Abstract
Hand motor impairment resulting from cerebrovascular accidents severely hinders activities of daily living and diminishes independence in post-stroke individuals. While conventional rigid robotic exoskeletons can provide repetitive physical therapy, their high mechanical impedance, joint misalignment issues, and substantial bulk restrict clinical and home-based adoption. This study presents the design, fabrication, and clinical evaluation of a novel lightweight soft robotic exoskeleton glove integrated with thin-film piezoresistive force sensors for closed-loop assistive hand rehabilitation. The device employs fiber-reinforced elastomeric pneumatic actuators aligned along the dorsal aspect of each digit, delivering physiological flexion and extension assistance while avoiding unnatural joint constraints. Integrated distal phalangeal force sensors enable an assistance-as-needed control paradigm that dynamically responds to residual voluntary effort. Eighteen chronic post-stroke hemiparetic patients participated in a four-week clinical intervention involving task-oriented training. Post-intervention assessments demonstrated statistically significant improvements in the distal upper extremity Fugl-Meyer Assessment score (mean increase of 7.6 points, p < 0.001) and the Box and Block Test (mean increase of 6.4 blocks, p < 0.001). Furthermore, maximum voluntary grip strength increased by an average of 38.5%, with high system usability ratings (System Usability Scale score: 84.2 ± 6.8) and zero adverse events. These findings indicate that the proposed sensorized soft exoskeleton glove promotes functional neuromuscular recovery and provides an effective, ergonomic platform for neurorehabilitation.
