为渐冻症与脊髓损伤患者提供手腕内外翻辅助，提升日常动作完成度。
Clinical Evaluation of a Tongue-Controlled Wrist Abduction-Adduction Assistance in a 6-DoF Upper-Limb Exoskeleton for Individuals with ALS and SCI
- 用舌控六自由度外骨骼实现手腕内外翻辅助
- 倒水和刮棒任务失败率下降至16.7%，洒出率降至22.2%
- 用户感知性能提升，舒适度无下降，适合康复辅助设计
上肢外骨骼（ULE）有望恢复重度运动障碍患者的自理能力，但手腕自由度（尤其是内外翻，Ab-Ad）的临床价值仍不明确。本研究在一项自身对照实验中，评估了舌控六自由度外骨骼EXOTIC2在渐冻症患者1名、脊髓损伤患者5名中的手腕Ab-Ad辅助效果。受试者在倒水与刮棒水平任务中，分别在有/无手腕内外翻辅助条件下完成操作。评估指标包括任务成功率、完成时间、运动学数据及使用体验问卷（舒适度、功能感知、接受度）。启用手腕内外翻辅助后，两项日常活动的成功率均提升，洒出率从77.8%降至22.2%，失败放置率从66.7%降至16.7%。参与者仅使用功能范围内的部分腕关节活动，表明有效控制在功能区间内比最大关节活动更关键。问卷显示额外自由度未增加不适感，且用户感知任务表现改善。结论：手腕内外翻辅助可提升外骨骼使用时的功能表现，且不降低舒适度。其有效性取决于任务场景、控制可用性及个体策略。本研究提供了支持将手腕内外翻纳入外骨骼设计的临床相关、以用户为中心的证据，强调功能性与可用性平衡的重要性。
原文摘要 · Abstract (English)
Upper-limb exoskeletons (ULEs) have the potential to restore functional independence in individuals with severe motor impairments; however, the clinical relevance of wrist degrees of freedom (DoF), particularly abduction-adduction (Ab-Ad), remains insufficiently evaluated. This study investigates the functional and user-perceived impact of wrist Ab-Ad assistance during two activities of daily living (ADLs). Wrist Ab-Ad assistance in a tongue-controlled 6-DoF ULE, EXOTIC2, was evaluated in a within-subject study involving one individual with amyotrophic lateral sclerosis and five individuals with spinal cord injury. Participants performed drinking and scratch stick leveling tasks with EXOTIC2 under two conditions: with and without wrist Ab-Ad assistance. Outcome measure included task success, task completion time, kinematic measures, and a usability questionnaire capturing comfort, functional perception, and acceptance. Enabling wrist Ab-Ad improved task success rates across both ADLs, with consistent reductions in spillage (from 77.8% spillages to 22.2%) and failed placements (from 66.7% to 16.7%). Participants utilized task-specific subsets of the available wrist range of motion, indicating that effective control within functional ranges was more critical than maximal joint excursion. Questionnaire responses indicated no increase in discomfort with the additional DoF and reflected perceived improvements in task performance. In conclusion, wrist Ab-Ad assistance enhances functional task performance in assistive exoskeleton use without compromising user comfort. However, its effectiveness depends on task context, control usability, and individual user strategies. This study provides clinically relevant, user-centered evidence supporting the inclusion of wrist Ab-Ad in ULEs, emphasizing the importance of balancing functional capability with usability in assistive device design.
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