mano: A Wearable Hand Exoskeleton for Activities of Daily Living and Neurorehabilitation.

Hand sensorimotor impairments are among the most common consequences of injuries affecting the central and peripheral nervous systems, leading to a drastic reduction in the quality of life for affected individuals. Combining wearable robotic exoskeletons and human-machine interfaces is a promising avenue for the restoration and substitution of lost and impaired functions for these users. In this study, we present a novel hand exoskeleton, mano, designed to assist and restore hand functions of people with motor disabilities during activities of daily living (ADL) and in neurorehabilitative scenarios. Compared to state-of-the-art devices, our system is fully wearable, portable, and minimally obtrusive on the hand. The exoskeleton can actively control flexion and extension of all fingers, while allowing natural somatosensorial interactions with the environment surrounding the users. We evaluated the device from four different perspectives. A mechanical characterization, showing that the exoskeleton can cover more than 70% of healthy hand workspace and it can achieve forces at the fingertips sufficient for ADL. A functional characterization, where we showed how two users who suffered from spinal cord injuries were able to perform several ADL for the first time since their accidents. Third, we evaluated the system from a neuroimaging perspective, showing that the device can elicit EEG brain patterns typical of natural hand motions. We finally exemplified the control of the hand exoskeleton within an exemplar framework, a brain-machine interface scenario, showing that motor intention can be decoded for a continuous control of the device. Overall, our results showed that the device represents an ecological solution for use both in ADL and in scenarios aimed at promoting sensorimotor recovery.