A Dexterous Soft Hand Exoskeleton Restores Intentional Grasping for Individuals with Severe Hand Impairment

Restoring reliable grasping of diverse objects is a priority for individuals with severe hand impairments. We report the translational development of a lightweight, textile-based soft robotic exoskeleton glove with wrist dorsiflexion and an active opposable and abductable thumb, designed to restore hand function in a patient with severe right-hand impairment due to amyotrophic lateral sclerosis (ALS). We followed a co-creation approach, enhancing dexterity by increasing hand articulations based on patient needs. Furthermore, to enhance the patients' sense of control, a non-invasive sEMG-based grasp predictor (97% sensitivity) was combined with motion data and ML-based error-correction to compensate for weak, noisy muscle signals, compared to healthy controls (n=15). The exoskeleton assistance enabled the patient to intentionally grasp everyday objects, achieve a Box-and-Blocks Test score of 5, and regain the ability to feed himself. To evaluate broader applicability, we validated the exoskeleton with stroke patients (n=6). While exoskeleton assistance on average reduced ARAT scores of moderately impaired patients by 9, severely impaired patients scored 17 points higher when using the exoskeleton.