A Dexterous Soft Hand Exoskeleton Restores Intentional Grasping for Individuals with Severe Hand Impairment

A Dexterous Soft Hand Exoskeleton Restores Intentional Grasping for Individuals with Severe Hand Impairment | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article A Dexterous Soft Hand Exoskeleton Restores Intentional Grasping for Individuals with Severe Hand Impairment John Nassour, Nicolas Berberich, Daniel Utpadel-Fischler, Tobias Wächter, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7855715/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted You are reading this latest preprint version Abstract Restoring reliable grasping of diverse objects is a priority for individuals with severe hand impairments. We report the translational development of a lightweight, textile-based soft robotic exoskeleton glove with wrist dorsiflexion and an active opposable and abductable thumb, designed to restore hand function in a patient with severe right-hand impairment due to amyotrophic lateral sclerosis (ALS). We followed a co-creation approach, enhancing dexterity by increasing hand articulations based on patient needs. Furthermore, to enhance the patients' sense of control, a non-invasive sEMG-based grasp predictor (97% sensitivity) was combined with motion data and ML-based error-correction to compensate for weak, noisy muscle signals, compared to healthy controls (n=15). The exoskeleton assistance enabled the patient to intentionally grasp everyday objects, achieve a Box-and-Blocks Test score of 5, and regain the ability to feed himself. To evaluate broader applicability, we validated the exoskeleton with stroke patients (n=6). While exoskeleton assistance on average reduced ARAT scores of moderately impaired patients by 9, severely impaired patients scored 17 points higher when using the exoskeleton. Health sciences/Health care/Quality of life Physical sciences/Engineering/Biomedical engineering Full Text Additional Declarations There is NO Competing Interest. Supplementary Files 5GraspRobustnessExperiments.mov Robustness 3EMGtrainingGames.mov EMG traning SiliconHandThumbCoactivationFlexExtNiddle.mp4 Silicon Hand ThumbCoactivationFlexExt-Niddle 1overview.mov Overview SiliconHandPinchCylindricalLateral.mp4 Silicon Hand Pinch-Cylindrical-Lateral SiliconHandPowerGraspCubes.mp4 Silicon Hand Power Grasp Cubes SiliconHandWaterBottle.mp4 Silicon Hand Water Bottle 2multipleGraspTypes.mov patient various grasp 4BoxAndBlocksTest.mov Box and Blocks test SiliconHandWristDorsiflexion.mp4 Silicon Hand Wrist Dorsiflexion 6ARATValidationStroke.mov ARAT test Validation with Stroke patients SiliconHandTwoFingersPinching.mp4 Silicon Hand Two-Fingers Pinching Cite Share Download PDF Status: Under Review Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7855715","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":529594480,"identity":"cbeffea2-adb0-4728-9c00-dc7732088b7e","order_by":0,"name":"John Nassour","email":"","orcid":"","institution":"Technical University of Munich","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"","lastName":"Nassour","suffix":""},{"id":529594481,"identity":"dedffa02-8f52-483e-b672-3da41c19c675","order_by":1,"name":"Nicolas Berberich","email":"","orcid":"","institution":"Institute for Cognitive Systems, Technical University of 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