  We studied the performance of a robotic orthosis designed to assist the
paretic hand after stroke. It is wearable and fully user-controlled, serving
two possible roles: as a therapeutic tool that facilitates device mediated hand
exercises to recover neuromuscular function or as an assistive device for use
in everyday activities to aid functional use of the hand. We present the
clinical outcomes of a pilot study designed as a feasibility test for these
hypotheses. 11 chronic stroke (> 2 years) patients with moderate muscle tone
(Modified Ashworth Scale less than or equal to 2 in upper extremity) engaged in
a month-long training protocol using the orthosis. Individuals were evaluated
using standardized outcome measures, both with and without orthosis assistance.
Fugl-Meyer post intervention scores without robotic assistance showed
improvement focused specifically at the distal joints of the upper limb,
suggesting the use of the orthosis as a rehabilitative device for the hand.
Action Research Arm Test scores post intervention with robotic assistance
showed that the device may serve an assistive role in grasping tasks. These
results highlight the potential for wearable and user-driven robotic hand
orthoses to extend the use and training of the affected upper limb after
stroke.
