Robot-assisted rehabilitation has only recently begun to be applied to improvement of hand function after stroke. In a preliminary study, involving 4 post-stroke subjects, more than 2 years following the stroke, we have been able to show that 8 weeks of robot-assisted training leads to changes in patterns of arm and finger muscle activation. The patterns were quantified in terms of synchronous muscle synergies which allowed for comparison with muscle activation patterns of healthy age-matched subjects. We found that the muscle synergies of the post-stroke subjects became more similar to those of the healthy subject group following training.

The systems which have been developed are safe, easily transportable and offer various training possibilities. Virtual-reality games have been implemented to increase motivation during the 8 weeks of training with post-stroke subjects. Clinical trials have shown that chronic stroke patients can perform the required tasks and that training improves their motor function.

This paper describes a two-degrees-of-freedom haptic interface to investigate the brain mechanisms of human motor control, which is capable of safely and gently interacting with human arm motion during functional magnetic resonance imaging (fMRI). A hydrostatic transmission separates the interface into a master and an MR compatible slave system, allowing the placement of all interfering components outside the electromagnetic shield of the MR room. The transmission mirrors force and motion of the master actuators on the slave system placed close to the MR scanner. The parallel architecture takes advantage of the linear MR compatible actuators and allows human subjects to perform reaching movements comfortably in the small workspace limited by the dimensions of the MR scanner and the biomechanics of the arm. The kinematic structure of the slave interface was optimized with respect to the available space and types of movements to be investigated. Materials were chosen based on their MR compatibility, their stiffness and weight. The interaction force with the subject is measured over two optical force sensors, located close to the output of the interface. Two shielded optoelectronic encoders measure the extension of the slave hydraulic pistons. Detailed tests demonstrated the fMRI compatibility even during movement of the interface

The strong impairment of motor functions in stroke survivors affects daily activities such as eating, manipulating objects or writing. Our goal is to induce long lasting improvements in such tasks by having patients perform systematic exercises using haptic interfaces. This paper describes a novel two-degrees-of-freedom interface which we have developed to help stroke patients gradually recover the ability to open and close the hand and manipulate knobs. Different solutions are studied and a design consisting of two parallelogram structures interacting with the fingers is proposed. The mechanical design offers the possibility to adapt the interface to various hand sizes and finger orientations, and to right or left-handed subjects. Design kinematics as well as actuation and system control are described. Several knobs are proposed to interact with patients, especially a cone mechanism to train a complete opening movement from a strongly contracted and closed hand to a large opened position. The interaction force with the subject is measured over four force sensors located close to the output of the interface. A preliminary study has been performed to evaluate the performances of the haptic interface