Soft robotic devices have desirable traits for applications in minimally invasive surgery (MIS), but many interdisciplinary challenges remain unsolved. To understand current technologies, we carried out a keyword search using the Web of Science and Scopus databases, applied inclusion and exclusion criteria, and compared several characteristics of the soft robotic devices for MIS in the resulting articles. There was low diversity in the device designs and a wide-ranging level of detail regarding their capabilities. We propose a standardized comparison methodology to characterize soft robotics for various MIS applications, which will aid designers producing the next generation of devices.

Soft Robotics in Minimally Invasive Surgery.

The debilitating effects on hand function from a number of a neurologic disorders has given rise to the development of rehabilitative robotic devices aimed at restoring hand function in these patients. To combat the shortcomings of previous traditional robotics, soft robotics are rapidly emerging as an alternative due to their inherent safety, less complex designs, and increased potential for portability and efficacy. While several groups have begun designing devices, there are few devices that have progressed enough to provide clinical evidence of their design’s therapeutic abilities. Therefore, a global review of devices that have been previously attempted could facilitate the development of new and improved devices in the next step towards obtaining clinical proof of the rehabilitative effects of soft robotics in hand dysfunction. A literature search was performed in SportDiscus, Pubmed, Scopus, and Web of Science for articles related to the design of soft robotic devices for hand rehabilitation. A framework of the key design elements of the devices was developed to ease the comparison of the various approaches to building them. This framework includes an analysis of the trends in portability, safety features, user intent detection methods, actuation systems, total DOF, number of independent actuators, device weight, evaluation metrics, and modes of rehabilitation. In this study, a total of 62 articles representing 44 unique devices were identified and summarized according to the framework we developed to compare different design aspects. By far, the most common type of device was that which used a pneumatic actuator to guide finger flexion/extension. However, the remainder of our framework elements yielded more heterogeneous results. Consequently, those results are summarized and the advantages and disadvantages of many design choices as well as their rationales were highlighted. The past 3 years has seen a rapid increase in the development of soft robotic devices for hand rehabilitative applications. These mostly preclinical research prototypes display a wide range of technical solutions which have been highlighted in the framework developed in this analysis. More work needs to be done in actuator design, safety, and implementation in order for these devices to progress to clinical trials. It is our goal that this review will guide future developers through the various design considerations in order to develop better devices for patients with hand impairments.

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Soft robotic devices for hand rehabilitation and assistance: a narrative review

Soft robotics is a branch of robotics that deals with mechatronics and electromechanical systems primarily made of soft materials. This paper presents a summary of a chronicle study of various soft robotic hand exoskeletons, with different electroencephalography (EEG)- and electromyography (EMG)-based instrumentations and controls, for rehabilitation and assistance in activities of daily living. A total of 45 soft robotic hand exoskeletons are reviewed. The study follows two methodological frameworks: a systematic review and a chronological review of the exoskeletons. The first approach summarizes the designs of different soft robotic hand exoskeletons based on their mechanical, electrical and functional attributes, including the degree of freedom, number of fingers, force transmission, actuation mode and control strategy. The second approach discusses the technological trend of soft robotic hand exoskeletons in the past decade. The timeline analysis demonstrates the transformation of the exoskeletons from rigid ferrous materials to soft elastomeric materials. It uncovers recent research, development and integration of their mechanical and electrical components. It also approximates the future of the soft robotic hand exoskeletons and some of their crucial design attributes.

Moving toward Soft Robotics: A Decade Review of the Design of Hand Exoskeletons.

Various robotic exoskeletons have been proposed for hand function assistance during activities of daily living (ADL) of stroke survivors. However, traditional exoskeletons involve the use of complex rigid systems that impede the natural movement of joints, and thus reduce the wearability and cause discomfort to the user. The objective of this paper is to design and evaluate a soft robotic glove that is able to provide hand function assistance using fabric-reinforced soft pneumatic actuators. These actuators are made of silicone rubber which has an elastic modulus similar to human tissues. Thus, they are intrinsically soft and compliant. Upon air pressurization, they are able to support finger range of motion (ROM) and generate the desired actuation of the finger joints. In this work, the soft actuators were characterized in terms of their blocked tip force, normal and frictional grip force outputs. Combining the soft actuators and flexible textile materials, a soft robotic glove was developed for grasping assistance during ADL for stroke survivors. The glove was evaluated on five healthy participants for its assisted ROM and grip strength. Pilot test was performed in two stroke survivors to evaluate the efficacy of the glove in assisting functional grasping activities. Our results demonstrated that the actuators designed in this study could generate desired force output at a low air pressure. The glove had a high kinematic transparency and did not affect the active ROM of the finger joints when it was being worn by the participants. With the assistance of the glove, the participants were able to perform grasping actions with sufficient assisted ROM and grip strength, without any voluntary effort. Additionally, pilot test on stroke survivors demonstrated that the patient's grasping performance improved with the presence and assistance of the glove. Patient feedback questionnaires also showed high level of patient satisfaction and comfort. In conclusion, this paper has demonstrated the possibility of using soft wearable exoskeletons that are more wearable, lightweight, and suitable to be used on a daily basis for hand function assistance of stroke survivors during activities of daily living.

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Design and Preliminary Feasibility Study of a Soft Robotic Glove for Hand Function Assistance in Stroke Survivors

Over the last couple of decades, the advancement in Microelectromechanical System (MEMS) devices is highly demanded for integrating the economically miniaturized sensors with fabricating technology. A sensor is a system that detects and responds to multiple physical inputs and converting them into analogue or digital forms. The sensor transforms these variations into a form which can be utilized as a marker to monitor the device variable. MEMS exhibits excellent feasibility in miniaturization sensors due to its small dimension, low power consumption, superior performance, and, batch-fabrication. This article presents the recent developments in standard actuation and sensing mechanisms that can serve MEMS-based devices, which is expected to revolutionize almost many product categories in the current era. The featured principles of actuating, sensing mechanisms and real-life applications have also been discussed. Proper understanding of the actuating and sensing mechanisms for the MEMS-based devices can play a vital role in effective selection for novel and complex application design.

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A Review of Actuation and Sensing Mechanisms in MEMS-Based Sensor Devices

In the present study, the performance of silicone rubber-based bellows-structured pneumatic actuator was analyzed in terms of output bending motion and bending force with relation to input pressure. To perform the analysis, the structural parameters of length, diameter, and wall thickness were characterized and tested with two different silicone materials. The simulation analysis revealed that the stiffness of the silicone materials selected for the bellows actuator imposes strong effects on its bending motion and pneumatic input pressure requirement. Furthermore, the characterization of material-S-based bellows actuator having lengths 84, 126, and 168 mm, with a maximum diameter and a wall thickness of 14 and 1.4 mm, respectively, resulted in maximum output bending angles of 142.4°, 137.5°, and 117° at minimum pneumatic input pressures of 85.5, 66.5, and 85.5 kPa, respectively. Hence, the bellows actuator that simulated in a maximum bending angle of 142.4° was fabricated for validation and experimentally resulted in an average bending force of 9 N.

Design, characterization, and manufacturing of circular bellows pneumatic soft actuator

MEMS actuators for biomedical applications: a review

This paper presents a monolithic novel polydimethylsiloxane-based dual-channel bellows-structured pneumatic actuator, fabricated through a sacrificial molding technique. A finite element analysis was performed to find the optimal structure and analyze the bending performance of the square-bellows actuator. The actuator was designed with an overall cross-sectional area of 5 × 5 mm2, while its structural parameters were characterized in terms of 8, 12, 16 and 20 number of bellows. The actuator models were fabricated using acrylonitrile butadiene styrene-based sacrificial molds to form the channel and bellows structures. The experimental validation has revealed that the actuator having highest number of bellows with a size of 5 × 5 × 68.4 mm3 attained a smooth bi-directional bending motion, with maximum angles of −65° and 75°, and force of 0.166 and 0.221 N under left and right channel actuation, respectively, at 100 kPa pressure. Hence, the state-of-the-art dual-channel square-bellows actuator was able to achieve an optimal bi-directional bending with slight variations to change in temperature, which would push the boundaries of soft robotics toward the development of safer and more flexible robotic surgical tools.

PDMS-based dual-channel pneumatic micro-actuator

Over recent years, the reseach in the field of soft actuation has been extensively increased for achieving more complex motion path with smooth, high flexible movement and high generated force at minimum operating pressure. This paper presents the study on gripping force capability of soft actuators applied on glove-type finger exoskeleton, developed in motivation to assist individuals having weak finger gripping ability in their rehabilitation exercise towards hand function restoration. The exoskeleton utilizes five cylindrical shaped pneumatic bending actuators developed in the lab, which use fiber reinforcement as a cause of bending motion that drive finger’s flexion movement. Four right-handed healthy volunteers simulated paralysis participated in the study. At 200kPa safe operating pressure, the soft exoskeleton worn by the subjects demonstrates the ability to provide adequate grip force. The grip force generated from exoskeleton worn on passive right hand is 4.66 ± 0.2 N and 3.61± 0.2 N from passive left hand, both higher than the minimum grip forces measured to hold the Hand Dynamometer of 240 g. It shows good potential to be used as a finger rehabilitation assist device.

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Grip force measurement of soft- actuated finger exoskeleton

In this paper, metallic thermoelectric generators were studied and fabricated using copper (Cu) and cobalt (Co) as their respective positive and negative thermoelements. Thus, the chosen Cu-clad polyimide substrate alleviated the deposition of Cu and eased the microfabrication. A lateral device structure might assist in generating larger output power through its longer thermoleg length. Hence, the fabricated thick-film devices had planar and lateral structures with lateral heat flow and lateral thermopile layout. The strong correlations of electrical and thermal conductivities in metal thermoelements have resulted in lower Seebeck coefficient along with reduced thermoelectric power-generating performances. Alternatively, a thermoleg cross-sectional area ( ${A}$ ) optimization approach may optimize these disrupting correlations and improve their power-generating effectiveness, whereas a sandwiched planar structure can allow more thermopiles to be integrated without influencing the generator’s size. Both A optimization and sandwiched planar structure have rarely been applied and studied in the past works and have never been implemented using metal thermoelements. Hereafter, a Cu–Co device was enhanced through ${A}$ optimization by increasing the thickness of Co over 3.86 times the Cu thickness, and the implementations of a sandwiched planar structure. Herein, a flexible sandwiched planar thermoelectric generator was fabricated for the first time, using simpler microfabrication. This enhanced Cu–Co generator achieved a thermoelectric efficiency factor of ${6.6} \times {10}^{-{3}}\,\,\mu $ Wcm−2K−2( $12.89~\mu $ Wcm−2) at a temperature difference of 44.2 K. It remarked 3.1 times of improvement (by stacking three sets of thermopile) than its similar single Cu–Co thermopile of ten thermocouples.

Tariq Rehman

Papers

Design, characterization, and manufacturing of circular bellows pneumatic soft actuator

MEMS actuators for biomedical applications: a review

PDMS-based dual-channel pneumatic micro-actuator

Grip force measurement of soft- actuated finger exoskeleton

Copper–Cobalt Thermoelectric Generators: Power Improvement Through Optimized Thickness and Sandwiched Planar Structure