The past decade has seen the emergence of rehabilitation treatments using Virtual Reality (VR) environments, although translation into clinical practice has been limited so far. In this paper an immersive virtual reality rehabilitation training system endowed with wearable haptics is proposed for children with neuromotor impairments: it aims to enhance involvement and engagement of patients, to provide congruent multi-sensory afferent feedback during motor exercises and to benefit from the flexibility of VR in adapting exercises to the patient’s need. An experimental rehabilitation session conducted with children with Cerebral Palsy (CP) and Developmental Dyspraxia (DD) has been performed to evaluate the usability of the system and proof of concept trial of the proposed approach. We compared CP/DD performance with both Typically Developing (TD) children and ADult (AD) control group. Results show the system was compliant with different levels of motor skills and allowed patients to complete the experimental rehabilitation session, with performance varying according to the expected motor abilities of the different groups. Moreover, a kinematic assessment based on the presented system has been designed. Obtained results reflected the different motor abilities of patients and participants, suggesting suitability of the proposed kinematic assessment as a motor function outcome.

This letter presents the design of a new exoskeleton for thumb. The main feature of this device is a high degree of underactuation. In fact, the five degrees of freedom (dof) of the thumb are actuated by just one linear actuator. Other features of the thumb-exos are its capability of exert only forces normal to the phalanx axis in the contact point, and its adaptability to different finger sizes. In this letter, the spatial kinematic model is described and the link lengths are determined by means of a genetic algorithm (GA) over four basic grasping poses and the open hand pose. Finally, the thumb-exos mechanism was implemented and integrated in a full hand exoskeleton device. Performance of the thumb exoskeleton in terms of adaptation to different objects and hand sizes, and in terms of grasping forces have been evaluated through experiments and measuring muscular activity, grasping pressure and forces at different locations of the mechanism.

We present a novel soft exoskeleton providing active support for hand closing and opening. The main novelty is a different tendon routing, folded laterally on both sides of the hand, and adding clenching forces when the exoskeleton is activated. It improves the stability of the glove, diminishing slippage and detachment of tendons from the hand palm toward the grasping workspace. The clenching effect is released when the hand is relaxed, thus enhancing the user's comfort. The alternative routing allowed embedding a single actuator on the hand dorsum, resulting more compact with no remote cable transmission. Enhanced adaptation to the hand is introduced by the modular design of the soft polymer open rings. FEM simulations were performed to understand the interaction between soft modules and fingers. Different experiments assessed the desired effect of the proposed routing in terms of stability and deformation of the glove, evaluated the inter-finger compliance for non-cylindrical grasping, and characterized the output grasping force. Experiments with subjects explored the grasping performance of the soft exoskeleton with different hand sizes. A preliminary evaluation with Spinal Cord Injury patients was useful to highlight the strengths and limitations of the device when applied to the target scenario.