarino and et al., “Robot-Assisted Therapy for Long-Term Upper-Limb Impairment after Stroke”, New England Journal of Medicine, Vol. 362, No. 19, 2010, pp. 1772-1783.
[4]      Michielsen, ME., Selles, RW., Vander Geest JN., Eckhardt, M., Yavuzer, G., Stam, HJ., Smits, M., Ribbers GM., and Bussmann, JB., “Motor Recovery and Cortical Reorganization after Mirror Therapy in Chronic Stroke Patients a Phase Ii Randomized Controlled Trial”, Neurorehabilitation and Neural Repair, Vol. 25, No. 3, 2011, pp. 223-215.
[5]      Hayner, K., Gibson, G., and Giles, G, M., “Comparison of Constraint-Induced Movement Therapy and Bilateral Treatment of Equal Intensity in People with Chronic Upper-Extremity Dysfunction after Cerebrovascular Accident”, The American Journal of Occupational Therapy, Vol. 64, No. 4, 2010, pp. 528-539.
[6]      Hammer, A, M., Lindmark, B., “Effects of Forced Use on Arm Function in the Subacute Phase after Stroke: A Randomized, Clinical Pilot Study”, Physical Therapy, Vol. 89, No. 6, 2009, pp. 526-539.
[7]      Novak, D., Ziherl, Z., Olensek, A., and Milavec, M., et al., “Psychophysiological Responses to Robotic Rehabilitation Tasks in Stroke”, IEEE Transactions on Neural Systems and Rehabilitation Engineering, Vol. 18, No. 4, 2010, pp. 171-361.
[8]      Choi, H., Gordon, J., Kim, D., and Schweighofer, N., “An Adaptive Automated Robotic Task-Practice System for Rehabilitation of Arm Functions after Stroke”, IEEE Transactions on Robotics, Vol. 25, No. 3, 2009, pp. 556-568.
[9]      Poli, P., Morone G., Rosati G., and Masiero S., “Robotic Technologies and Rehabilitation: New Tools for Stroke Patients’ Therapy”, BioMed Research International, 2013, pp. 153872.
[10]   Esmzade, R., and Khosrojerdi M., “Modeling and Control of the Exoskeleton for Rehabilitation of Shoulder, Elbow and Wrist Motions”, nineteenth Conference on Biomedical Engineering, 2012.
[11]   Jamshidi, M., Rahmanzade, H., and Kaboudi, T., “Robotic Modeling for Rehabilitation of Arm and Knee Muscles”, First Conference of Rehabilitation Robotics, 2012.
[12]   Abdolvahab, M., Bagheri H., Movahedian, M., Olyaei GR., Jalili, M., and Baghestani, AR., “The effect of constraint-induced therapy on Activityof Daily Living of adults hemiplegic patients”, (in Persian), Modern Rehabilitation, Vol. 3. No. 1, 2, 2008, pp. 28-32.
[13]   Worsnopp, T. T., Peshkin, M. A., Colgate, J. E., and Kamper, D. G., “An actuated finger exoskeleton for hand rehabilitation following stroke”, Proceedings of the IEEE 10th International Conference on Rehabilitation Robotics, Vol. 1, 2007.
[14]   Santos, V., Valero-Cuevas, F., “Reported Anatomical Variability Naturally leads to multimodal distributions of Denavit_Hartenberg parameters for the human thumb”, IEEE Transactions on Biomedical Engineering. Vol. 53, No. 2, 2006, pp. 155-63.
[15]   Abdallah, M. E., Platt, R., and Wampler, C. W., “Hargrave, B., Applied Joint-Space Torque and Stiffness Control of Tendon-Driven Fingers”, In Proceedings of the 10th IEEE-RAS International Conference on Humanoid Robots (Humanoids), Nashville, TN, USA, 6–8 December, 2010, pp. 74–79.
[16]   Borghesan, G., Palli, G., and Melchiorri, C., “Design of Tendon-Driven Robotic Fingers: Modeling and Control Issues”, In Proceedings of the IEEE International Conference  on  Robotics  and Automation, Anchorage, AK, USA, 3–7 May 2010,pp. 793–798.
[17]   Otadi, K., Hadian, MR., Olyaei, GR., Rasoulian, B., Emamdoost, S., Barikani, E., Torbatian, E., and Ghasemi, A., “The effect of modified constraint induced movement therapy on quality and amount of upper limb movements in chronic hemiplegic patients in comparison with traditional rehabilitation” (in Persian), Modern Rehabilitation, Vol. 6, No. 1, 2012, pp. 13-18.
[18]   Bagheri, H., Abdolvahab, M., Dehghan L., Jalili M., and Beheshti, S., Z., “The effect of task oriented training on upper extremity function in children with spastic diplegia 8-12 years old”, (in persian), Modern Rehabilitatio, Vol. 3, No. 3, 2010, pp. 57-61.
[19]   Sung, HoCA, J., Yun-Hee, K., Sang-Hyun, CH., Jin-Hee, L., Ji-Won, P., and Yong-Hyun, K., “Cortical reorganization induced by task-oriented training in chronic hemiplegic stroke patients”, Neuroreport, Vol. 14, No. 1, 2003, pp. 137-141.
[20]   Lu, E., Wang, R, Boger, Hebert, J, D., and Mihailidis, A., “Development of a rehabilitation robot: national differences in therapist practice”, in Rehabil. Eng. Assist. Technol. Soc., 2011.
[21]   Dovat, L., Lambercy, O., et al., “HandCARE: a cable-actuated rehabilitation system to train hand function after stroke”, IEEE Trans Neural Syst. Rehabil. Eng., Vol. 16, 2013, pp. 582-91.
[22]   Li, J. W., Bu, C. G., and Wang, L., “The application of Macro command in ADAMS in building the virtual prototype of cable drill”, Mach. Tool Hydraul., Vol. 39, 2011, pp. 150–153.