A pediatric robotic thumb exoskeleton for at-home rehabilitation: the Isolated Orthosis for Thumb Actuation (IOTA).

In this paper, we present the design of a thumb exoskeleton for pediatric at-home rehabilitation. Pediatric disorders, such as cerebral palsy (CP) and stroke, can result in thumb in palm deformity greatly limiting hand function. This not only limits children's ability to perform activities of daily living but also limits important motor skill development. Specifically, the device, dubbed IOTA (Isolated Orthosis for Thumb Actuation) is a 2-DOF thumb exoskeleton that can actuate the carpometacarpal (CMC) and metacarpalphalangeal (MCP) joints through ranges of motion required for activities of daily living. The device consists of a lightweight hand-mounted mechanism that can be custom secured and aligned to the wearer. The mechanism is actuated via flexible cables that connect to a portable control box. Embedded encoders and bend sensors monitor the two degrees of freedom of the thumb and flexion/extension of the wrist. Using this platform, a number of control modes can be implemented that will enable the device to be intuitively controlled by a patient to assist with opposition grasp, fine motor control, and ultimately facilitate motor recovery. We envision this at-home device augmenting the current in-clinic therapy and enabling tele-rehabilitation where a clinician can remotely monitor a patient's usage and performance.