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The purpose of this study is to present a novel hybrid closed-loop control method together with its performance validation for the dexterous prosthetic hand.

The hybrid closed-loop control is composed of a high-level closed-loop control with the user in the closed loop and a low-level closed-loop control for the direct robot motion control. The authors construct the high-level control loop by using electromyography (EMG)-based human motion intent decoding and electrical stimulation (ES)-based sensory feedback. The human motion intent is decoded by a finite state machine, which can achieve both the patterned motion control and the proportional force control. The sensory feedback is in the form of transcutaneous electrical nerve stimulation (TENS) with spatial-frequency modulation. To suppress the TENS interfering noise, the authors propose biphasic TENS to concentrate the stimulation current and the variable step-size least mean square adaptive filter to cancel the noise. Eight subjects participated in the validation experiments, including pattern selection and egg grasping tasks, to investigate the feasibility of the hybrid closed-loop control in clinical use.

The proposed noise cancellation method largely reduces the ES noise artifacts in the EMG electrodes by 18.5 dB on average. Compared with the open-loop control, the proposed hybrid closed-loop control method significantly improves both the pattern selection efficiency and the egg grasping success rate, both in blind operating scenarios (improved by 1.86 s, p < 0.001, and 63.7 per cent, p < 0.001) or in common operating scenarios (improved by 0.49 s, p = 0.008, and 41.3 per cent, p < 0.001).

The proposed hybrid closed-loop control method can be implemented on a prosthetic hand to improve the operation efficiency and accuracy for fragile objects such as eggs.

The primary contribution is the proposal of the hybrid closed-loop control, the spatial-frequency modulation method for the sensory feedback and the noise cancellation method for the integrating of the myoelectric control and the ES-based sensory feedback.

The purpose of this paper is to develop textile-based transcutaneous electrical nerve stimulation (TENS) electrodes using conductive yarn to bring a solution to uncomfortable feelings and hygiene problems of conventional conductive hydrogel electrodes. It proposes washing process, resistance measurements and subjective tests to evaluate the performance of the developed textile-based electrode.

In this study, six different textile electrode pairs were designed and produced with different patterns. Designed electrodes were washed for ten times. In order to evaluate the effect of pattern differences and washing process on electrode performances, two different tests were realized before and after washing. The first of these tests is resistance measurement with a multimeter, and the second one is subjective test carried out on subjects.

The results obtained from resistance measurements indicated that the pattern differences cause resistance values of electrodes to change. It is reported that subjects had electrical stimulation from all electrode samples in conducted trials and it is noticed that washing process does not cause any stimulation problems.

In this study, textile-based TENS electrodes having different patterns were produced by machine stitching technique and their long-term usage behaviors were examined with repeated washing processes and trials on the subjects.

The purpose of this paper is to present a five-fingered, multisensory prosthetic hand integrating both intuitive myoelectric control and sensory feedback.

The artificial hand’s palm has a three-arcuate configuration and the thumb can move along a cone surface, improving the resemblance with the biological hand. By using a coupling linkage mechanism, each finger is independently actuated by a direct current motor. Both torque and position sensors are embedded in the finger to sense the hand’s status and its interaction with the outer environment. The proposed human-in-the-loop control system consists of an internal motion control scheme and an external human–machine interface. The pattern recognition-based electromyography (EMG) control scheme is adopted to control the motion of the hand, and the transcutaneous electrical nerve stimulation (TENS) is utilized to feedback the hand’s sensory information to its user.

The hand prototype shows that it has an anthropomorphic appearance (85 per cent to an average human hand), low weight (420 g), great power (10 N on the fingertip) and eligible dexterity. Clinical evaluation of the prosthetic hand on transradial amputees also approves the hand design.

From a systematic view, the paper details the design concepts of the HIT–DLR prosthetic hand IV, especially on its appearance, mechanism, myoelectric control and sensory feedback.

Carpal tunnel syndrome (CTS) is a hand disease caused by the pressing of the median nerve present in the palmar side of the wrist. It causes severe pain in the wrist, triggering disturbance during sleep. Different products like splints, braces and gloves are available in the market to alleviate this disease but there was still a need to improve the wearability, comfort and cost of the product. This study was about designing a comfortable and cost-effective wearable system for mild-to-moderate CTS. Transcutaneous electrical nerve stimulation (TENS) therapy has been used to reduce the pain in the wrist.

After simulation by using Proteus software (which allowed the researchers to draw and simulate electrical circuits using ISIS, ARES and PCB design tools virtually), the circuit with optimum frequency, i.e. 33 Hz was selected, and the circuit was developed on a printed circuit board (PCB). The developed circuit was integrated successfully into the half glove structure.

The developed product had good thermophysiological comfort and hand properties as compared to the commercially available product of the same kind. In vivo testing (It involves the testing with living subjects like animals, plants or human beings) was performed which resulted in 85% confirmed viability of the product against CTS. A glove with an integrated circuit was developed successfully to accommodate various sizes without any sex specifications in a cost-effective way to mitigate the issue of CTS.

Industrial workers, individuals frequently using their hands or those diagnosed with CTS may wish to use this product as therapy. The attention could not be paid to the aesthetic or visual appeal of the developed product.

A very comfortable glove with integrated TENS electrodes was developed successfully to accommodate various sizes without any sex specifications in a cost-effective way to mitigate the issues of CTS.

The purpose of this paper is to develop a user friendly, wearable pain management system by optimizing CAD embroidery parameters for manufacturing high performance dry transcutaneous electrical neural stimulation (TENS) electrodes.

User-centered design methodology is employed to identify user needs related to TENS devices. Optimization of CAD embroidery parameters was done by measuring and calculating resistance and signal-to-noise values for electrodes manufactured with different conductive thread, stitch pattern, and stitch density types.

Characteristics of the conductive thread such as thickness and irregularity, embroidery stitch pattern, stitch density therefore the amount of conductive thread used all effect resistance values and signal-to-noise values of TENS electrodes. Low resistance of TENS electrode surface does not mean high signal-to-noise ratio and high TENS signal quality. Satin stitch type with low stitch density provides the best resistance and signal-to-noise ratio for a TENS electrode.

This study reported the design process of a wearable pain management system with a focus on optimization of embroidery manufacturing parameters for development of TENS electrodes. The design process not only required technical optimization but also understanding user problems related to use of conventional TENS devices. Proposed end product is a user friendly, electronic textile based, wireless wearable pain management system in different forms suitable for major pain areas such as knee, elbow and neck.

This study aims to evaluate the effect of Alpha-Stim Anxiety, Insomnia and Depression (AID) cranial electrotherapy stimulation (CES) on anxiety, depression and health-related quality of life for primary care social prescribing service patients with anxiety symptoms.

Open-label patient cohort design with no control group. A total of 33 adult patients (average age 42 years) completed six weeks of Alpha-Stim AID use. Pre- and post-intervention assessment with participant self-report measures: Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7) and European Quality of Life Five Dimension (EQ-5D-5L).

Reliable improvement and remission rates, respectively, were 53.39% and 33.3% for GAD-7; 46.7% and 29.5% for PHQ-9. There was a significant improvement in GAD-7 and PHQ-9 with large effect sizes. EQ-5D-5L results showed significant improvements in health-related quality of life. Perceived quality of life increased by 0.17 on the health index score, with the intervention adding 1.68 quality-adjusted life years (QALYs).

Alpha-Stim AID can be delivered through a primary health-care social prescribing service and most patients will use as prescribed and complete treatment course. Alpha-Stim AID CES may be an effective anxiety and depression treatment for people with anxiety symptoms. The widespread roll-out of Alpha-Stim AID in health-care systems should be considered.

To the best of the authors’ knowledge, this is the first study to respond to the UK’s National Institute for Health and Care (NICE) request for the collection of real-world data to understand better Alpha-Stim AID in relation to people’s treatment uptake, response rates and treatment completion rates (NICE, 2021).

As one of the most dynamic and consequential areas of biomedical research, neuroscience must be analyzed in a broader political context. Research initiatives, individual use, and aggregate social consequences of unfolding knowledge about the brain and the accompanying applications require particularly close scrutiny because of the centrality of the brain itself to human behavior and thoughts. As one of the last frontiers of medicine, neuroscience has strong support because it promises to benefit many patients suffering from an array of behavioral, neurological, and mental disorders and injuries. Given the inevitability of expanded strategies for exploration and therapy of the brain, it is important that the political issues surrounding their application be clarified and debated before such techniques fall into routine use.

Urinary incontinence is one of the most important health problems for people over 65 years of age. It is defined as involuntary and uncontrolled loss of urine. This paper aims to present a contemporary view on the effects of physiotherapeutic procedures in combating urinary incontinence. Physiotherapeutic procedures were compared: pelvic floor muscle exercises, physical therapy and biofeedback (BF) to demonstrate their effectiveness in managing urinary incontinence in the elderly.

The databases Pubmed and GoogleScholar have been searched for articles on the impact of interventions – physiotherapeutic procedures on the effectiveness of the treatment of urinary incontinence in the elderly.

Pelvic floor muscle exercises are effective in the treatment of urinary incontinence, strengthen muscle strength and improve patients' quality of life. A long-lasting, systematic and individual training program with a physiotherapist is the most effective. BF helps to intensify the therapeutic effect of exercise but also allows you to achieve good results as an independent treatment method. Positive effects are also noticeable in physical therapy, electrostimulation and magnetotherapy are very effective. Physiotherapeutic procedures have a positive effect in the treatment of urinary incontinence in the elderly. However, further research is needed to clarify the most effective methods.

This paper offers many ways to deal with urinary incontinence in the elderly using physiotherapeutic procedures, thus helping to improve the quality of life of those affected by urinary incontinence.

A novel model of the upper arm under transcutaneous electrical stimulation with multi-pad electrodes is presented and experimentally validated. The model aims at simulating and analysing the effects of surface electrical stimulation on biceps brachii. The paper aims to discuss these issues.

Both the passive properties of tissues surrounding nerve bundles and the active characteristics of the nervous system are included. The output of the proposed model is nerve recruitment and muscle contraction.

Simulations and experimental tests on six healthy young adults have been conducted and results show that the proposed model gives information on electrically elicited muscle contraction in accordance with in-vivo tests and literature on motor unit recruitment order. Tests with different electrodes configurations show that the spatial distribution of active electrodes is a critical factor in electrically elicited muscle contractions, and that multi-pad electrodes can optimise the stimulation effectiveness and patient comfort with sequences of biphasic pulses of 350 μs at 30 pulses/s and threshold values of 2 mA.

Results encourage the use of the proposed model of the upper arm as a valid and viable solution for predicting the behaviour of the neuromuscular system when surface electrical stimulation is applied, thus optimising the design of neuroprosthetics.

Hematopoietic stem cell transplant (HSCT) patients can suffer from long-term transplant-related complications that affect their quality of life and daily activities. This study, a narrative review, aims to report the impact of HCT complications, the benefits of rehabilitation intervention, the need for long-term care and highlights the research gap in clinical trials involving rehabilitation.

A comprehensive search strategy was performed on several databases to look for relevant articles published from 1998 to 2018. Articles published in English with the following terms were used: hematopoietic stem cell transplant, chronic graft-versus-host disease, rehabilitation, exercise, physical therapy, occupational therapy. A patient/population, intervention, comparison, and outcomes (PICO) framework was employed to ensure that the search strategies were structured and precise. Study year, design, outcome, intervention, sample demographics, setting and study results were extracted.

Of the 1,411 records identified, 51 studies underwent title/abstract screening for appropriateness, 30 were reviewed in full, and 19 studies were included in the review. The review found that, for the majority of patients who underwent HSCT and developed treatment-related complications, rehabilitation exercises had a positive impact on their overall quality of life. However, exercise prescription in this patient group has not always reflected the scientific approach; there is a lack of high-quality clinical trials in general. The review also highlights the need to educate healthcare policymakers and insurance companies responsible for rationing services to recognise the importance of offering long-term follow-up care for this patient group, including rehabilitation services.

A large number of HSCT patients require long-term follow-up from a multidisciplinary team, including rehabilitation specialists. It is important for healthcare policymakers and insurance companies to recognise this need and take the necessary steps to ensure that HSCT patients receive adequate long-term care. This paper also highlights the urgent need for high-quality rehabilitation trials to demonstrate the feasibility and importance of rehabilitation teams.

Healthcare policymakers and insurance companies need to recognise that transplant patients need ongoing physiotherapy for early identification of any functional impairments and appropriate timely intervention.