Design of a continuous passive and active motion device for hand rehabilitation.

This paper presents the design of a novel, portable device for hand rehabilitation. The device provides for CPM (continuous passive motion) and CAM (continuous active motion) hand rehabilitation for patients recovering from damage such as flexor tendon repair and strokes. The device is capable of flexing/extending the MCP (metacarpophalangeal) and PIP (proximal interphalangeal) joints through a range of motion of 0 degrees to 90 degrees for both the joints independently. In this way, typical hand rehabilitation motions such as intrinsic plus, intrinsic minus, and a fist can be achieved without the need of any splints or attachments. The CPM mode is broken into two subgroups. The first mode is the use of preset waypoints for the device to cycle through. The second mode involves motion from a starting position to a final position, but senses the torque from the user during the cycle. Therefore the user can control the ROM by resisting when they are at the end of the desired motion. During the CPM modes the device utilizes a minimum jerk trajectory model under PD control, moving smoothly and accurately between preselected positions. CAM is the final mode where the device will actively resist the movement of the user. The user moves from a start to end position while the device produces a torque to resist the motion. This active resistance motion is a unique ability designed to mimic the benefits of a human therapist. Another unique feature of the device is its ability to independently act on both the MCP and PIP joints. The feedback sensing built into the device makes it capable of offering a wide and flexible range of rehabilitation programs for the hand.