IEEE ROBOTICS AND AUTOMATION LETTERS. PREPRINT VERSION. ACCEPTED OCTOBER, 2018 1 A Hybrid Rigid-Soft Hand Exoskeleton to Assist Functional Dexterity Chad G. Rose and Marcia K. O’Malley Abstract—A hybrid hand exoskeleton, leveraging rigid and soft elements, has been designed to serve as an assistive device to return the ability to perform activities of daily living (ADLs) and improve quality of life (QOL) for a broad population with hand impairment. This glove-like exoskeleton, the SeptaPose Assistive and Rehabilitative (SPAR) Glove, is underactuated, enabling seven hand poses which support most ADLs. The device resides on the spectrum between traditional rigid devices and the latest soft robotic designs. It includes novel ergonomic elements for power transmission and additional features to Rigid Soft enable self-donning and doffing. Embedded sensors enable pose estimation and intent detection for intuitive control of the Fig. 1. Devices fall along the rigid-soft spectrum, with most, such as the glove. In this paper, we summarize the overall design of the Cybergrasp [10] and the glove by Polygerinos et al. [11], residing at the glove, and present details of the novel rigid palm bar and ends. In the hybrid middle of the spectrum, we propose the SPAR Glove, hyperextension prevention elements. We characterize the grasp a novel device which leverages the strengths of each end of the spectrum force and range of motion (ROM) of the glove, and present initial to serve as a technology framework for investigating impacts of assistive feedback from an end-user. The SPAR Glove meets or exceeds devices, developing novel intent detection schemes, and creating softgoods the functional requirements of ADLs for both ROM and grasp (fabric and other flexible material-based) designs to promote wearability. force. Additionally, the glove exceeds the grasp force capabilities of comparable devices, while simultaneously offering the highest To significantly impact therapeutic outcomes and recov- number of poses. In addition to its role as an assistive device, ery of hand functions, therapy must occur outside of the the SPAR Glove exoskeleton has the potential to provide “hands- clinic, and interventions must target the distal degrees of in” rehabilitation centered on performing functional tasks. In the near term, the glove is a highly capable prototype for freedom (DOF) of the upper limb [7], [8]. These interven- exploring hybrid assistive device design, intent detection, and tions should include devices that both assist in completing user interface research. ADLs and support recovery of motor coordination by over- Index Terms—Physically Assistive Devices, Wearable Robots, coming learned non-use of the impaired limb [9]. Rehabilitation Robotics, Prosthetics and Exoskeletons A robotic intervention that supports ADLs and encour- ages recovery of motor function outside of the clinic, I. INTRODUCTION will have to overcome the limitations of current designs significant population has reduced upper extremity (reviewed by Bos et al. [12]). These devices typically reside A motor function as a result of neuromuscular injury or at the extremes of a rigid-soft spectrum, shown in Fig. 1. disorder. Many of the 6.6 million Americans with stroke [1] Most rigid hand rehabilitation systems either offer limited and the 5.3 million with traumatic brain injury (TBI) [2] functionality in terms of movement or exhibit significant have hand impairment that prevents unaided completion weight and bulk, limiting their wearability as an assistive of ADLs. Other populations, such as those with ataxia [3] device, as detailed by Yun et al. [13]. For example, the or certain classifications of dystonia [4], can have similar Cybergrasp [10], while exhibiting high precision torque and debilitating impairments. More than half of the 17,000 position control, is large, heavy, and expensive. As a result, annual incidences of spinal cord injury (SCI) in the United rigid devices are relegated to clinical environments. States are at the cervical level [5] and result in severe arm Towards the soft end of the spectrum are tendon-driven and hand disabilities. Restoration of this lost hand function devices, which typically leverage Bowden cable transmis- is the highest priority for over half of the individuals with sions and remote actuation to assist grasps. Most of these tetraplegia due to SCI [6], underscoring the clear, critical tendon-driven devices, such as the Exo-Glove [14] and the need for specialized interventions and the outsized impact glove proposed by Xiloyannis et al. [15], support only a they can have on post-injury QOL and life expectancy. single three finger grasp and nearly meet force requirements Manuscript received: July 5, 2018; Revised September 27, 2018; Accepted for ADL, with the Exo-Glove providing 40 N for cylindrical October 20, 2018. grasps [14]. However, the soft construction of these devices This paper was recommended for publication by Allison M. Okamura limits their force output and cannot prevent hyperexten- upon evaluation of the Associate Editor and Reviewers’ comments. This work was supported by NSTRF NNX13AM70H and by Mission Connect, a sion. Devices such as the Graspy Glove [16] are promising project of the TIRR Foundation, grants 015-103 and 017-114. in their support of multiple poses, but distal location of C. Rose and M. O’Malley are with Mechatronics and Haptic Interfaces actuators can reduce their wearability. All of these devices Lab, Mechanical Engineering Department, Rice University, Houston, TX 77005 USA. [email protected] rely on a single DOF thumb which cannot support lateral Digital Object Identifier (DOI): see top of this page. pinch grasps. Very soft devices often have performance 2 IEEE ROBOTICS AND AUTOMATION LETTERS. PREPRINT VERSION. ACCEPTED OCTOBER, 2018 limitations stemming from their actuation strategies, such design goal is the functional ROM, which averages 61±, 60±, as the limited torque and bandwidth available to pneumatic and 39± for MCP, PIP, and DIP respectively [27]. devices such as the glove proposed by Polygerinos et al. [11] C. Grasp Forces and refined by Cappello et al. [17], [18]. While healthy users can provide maximal forces of 95.6 Few devices for the hand reside in the middle of the spec- N and 400 N in precision and power grasps [28], we define trum. Hybrid designs, such as Armstrong [19], a rigid-soft the design targets to be the requirements for ADLs, with exoskeletal garment for proximal upper limb rehabilitation, the maximum required forces around 15 lbf (66.7 N) [29], and the Exo-Glove PM [20], a device combining soft pneu- and 75% of ADLs requiring less than 10.5 N [30]. matic actuators with rigid connections, have potential as III. THE SPAR GLOVE assistive devices. With rigid elements enabling power trans- mission, mechanically-programmed safety features, and soft The SPAR Glove, shown in Fig. 2, is a novel design interfaces enhancing wearability, hybrid designs have the integrating rigid and soft elements to overcome design potential to support and train ADLs in ways not achievable limitations of fully rigid or fully soft devices. The key con- with fully soft or fully rigid systems. tributions of this design can be organized into the design To this end, we designed the SeptaPose Assistive and of softgoods, power transmission, and compliant sensing. Rehabilitative (SPAR) Glove, and update the first presen- The softgoods design had three goals: first, provide a com- tation [21] with more specific design guidelines described pliant fit to promote comfort and safety; second, enable in Section II. Section III provides new details concern- donning and doffing by impaired individuals; and third, ing the design of the softgoods, power transmission, and integrate rigid elements for safety and power transmission compliant sensing integral to the SPAR Glove. We then (Section III-A). The power transmission, building off the present new performance characterization and comparison rigid elements embedded in softgoods, provides torque to other assistive devices in Section IV. The results of this through a flexible Bowden cable transmission and ensures characterization are discussed in Section V, and the novel safety through the judicious placement of rigid elements, contributions are summarized in Section VI. while promoting wearability through the remote placement of motors and implementation hardware (Section III-B). II. DESIGN APPROACH Connecting the softgoods and power transmission are com- pliant sensors used to estimate finger pose and detect the By bridging the gap between fully rigid and fully com- wearer’s intent (Section III-C). Key features of all of these pliant hand-based devices, it is possible to achieve both contributions are summarized in Fig. 3. assitance in ADLs and functional training with a semi- portable, self-donnable device. We propose the SPAR Glove to support ADLs and simultaneously promote functional use of the impaired limb, a capability known to have great cognitive importance [22]. To this end, we prioritize multiple DOF, sufficient ROM, and torque output to achieve a majority of ADLs, while also striving for practical safety features, ease of maintenance, and reasonable weight. A. Achieving Functional Grasps Neither complete grasp taxonomies proposed in the robotic manipulator field [23], [24] nor single DOF tax- onomies [14] are suitable targets for supporting ADLs, since complete taxonomies require fully actuated, complex Fig. 2. The SPAR Glove combines a novel glove-based exoskeleton with devices, and single DOF taxonomies omit grasps such as the intent detection at the wrist, EMG at the forearm, and proximally located lateral pinch crucial to ADLs and assessments such as the actuation to create a powerful, wearable system for hand assistance and Fugl-Meyer [25]. A subset within the Cutkosky Grasp Tax- functional task based training. Motors can be packaged in a wide range of configurations on the arm or in a backpack. onomy proposed by Dalley et al. for myoelectric prosthetic control [26], shown in Fig. 10, comprises an estimated 85% A.