# A Novel Soft Robotic Exoskeleton System for Hand Rehabilitation and Assistance Purposes
## 1 Introduction
These actuators were connected with a portable hydraulic system (pump & controller), resulting in a portable device designed to facilitate the movement of the human hand and fingers. Furthermore, [PERSON] et al. [17] developed a similar device with the addition of abduction capabilities and a telescopic thumb combined with a mobile application for the control to facilitate the interaction between the user and the device. Moreover, [PERSON] and [PERSON] [18] published a narrative review about soft robotic devices for hand rehabilitation and assistance tasks. In this review, more than 60 studies were examined and presented from the last decade, pointing out the plethora of soft pneumatic robotic devices with SEG configuration providing mainly flexion motion capabilities. In addition, the study highlighted the lack of integrated hand rehabilitation devices and the absence of results from clinical trials. To this end, the objective of the current research is to present the workflow of the design, development, and examination of a fully functional and complete soft robotic exoskeleton system for hand rehabilitation and assistance purposes, which is already utilized in ongoing clinical trials in hospitals and rehabilitation centers applied to participants with hand movement difficulties. The novelty of the developed SEG focuses on the ability to monitor and control in real-time the position of each finger and also the capacity to regulate the device's motion through the software or through a control glove that captures the desired finger motion from the healthy hand and repeated in the hand with the mobility difficulty. In this context, the function and the control of the SEG's motion become easier, more accurate, and more realistic. Furthermore, the presented SEG reveals an innovative manufacturing procedure to rapidly fabricate customized devices for healthy applications via the utilization of additive manufacturing techniques (rapid tooling, direct manufacturing, etc.) [19; 20]. To summarize, the current article presents an integrated, fully functional SEG device with real-time control and monitoring implementing modular design for the SEG via the additively manufactured parts. We present a unique system composed of an SEG that co-operates with the data glove in order to transfer the motion from the healthy hand to a hand with particular motion constraints. The design is unique, allowing bidirectional finger motions, the control is offered in real-time based on an axis flexible sensor, and the overall system is designed to respect the safety constraints imposed by the targeted application domain. In particular, the current paper consists of five sub-sections, of which Section 2.1 lists the requirements coupled with the technical specifications of an SEG device. In Section 2.2, the employed actuator is presented with its motion mechanism and the measured experimental capabilities. Furthermore, the strategies of the developed software for this device are described in Section 2.3. In Section 3.1, the final design and assembly of the developed SEG are depicted with both the physical device and the software application. Finally, Section 3.2 summarizes the most important results from measurements of the device function coupled with the certifications and the extensive testing that has been conducted by healthy participants (control group) and patients. Figure 1 portrays the flowchart of the SEG's device development coupled with a detailed description of each followed procedure. Figure 1: Flowchart of the soft robotic exoskeleton’s development.