Mechanism and Machine Theory 99 (2016) 83102

Contents lists available at ScienceDirect

Mechanism and Machine Theory

journal homepage: www.elsevier.com/locate/mechmt

A novel motion-coupling design for a jointless tendon-driven

nger exoskeleton for rehabilitation
Jianyu Yang* , Hualong Xie, Jiashun Shi
School of Mechanical Engineering and Automation, Northeastern University, 110819 Shenyang, Liaoning, PR China

A R T I C L E I N F O A B S T R A C T

Article history: We have designed a new jointless tendon-driven exoskeleton plan for the human hand that
Received 11 March 2015 provides a correct and stable motion sequence while keeping the structure lightweight, com-
Received in revised form 23 November 2015 pact and portable. Before the development, anatomy analysis and a kinematics study of the
Accepted 24 December 2015 human nger were performed, and bending angle relationships among the metacarpopha-
Available online 21 January 2016
langeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints were
analyzed. Detailed implementation is discussed, including the basic theory of the joint motion
Keywords: coupling method, related formula derivations and mechanical design of an experimental
Finger rehabilitation device. An experimental setup was built, and series of experiments was conducted to exam-
Hand exoskeleton ine and evaluate the developed joint motion coupling plan.The results indicated that the new
Jointless tendon-driven
plan worked correctly as desired, that an incorrect nger motion sequence did not occur and
Motion coupling
that the new coupled tendon driven plan can drive nger bending as naturally as a human.
The compactness and light weight of the entire structure of the device means that its parts
can be arranged for a hand glove or ngerstall more easily than most bar-linkage exoskeleton
structures.
2015 Elsevier Ltd. All rights reserved.

1. Introduction

A motion failure in a hand or nger can be cured by passive repetitive movement called therapy training for the suffering
joints. Usually, these therapy movements are performed by a therapist; however, the boring training processes and shortage of
therapists may cause the patient discontinue them [1]. On the other hand, major joints of affected body parts usually recover
sooner than minor joints. Therefore, hand and nger joints normally experience the most dicult recoveries. To avoid the
drawbacks of traditional manual therapy training, many exoskeleton devices have been developed for hand or nger motion
rehabilitation.
For example, H. Kawasaki et al. built a hand-assist robot with multiple DOF (degrees of freedom) for hand rehabilitation.
The robot is an in-hospital device that can generate precise movements for each nger joints in the human hand [2,3,4]. Other
devices for the same purpose with different mechanisms were developed by Y. Huang [5] and by L. Dovat et al., with a device
called HANDCARE [6,7]. These devices were developed as in-hospital devices that sacriced small size for ease in arranging
complicated mechanisms. The advantage was obviously that with the complicated mechanisms, adjustment of more precise
motion sequences and force outputs was easier, producing better rehabilitation performance.
However, with in-hospital devices, patients had to come to the hospital for therapy training, which still limited the ther-
apy duration. Therefore, various wearable devices that patients can take with them, have been developed for rehabilitation.

* Corresponding author. Tel./fax: +8602483671585.

E-mail address: jyyang@mail.neu.edu.cn (J. Yang).

http://dx.doi.org/10.1016/j.mechmachtheory.2015.12.010
0094-114X/ 2015 Elsevier Ltd. All rights reserved.
84 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

An EMG controlled exoskeleton device for hand rehabilitation by M. Mulas et al. is a wearable device with a reduced mechan-
ical structure that provides only basic and imprecise open-close movements for the hand [8] . A similar device developed by
J. H. Bae uses an air piston to drive four ngers at distal phalanges to bend toward or away from the thumb, but ignores the
angle relationships among nger joints while bending the ngers [9]. N. Ho et al. developed a more dedicated hand exoskeleton
devece a ve-ngered pneumatic hand robot. In this device, piston-driven exoskeleton parts drive ve ngers separately at
their middle phalanges [10].
For more accurate and complex nger movement, exoskeleton devices with more joints were developed, that have more
complicated mechanisms, usually a bar-linkage system or gear system, such as the device built by Andreas Wege and et al.
[11,12,13]. They developed a ve ngered tendon-driven bar-linkage exoskeleton system with EMG support for rehabilitation.
Other jointed devices with bar-linkage or gear mechanical structures were also developed by B. L. Shields et al. [14], B. Choi et
al. [15,16], T. Worsnopp et al. [17], HandEXOS by A. Chiri et al. [18], M. Fontana et al. [19], R. Riener et al. [20], B. Lee et al. [21],
A. P. Tjahyono et al. [22], M. Cempini et al. [23], and J. Li et al. [24].
As mentioned above, Heo [25] noted that the current styles of wearable mechanisms used as hand or nger exoskeletons
for matching the center of rotation or eliminating the need for precise alignment include: 1) a direct matching of joint centers,
2) linkages for a remote center of rotation, 3) a redundant linkage structure, 4) a serial linkage attached to distal segment,
5) a bending actuator attached to the joint. Mechanically, these devices were functionally successful in realizing or assisting
the kinematics and dynamics aspects of human nger movements. However, unlike industrial-purposed devices, mechanical
functional success is not enough for these human related devices: factors have to be considered more seriously such as cost,
weight, size and appearance, safety, and manmachine interfacing [26]. From the portability and wearability points of view,
current devices still need to be improved. Thus, jointless tendon-driven mechanisms were developed.
In comparison with the formal ve exoskeleton devices, jointless tendon-driven mechanism is the most compact, light-
weight and portable. Therefore, in this paper, we focus on developing a new jointless tendon-driven exoskeleton design, with
which humanly motion sequence among the nger joints can be acquired to avoid the drawbacks of the traditional one, which
will be discussed in detail in the next section. With such wearable device, it is not only that therapy training can be brought
into the patients daily lives, but additionally the devices can assist the patient to accomplish basic movements, improving living
experience before the recovery of their disabled body part.

2. Drawback of traditional tendon driven plans

According to Heo [25], the tendon arrangement plans of most current jointless tendon-driven hand exoskeleton structures
can be abstracted as in Fig. 1. One tendon cable on the dorsal side is xed at the tip of the nger, simply passed through the
sheaths mounted beside each joint and nally pulled by an actuator; the ventral side tendon cable, pulled by another actuator,
is xed and arranged in the same way. In this case, whole structure of the exoskeleton can be designed as compactly as possible;
usually all the parts except the actuators can be integrated and hidden in a hand glove, such as the Tendon-Driven Glove [27],
and the SNU Exo-Glove [28].
However, the above tendon-driven plan usually produces an incorrect bending sequence that the farther joints of the nger
have higher priority in the moving sequence than the nearer. This non-human motion can be observed in Fig. 2, by simply using
the tendon arrangement plan shown in Fig. 1, with a nger exoskeleton demonstrating setup.
As seen in subgures (a) through (d) of Fig. 2, the wrong bending sequence can be produced when the ventral tendon is
pulled, the DIP joint of the nger bends rst, the PIP joint would not bend until the DIP reached its limit, and the same happened
between the PIP and the MCP joints. However, it can be easily observed from (a) through (d) of Fig. 3, showing the natural poses
of a bending human nger, that as a nger bends naturally, all three joints should be coupled. Bending sequence of nger joints
is important in the late recovering stage and for patients who had suffered from nger function failure sequelae 23 years after
the recovering from the stroke. For these stages, patients usually receive rehabilitation trainings at home, and grasping as well

Driving tendons

Rotary center of PIP

Rotary center
Sheathes
of DIP
Rotary center
of MCP

Fig. 1. Tendon cable arrangement plan of current jointless hand exoskeletons.

 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102 85

(a) (b) (c) (d)

Fig. 2. Tendency for incorrect motion produced by traditional tendon arrangement.

as handling movements are involved. Thus, it is necessary for the exoskeleton device to offer coupled motion sequence among
the three nger joints, otherwise training of grasping movement would fail.
By adjusting friction between the tendon cables and sheaths at every joint, the incorrect sequence can be xed; however,
it is predictable that as long as abrasion occurs, the scheme of adjusting friction will not keep the motion stable. Furthermore,
adding friction will usually lower eciency, which could be a challenge to actuators, such as shape memory alloy actuators
[26,29,30], with the characteristics of small volume, low power input and low weight that are necessary for portability.
Considering the above factors, it is necessary to develop a new tendon-driven plan for nger exoskeletons that can achieve
the correct joint-bending sequence while satisfying portability demands. Note that, the goal of this research was not to develop
one device for all stages during nger/hand rehabilitation, but exactly for helping patients in the late recovering stages at home
as mentioned above, by rehabilitating and assisting ordinary grasping and handling movements. From this point of view, offering
motion sequence is also meaningful.

3. Anatomy and kinematics studies of human ngers

To nd a good plan for tendon arrangement for our nger exoskeleton, that will couple joints movements eciently while
keeping the whole structure compact, studies of human nger structure characteristics and kinematics are needed.

3.1. Finger anatomy studies

As shown in Fig. 4, the bone structure of the motion mechanism of the human nger is mainly determined by the metacarpal
and phalanges. The metacarpal is located in in the palm of the human hand providing a rotating and xing base to the nger,
while phalanges make up the nger and are connected to the metacarpal. There are three phalange components, including the
proximal phalanx, middle phalanx and distal phalanx. These bones are connected by three joints: the MCP joint, connecting
metacarpal bone and proximal phalanx; the PIP joint, connecting proximal and middle phalanx, and the DIP joint, connecting
the middle and distal phalanx.
Four degrees of freedom (DOF) govern the motion of these three joints; the MCP has two DOFs as a universal joint allowing
for both exion/extension and adduction/abduction, while each of the other two has a single DOF as a normal rotary joint,
supporting exion/extension only. In this case, an index nger can be regarded as a four-DOF-bar mechanical system within
which the DIP DOF is subordinated to that of the PIP, and the motion of DIP joint is usually coupled with the PIP when the nger
does a natural bend.
According to Levangie, the typical maximum motion range of the index nger is 90 for the MCP, 100 110 for the PIP and
80 for the DIP in exion/extension movements. For its adduction/abduction movements, the index nger has a range of motion
of approximately 40 [31]. However, these motion ranges of the joints can vary between different ngers as well as different
persons [28,32] because the factors that dene the range of joint motion are not only bone geometry in the nger but also the
tendon and muscle structural characteristics of the hand. Thus, the index nger has the greatest range of motion compared
with the others; some peoples ngers may bend very far in the opposite direction of the palm side of the hand. Therefore, it is

(a) (b) (c) (d)

Fig. 3. Natural poses of human nger movements.
86 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

Phalanx Extensor Hood

Metacarpal bone
Distal Middle Proximal MCP
Joint
PIP
DIP Joint EDC&EIP
Joint Tendon

FDP FDS
Tendon Tendon Lumbrical Interosseous
Muscle(LU) Muscle(IO)

Fig. 4. Anatomy of the index nger [26].

required to customize the dimensions as well as kinematics of an exoskeleton device according to measured data of each specic
user. In this paper, the ranges of motion of the three joints came from index nger motion tests during the kinematics study.

3.2. Finger kinematics studies

A kinematics study of the nger was undertaken to ensure that the following development of the exoskeleton device would
provide the correct motion tendency when driving the disabled nger. The study was based on a series of measuring tests of
the index nger. A type of exoskeleton device with rotary sensors was developed for measuring the bending angle vs. time
relationships of all MCP, PIP and DIP joints. As shown in Fig. 5, the developed measuring device was worn on the left index
nger; one rotary sensor was mounted at the MCP joint, and another two rotary sensors were mounted at the DIP and PIP joints
on the other side of the nger. The device was custom designed to strictly match the dimensions of the tester left index nger;
marked parts (1, 2, 3, 4) were axed to the corresponding nger segments and the hand, ensuring fewer rotary errors during
the tests. Proportional voltage signals were read by a data acquisition (DAQ) card.
Note that, the translational motion of phalanges during bending is smaller than muscles and skins transformation values
which affects the measuring more signicant during nger exing. For example, Florian Hess etal. have observed the trans-
lational motion was between 0.06 mm and 0.73 mm for the PIP joint in their experiments [33]. In this case, many current
researchers had treated the nger joints as pure revolute joints [34,35,36,37]. Thus, it is reasonable to use rotary sensors to
measure the angles of nger joints.
With the measuring device, the test on the index nger was conducted by repeatedly making exion/extension movements.
The data of the exion/extension angles of three joints vs. time were recorded as in Fig. 6, from which the maximum bending
angles are listed in Table 1: 87 for the MCP, 110 for the PIP and 60 for the DIP. Note that the PIP joint usually reaches its
limitation angle of 110 before the other two joints reach their respective limits; 87 and 60 are not the limits of the MCP or
DIP, because if the tester used more force, the bending angles of MCP and DIP could go farther. The variation of force during the
exion movements caused the joint maximum angles to vary during the test.

Stuck point

1 2

4
Rotary Sensors
(One for each joint)

Fig. 5. Joint bending angle measuring device.

 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102 87

140
PIP MCP DIP
120

100

80

Angles
60

40

20

0
0 2000 4000 6000 8000 10000 12000
Time(ms)

Fig. 6. Joints exion/extension angle vs. time on index nger.

Selected data were used to produce the angle relationships as in Fig. 7, in which the data from nger exion and extension
were processed separately. Fig. 7 (a) is the PIP vs MCP relationship in nger exion, where the data seems disordered because
there is no anatomically coupling between the PIP and MCP during exion movements: the two joints can move independently.
Fig. 7 (b) is the DIP vs. PIP relationship in nger exion: the data became more focused, showing a coupling effect between
the two joints. Between 40 and 80 of PIP, the data became more scattered, which means the coupling effect became weaker,
allowing the DIP joint to have structural adaptability for different shapes the nger touched and forces it used.
Compared to sub-gures (a) and (b), the data in (c) and (d), which are nger-extending PIP vs. MCP and DIP vs. PIP angle
relationships, seem more regular. Anatomically, the arrangement of the EDC and EI tendons in Fig. 4 offers the nger a better
movement-coupling mechanism for extension. EDC and EI are the main extensor tendons for a nger; they merge at the MCP
joint with the extensor hood, while on the other side of the MCP they separate into three tendons, one linked to the middle
phalanx, the other two rejoin at and attach to the distal phalanx.
Note that in Fig. 7 (c) and (d), as long as the nger extended, the data were generated from the upper right to the lower
left, and because of the data regularity, approximation became more meaningful. In Fig. 7 (c), when the MCP angle decreases in
area [70 , 87 ] and [0 , 10 ], the PIP angle changes slightly. For the entire movement, a 4th degree polynomial approximation
matches the data well, as in Eq. (1), where x represents the MCP angle and y represents the PIP angle.

y = 6e 06x4 0.0015x3 + 0.11x2 0.96x + 5.6 (1)

In Fig. 7 (d), the data presents a similar tendency as in Fig. 7 (c) as the PIP angle decreases in area [90 , 110 ] and [0 , 20 ],
the DIP angle changes less than 5 . Eq. (2) is a 4th degree polynomial approximation to the entire motion, matching the data
better. If u represents the PIP angle value and v represents the DIP angle value, the equations are:

v = 1.7e 06u4 + 0.00026u3 0.0053u2 + 0.17u + 0.52. (2)

3.3. Considerations for a nger exoskeleton based on kinematics studies

From the anatomical study and kinematics study, the following four conclusions can be drawn for the structural design of an
exoskeleton:

1) During exing, the MCP and PIP joints of the index nger have no anatomical coupling mechanism; the relationship
between these joints could follow any possible rule. For the natural bending of the nger, the rule depends mainly on

Table 1
Motion range of index nger.

Joint name Range of motion(degree)

MCP exion/extension 87
PIP exion/extension 110
DIP exion/extension 60
88 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

120 70

60
100
PIP angle value(degrees)

50

DIP angle value(degrees)

80

40
60
30

40
20

20
10
MCP angle value(degrees) PIP angle value(degrees)
0 0
0 10 20 30 40 50 60 70 80 90 0 20 40 60 80 100 120

(a) PIP vs. MCP when flexing (b) DIP vs. PIP when flexing
120 70
PIP vs MCP data DIP vs PIP data
Approximation 60 Approximation
100

DIP angle value(degrees)

50
PIP angle value(degrees)

80

40
60
30

40
20

20
10
MCP angle value(degrees) PIP angle value(degrees)
0 0
0 10 20 30 40 50 60 70 80 90 0 20 40 60 80 100 120

(c) PIP vs. MCP when extending (d) DIP vs. PIP when extending
Fig. 7. Angle relationships among MCP, PIP and DIP.

the nger-bending situation and the tester desires. For a mechanical nger or a nger exoskeleton, this translates to freer
choices for controlling the bending relationship between MCP and PIP when exing.
2) During exing, DIP vs. PIP joint relationship shows a coupling tendency relative to that of PIP vs. MCP, but it becomes
weaker when PIP bends into the area of [40, 80]. This gives the DIP joint the capability of adapting to the bending situation
and the contact force at the nger tip. This means that it is unnecessary to strictly couple PIP and DIP through the entire
ex because the nger has more adaptability for exion movement.
3) During extension, DIP vs. PIP and PIP vs. MCP both have stronger movement coupling and a 4th degree polynomial approx-
imation ts all data very well. Considering points 1) and 2), as well as the anatomy of human nger, these extension
approximation curves can be used for controlling the nger bending.
4) Recovering the basic bending function of the ngers and normal grasping function of the hand should have priority over
other precision and complex movement functions. It is also reasonable for the exoskeleton to subordinate the PIP DOF to
the MCP joint when coupling the movements of all three joints while bending. This change will enhance the portability
of the exoskeleton, simplify the mechanical structure of the exoskeleton, reduce the number of actuators and lower the
weight as well.

4. Development plan and supporting mathematics

Before mechanical design, a new plan of coupling movements of three joints is proposed in this section for a jointless nger
exoskeleton using staggered tendons; these tendons impose an interactive constraint between two adjacent joints. The relative
coupling method, mathematics and simulation results are also discussed.
 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102 89

Major extension Sheaths

2
Auxflex DPflex 1

PMflex
4 3
1
Joint rotary centers
Major flexion

Fig. 8. New tendon arrangement plan for this paper.

4.1. Basic theory of the new plan for coupling the movements of joints

To keep the mechanical structure compact, we propose a new plan for coupling movements of joints by adding one pair of
staggered tendons to the traditional tendon-driven plan in Fig. 1. We call these staggered tendons DPex and PMex. They are
used for coupling the movements of the PIP and DIP as well as the MCP and PIP during nger exion. As shown in Fig. 8, the
exoskeleton parts are driven by the major-exion tendon and the major-extension tendon, which are separately mounted on
the ventral and dorsal sides of the DIP part, respectively. These two tendons act identically as in the old plan in Fig. 1, which
can produce high driving eciency. Another auxiliary tendon we call Auxex was added, and forces applied to this tendon will
maintain the coupling effect of DIP vs. PIP as well as PIP vs. MCP during nger extension.
When the major-exion Tendon is pulled, the DIP part of exoskeleton produces a bending tendency towards the PIP part,
which increases the distance between sheaths 1 and 2, as marked in the gure. Because the coupling tendon DPex is xed
between sheaths 1 and 4, the distance elongation between sheaths 1 and 2 will cause a shortening between sheaths 3 and
4, which drives the exoskeleton part on the middle phalanx to bend toward the proximal phalanx. In this way, the exion
movement of the DIP and PIP joints is coupled. The coupling tendon PMex acts similarly to DPex when the major-exion
tendon is pulled.
With this plan, the arrangement of circumferential and axial positions of the sheaths for coupling tendons is an issue that
affects the coupling relationships of the joint movements. In Fig. 9 for example, consider sheaths 1 through 4, when sheaths 1
and 2 are mounted on the dorsal side of the nger; the distance between them toward the DIP bending angle can be maximized,
and it decreases as the sheath circumferential positions are moved close to the joint bending axes. The same will happen to the
distance between sheaths 3 and 4 toward the PIP joint. It is not possible to x all 4 sheaths on the dorsal or ventral side of the
nger because the distance variations are different due to the dimensions of the DIP and PIP joints being different. In addition,
the sheath circumferential position arrangements also affect the friction between the coupling tendons and exoskeleton parts
because the friction changes with the variation of circumferential distance between sheaths 2 and 3, as well as the axial dis-
tance. Therefore, sheath positions must be calculated carefully and optimized. Related issues will be discussed in the following
sub-sections.
The exoskeleton parts on the dorsal side of the human nger can be designed longitudinally longer than on the ventral side
because human ngers have limited freedom of motion toward the dorsal side. Based on this idea, the design of the dorsal

Bending axis

Sheath 1
Sheath 2
Bending
Inter sheaths angle
distance

Fig. 9. Distance variation is affected by sheaths circumferential positions.

90 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

B
C
A

D
A
O

Fig. 10. Calculation of dorsal sheaths distance variation with the change of joint angle.

exoskeleton parts can be abstracted into two semi-cones, as in Fig. 10, such that when the joint is fully extended, two sectional
 and arc OBO
faces presented by arcs OAO  can be considered to coincide: this is also the approximate limited position for a
natural human nger. At this position, the bending angle ACB of the joint is zero, according to the gure, where points A and B
are right the dorsal positions of the exoskeleton parts on the distal and middle phalanges separately.

4.2. Variation relationship between dorsal inter-sheath distance and joint angle
 
In Fig. 10, segment OO represents the rotation axis of a nger joint, point C is the mid-point of OO , points A and B are
  
positions on the dorsal sheaths, and D is the intersection point of two vertical lines from A and B toward OO . Usually, A CD
  
equals to B CD, that A and B can be butted when the bending angle is zero. We treat the joint radius as a contant rd , as well as
 
the sheath position angles A CD and B CD as the constant bd , and dene two variables: the bending angle ACB as a, and the
length of arc A B as l , which represents the inter-sheath distance.
d
According to Fig. 10, the inter-sheath distance ld can be written as Eq. (3) for exion movement, because the dorsal sides are
active when the exoskeleton is bending: the inverse function of Eqs. (3) and (4) can be used for extension movement because
all dorsal sides are passive during extension.

2
ld = fld (a) = rd arccos[1 sin bd (1 cos a)] (3)

ld
1 cos rd
a = fad (ld ) = arccos(1 2
) (4)
sin bd

In Eqs. (3) and (4), a, bd [0, p/2]. The sheaths position angle bd should be set to a value in the interval [0, p/2], depending
on the requirements of the coupling method. If bd is set to 0, the two sheaths are located on both sides of point O, and the inter-
sheath distance would be zero. An the other extreme, bd equals to p/2 means the two sheaths are located at a right angle in
dorsal positions(positions A and B) of two exoskeleton parts and that the inter-sheath distance would be maximized.

4.3. Variation relationship between ventral inter-sheath distance and joint angle

Unlike the dorsal side, the dimensions of the ventral parts of a nger exoskeleton are limited because nger joints have
more motion range toward the ventral side that may produce interference between the parts. The rule for nding the maximum
dimension of a part is that when the bending angle reaches 90 , two adjacent parts just contact each other. In this case, we
abstracted ventral exoskeleton parts into two semi-cones that keep a distance from each other, as shown in Fig. 11.
In the gure, the segment OO is the rotation axis of the nger joint, and point C is again the center of the joint. Points M
and N are the centers of semi-circles of a cross-section of the exoskeleton parts, as two parts have been abstracted into semi-
cones. Points E and F are the positions of tendon sheaths on the exoskeleton: the radii of the two parts are segments ME and
 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102 91

C Z
O
N M

N
M
C O

F E

l2 C 0 M
N

e2
l1 E
F M
e1
E

Fig. 11. Calculation of sheaths distance variation toward the change of joint angle on ventral side.

 
NF designated as rv1 and rv2 . Segments EM and FN are the linear distances from E and F to their respective diameters. Sheath
 
position angles can be dened by EMM and FNN as bv . Based on the above, ZCM is the bending angle a, and the segment
EF is right the coupling tendon length that needed for a bending angle a.
For convenient calculation, we re-drew some segments of the upper part of Fig. 11 to form the lower subgure with some
 
auxiliary segments; points M and E represent M and E positions when the bending angle a equals zero. FC E as l0 is the

initial angle when a = 0, and FC E as l is the post-bending angle; both can be used for calculating the variation of a with the
change of tendon length FE as lv , EM , FN , C  M and N C  are marked separately as e1 , e2 , l1 and l2 .
During exion, the ventral sides are passive; the changes of joint angles are caused by coupling tendons PMex and DPex.
Then, the a to l relationship is needed for driving, which can be calculated by Eq. (5).

a = gav (lv ) = l0 l (5)


In Eq. (5), l0 can be calculated as Eq. (6), according to the gure, and after the nger joint bends through a, so that M and
 
E reach M and E: the new relation ship between l and lv can be calculated as Eq. (7).

e 1 e2 l 1 l 2
l0 = arccos   (6)
2 2 2 2
l1 + e1 l2 + e2

l + e + l2 + e2 lv
2 2 2 2 2
l = arccos 1  1  (7)
2 l21 + e21 l22 + e22

During extension, the ventral sides become active: varying joint angle a produces the change of inter-sheath distance lv ,
facilitating the coupling tendons DPext and PMext driving the extension of the PIP and MCP joints. For calculation convenience,
  
the lowerpart of Fig. 11 can be drawn in a orthogonal coordinate system, with setting C as the origin and C N as the negative


direction of the X axis. Thus the length of FE is the inter-sheath distance that can be solved by Eq. (8).

FE = CE CF (8)



In Eq. (8), the vector C  E can be considered as the vector C  E rotating a toward the pole C , and then the vector FE can be


calculated as Eq. (9), and the inter-sheath distance lv is the modules of vector FE as in Eq. (10).

T

l1 cos a e1 sin a + l2
FE = (9)
l1 sin a e1 cos a + e2


lv = glv (a) = | FE| (10)
92 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

Table 2
Index nger parameter value list.

Parameters rd (mm) l1 (mm) l2 (mm) rv1 (mm) rv2 (mm)

MCP 12.5 12.0 12.5 12.0 12.7

PIP 10.5 9.0 10.7 9.2 10.8
DIP 7.5 6.6 8.3 6.8 8.5

According to the upper part of Fig. 11, the following conditions are satised in Eq. (5) through Eq. (10):

e1 = rv1 sin bv


e2 = rv2 sin bv
(11)
a, bv [0, p/2]


l, l0 (0, p).

4.4. Motion coupling among three joints

To facilitate mathematics modeling and testing, a experimental setup of a human hand model was developed, and all of the
constant parameters needed for calculating the above equations were measured on it as listed in Table 2. Thus the maximum
values of Dld and Dlv of the three joints can be calculated and are listed in Table 3 when bd and bv are set to p/2. Note that these
maximum limits are values that the parameters could reach mechanically before the coupling, not the exact values acquired
during coupling movements. Dld and Dlv are dened in Eq. (12).

Dld = fld (a)
(12)
Dlv = glv (a) glv (0)

As the coupling occurs, ld and lv of adjacent joints will vary the same amount but inversely,meaning Dld = Dlv , neglect-
ing any deformation of tendon cables: thin metal twisted wires were used in the experimental setup, and the wire stiffness
was considered sucient to ignore deformations. Therefore, according to the basic idea of the new plan, conditions should be
satised as in Eq. (13), in which joint names in the parameter subscripts indicate the joints to which parameters belong.

Dld dip = Dlv pip
(13)
Dld pip = Dlv mcp

Following this idea, three joints can be coupled considering Eq. (3) and Eq. (5) together during the nger exoskeleton exing.
The angle relationships between adip and apip as well as apip and amcp can be calculated as in Eq. (14), in which joint names in
the parameter subscripts indicate the joints to which the parameters and functions belong.

apip = gav pip (glv pip (0) fld dip (adip ))
(14)
amcp = gav mcp (glv mcp (0) fld pip (apip ))

According to Table 3, the maximum values of Dld are smaller than those of Dlv of corresponding joints. Therefore, the value
of the sheath position angle on the ventral side should be set to a smaller value than that on the dorsal side as in Eq. (15); if a
full coupling movement is required, when a dorsal joint bends to the limited angle, the coupled ventral joint would also bend to
the corresponding limit.

bv pip< bd dip
(15)
bv mcp < bd pip

Assuming that the nger joints will not ex to the angle limits listed in Table 1 when the exoskeleton device is worn, we
reset the a angle limits to 60 for MCP, 90 for PIP and 57 for DIP, as listed in Table 4. These values were not set arbitrarily,

Table 3
The maximum values of Dld and Dlv for three joints.

Parameters MCP PIP DIP

Dld (mm) 19.64 16.49 11.78

Dlv (mm) 23.67 17.45 12.63

bv = bd = p/2.
 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102 93

but were chosen using Fig. 7, following the observation that when the PIP angle was 90 , the MCP and DIP angles were usually
near 60 and 57 . These values are also reasonable in that once they have been reached, the nger would be almost closed, as in
holding a pen.
To facilitate the movement coupling, bd angles were set to 60 for PIP and 90 for DIP; bv angles were set to 60 for MCP and
8 for PIP. In these conditions, the PIP joints would reach 90 when the DIP angle bends to 57 , and the MCP joints would reach
60 when the PIP angle bends to 90 . Consequently, Dld values were 7.46 mm for the DIP joint and 13.84 mm for the PIP joint,
slightly smaller than Dlv values of 7.66 mm for the PIP and 13.88 mm for the MCP joints. With these values, movement coupling
simulations were performed out and the results are presented in Figs. 12 and 13.
In Fig. 12, the green scatter data came from measurements of the index nger as in Fig. 7 (a); the red curve is the approx-
imation Eq. (1), for the PIP vs. MCP angular relationship during nger extension movements; the blue curve is the coupling
movement simulation curve. The simulation curve remains in the general scatting area of the bending scatter plot, which means
the setting of PMex tendon would offer coupling effect between the PIP and the MCP, when the coupling method is applied.
Note that every point in the scatter plot represents a possible natural bending pose of the joint, thus the scatting area can be
considered to be similar to the working space of a mechanism. In this case, following the simulation curve remaining in general
scatting area means sequential natural poses can be acquired.
Fig. 12 also shows that the tendency of the coupling simulation curve varies from that of extension approximation curve for
the PIP vs. MCP relationship. In this case, when the exoskeleton mechanism is extended at the MCP, the extension tendency
will just follow the coupling simulation curve. Hence, the extension relationship between the PIP and MCP will differ from the
natural active movements of the index nger. However, as discussed in Section 3.3, this tendency difference will not translate
to a bad experience for the wearer. In one aspect there is no anatomical coupling mechanism between the PIP and the MCP
in human ngers; the two joints can rotate independently. In another aspect, it is reasonable for a nger to perform reverse
movements of natural exion.
In Fig. 13, the green points are also scatter data as in Fig. 7 (b); the red curve is the approximation Eq. (2), for the DIP vs
PIP angular relationship during nger extension movements; the blue curve is the coupling simulation curve. It is clear that
the simulation curve is also remaining in the scatting area of the scatter plot, which means the DPex tendon would also offer
coupling effect with natural poses between the DIP and the PIP. Besides, the extending approximation curve is also in the
scatting area of exing measurements, meaning the coincidence between the scatting areas of exion and extension thus using
the coupling equations will produce natural coupling effects between the DIP and PIP not only during nger exion when driven
at the DIP, but also during extension movements when driven extending at the MCP.
Thus, the simulation results of the driving plan and coupling method developed in this section for the nger exoskeleton
produce natural driving tendencies and good coupling effects for the PIP and MCP as well as for the DIP and PIP joints during
both nger exion and extension, solving the problem that was stated in Section 2.

4.5. Discussion on applying the method

The joint motion-coupling plan can be used not only for the model mentioned in this paper, but also for models in dif-
ferent sizes of the same design. Usually, nger sizes vary in bone length values and joint diameters from person to person,
thus exoskeleton part dimensions will vary accordingly. On the dorsal side of the nger, longitudinal or thickness changes in
exoskeleton parts will not affect the exing of the nger, because the adjacent parts just depart from each other while the joint
is bending, as shown in Fig. 9. However, on the ventral side, the positions and the thicknesses of the parts may limit the nger
bending.
As in Fig. 11, the initial angle l0 is dened by the values of l1 , l2 , e1 and e2 , in which the former two variables are the distance
between the bending center of the joint and the two ventral exoskeleton parts mounted aside; the latter two variables are
relative to rv1 and rv2 listed in the Table 2, and also relative to the value of bv . In this way, if the value of l0 is too small, e.g.
l0 90 , the exoskeleton parts would block the joint from bending toward its limits. To avoid this, it is necessary to keep e1 l1 ,
and e2 l2 , meaning the exoskeleton part should not be too thick nor to be arranged too close to the bending center of the joint.
The positions of the sheaths are decided by bd on dorsal side and bv on ventral side. The selection of these two values should
rstly satisfy the requirements of Eq. (13), and then working out the simulation to see how well the results matching the natural
exing/extending tendency of a healthy human nger. Try to choose the pair of bd and bv values that making the best result.

Table 4
Variable limits for nger exoskeleton.

Parameters MCP PIP DIP

a 60 90 57
bd 60 90
bv 60 8
Dld (mm) 13.84 7.46
Dlv (mm) 13.88 7.66

Units: degree.
94 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

120

PIP value
100

80

60

40

PIP vs MCP scatter

20
Coupling simulation
MCP value Extension approximation
0
0 20 40 60 80 100

Fig. 12. Coupling effect simulation results of PIP vs. MCP.

5. Mechanical design and experimental setup assembly

Based on the foregoing theoretical analysis, an experimental device was developed, including a hand pattern (i.e., a robotic
hand) on which to attach the exoskeleton parts and related actuating and sensing devices. Details are discussed in this section.

5.1. Mechanical design of the hand pattern

The hand pattern was designed to be tted with the exoskeleton parts, facilitating tests of the coupling plan mentioned
above, because the exoskeleton device is jointless and cannot support itself. Fig. 14 presents the numerical model of the hand
pattern including its three main parts: the arm bracket, the palm and the nger assemblies. The arm bracket provides space for
sensors and actuators for further experiments. The palm is used to mount exoskeleton parts (not visible in the gure) for the
hand and for connecting the nger assemblies. The nger assemblies receive the jointless nger exoskeleton parts (dark yellow
parts).
All key dimensions of the hand pattern such as the lengths and thicknesses of its ngers and those of each phalanx bone
segment, as well as nger position arrangements, were taken from measurements of a human hand. The dimensions of the
nger phalanx bones and the joint bending limits of the hand pattern are listed in Table 5. All joint bending limits were set to
90 , considering the variable limits listed in Table 4 in the theoretical analysis of the previous section.
The yellow parts in Fig. 14 attached to the nger assemblies are the nger exoskeleton parts of the experimental setup. As
shown in Fig. 15 each part was designed as a semi-cone dimensionally compatible with that of the nger phalanx to which it

70
DIP vs PIP scatter
60 Extension approximation
Coupling simulation
50

40
DIP value

30

20

10
PIP value
0
0 20 40 60 80 100 120

Fig. 13. Coupling effect simulation results of DIP vs. PIP.

 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102 95

Finger assemblies

Arm bracket
Hand pattern Exoskeleton Parts

Fig. 14. 3D model of the hand pattern with exoskeleton parts mounted.

attached. Two semi-cones were required to drive one nger phalanx, attaching separately to its dorsal and ventral sides. For the
experiments, these semi-cone parts were attached to the nger assemblies directly.
To highlight the coupling effect of the driving plan during the experiment, all MCP joints of the nger assemblies were
reduced to one degree of freedom (DOF) instead of the more realistic two by xing the adduction and abduction DOFs to 0 .
With the listed values listed in Table 5, the initial working space of the index nger of the hand pattern can be visualized as
Fig. 16, which presents the initial reachability of the index nger mechanism before the exoskeleton device was applied. Once
the coupling tendons were arranged, the working space of the index nger assembly was constrained to a xed trajectory that
obeyed the denitions of the equations and joint bending limitations discussed in the previous section, the black curve in Fig. 16.
The hardware of the experimental setup was comprised with four components as shown in Fig. 17: the hand pattern and
exoskeleton device, the controller and driving system, sensors and transducers,and a data acquisition (DAQ) system.The setup
was built to measure the forces in the driving tendon and on the ngertip of the index nger of the hand pattern with the nger
exoskeleton device actuated. The hand pattern was constructed by a stereolithography apparatus 3D printer using the numerical
model of the previous subsection; the attached exoskeleton parts were made of aluminum, and the arm bracket and supporting
parts were 3D printed or machined metal. A pressure sensor was placed against the ngertip of the index nger assembly for
measuring the output force with the driving force applied, and a tension sensor was connected between the driving tendon of
the exoskeleton device and the pulling tendon to the winch to sense the driving force along the driving tendon. The measuring
range of both force sensors were the same at 5 kg, with a precision of 1 g/mV (gram per millivolt).
The winch producing the driving force was actuated by a Leadshine 57HS22-A stepping motor, with 2.2 N m maximum
torque output. Because the radius of the winch winder was 1 cm, the winch had the capability of generating up to approximately
22.4 kg tension force. An Arduino Mega 2560 micro-controller was used as a pulse generator; it was capable of forward, reverse,
fast forward and fast reverse pulse signals. An MD432C stepper driver was used to drive the 57HS22-A stepper. The DAQ card for
data acquisition was a PCI8622 with 16 bits AD (analog to digital) conversion accuracy by Beijing Art Technology Development
Co., Ltd.

5.2. Composition and fundamentals of the experimental setup

The basic force experiment is shown Fig. 18. When the winch pulls the tendon, the index nger assembly is forced to bend,
which is stopped by the pressure sensor against the nger tip. As long as the pulling force increases, the output force at the
ngertip also increases. Thus, the input and output force relationship can be acquired by changing the bending angle of the
ngertip as well as the position of the pressure sensor. Note that the bending angle of the ngertip is not any single bending
angle value of the DIP, PIP or MCP, but their sum.
To measure the bending angles of the DIP, PIP and MCP joints, another rotary-sensor-based measuring device was attached
to the index nger assembly, as shown in Fig. 19. This device appeared similar to and worked the same as that in Fig. 5 for
measuring the joint angles of a human index nger. In this way, real-time angle values could be gathered during the experiment

Table 5
Length of each phalanx bone on index nger.

Name Length (mm) Bending limit (degree)

Proximal phalanx 45 90
Middle phalanx 25 90
Distal phalanx 20 90
96 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

Dorsal parts

Ventral parts

Fig. 15. Exoskeleton parts for ngers.

while the nger was bending. The rotary sensors adopted were Murata model SV01A103 with a total resistance of 10 ky 30%
and linear accuracy of 2%.

6. Tests and results

Two series of experiments were conducted with the exoskeleton device. Tendon driving kinematics experiments were con-
ducted to evaluate the performance of coupling effect to see whether and how the PIP vs. MCP and DIP vs. PIP results matched
the simulation curve. Force relationship experiments were performed to evaluate the force performance of the new coupling
plan. To facilitate the experiment, we rotated the hand pattern 90 about the longitudinal axis as presented in Fig. 20, thus
leaving more space for the index nger assembly. Because there was no force load at the nger tip, the experiment could be
performed by directly pulling the driving tendon (major exion tendon) either manually or with the winch, which was actuated
by the stepper.
As the nger bent, three resistive rotary sensors on the joint-angle measuring device (see Fig. 19) converted the angular
information into voltage signals, which were then acquired by the DAQ at 1000 samples/s. The rotary sensors were linearly
resistive and were calibrated by dividing the output voltage range between the nger joint extreme positions of 0 and 90
into 90 divisions; thus, real-time joint bending angles could be acquired by measuring the voltage in real time. An adjustable
stabilized voltage supply was used for +24 V, +12 V, and +5 V power sources for the stepper driver, the force sensors and
transducers as well as the Arduino Mega micro-controller. Resistive rotary sensors on the nger angle measuring devices were
also powered by +5 V voltage.

6.1. Driving kinematics experiment

Tendons for nger bending were made of 0.5 mm stainless steel. They had exibility to wriggle through the sheaths at dif-
ferent positions while having suciently strong axial strength to avoid large elastic deformation from friction with the sheaths
and the force load applied at the ngertip. The kinematics of nger bending was much better than if an elastic tendon material,
such as nylon, were used.
Tests were repeated several times; the data acquired are presented as Figs. 21 and 22. In the two gures, green points are the
data acquired during the experiment, the blue curves are coupling simulations, and the red curves are extension approximations

0
Working space scatter
mm

-10
Couple motion curve
-20

-30

-40

-50

-60

-70

-80

-90
mm
-100
-50 -25 0 25 50 75 100

Fig. 16. Finger working space of the hand pattern design.

 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102 97

To DAQ
Transducers
Arduino Mega

Press
sensor
(blocked)
Wiring board
Stepper Driver

Exoskeleton
Stepper Tension sensor parts

Fig. 17. Hardware of the experimental setup.

as in Figs. 12 and 13. Both gures indicate the theoretical success of the designed coupling plan; the data scatter plots follow
the simulation curves well enough to generate the desired joint motion, although errors still exist.
We believed that the errors in Fig. 21 came mostly from mounting-position errors of the sheaths that the coupling tendons
passed through because scatter curves from different tests were very close to each other and merged together, with the same
deviation from the theoretical simulation. Errors also exist in Fig. 22; scatter-data curves from different tests, spread in the PIP
range from 0 to 60 , then merged above 60 . We believed these errors were mostly due to friction between the sheaths and
the tendons at the DIP part in addition to the reason mentioned above. On one hand, friction between the tendons and sheaths
was larger at DIP joint because dimensions of the parts near this joint are relatively smaller than that of the PIP and MCP;
both the coupling tendon and driving tendon need to bend much more to wriggle through the sheaths here than near the PIP
and MCP. The tighter bend caused more friction. On the other hand, the coupling tendon DPex acts only when the DIP part
moves prior to the PIP. Then, when the PIP joint had a tendency to bend slightly before the DIP due to the greater friction on
the coupling tendons at the DIP, the situation in Fig. 22 is to be expected. Certainly if the friction between the DPex coupling
tendon and related sheath is large enough to make the joint stick, or if there were an outer force applied at the distal and middle
phalanges to simply stop the DIP part from bending toward the PIP, the PIP joint would bend independently itself with this plan.
Nevertheless, in general situations this would not happen.
Note that without our PMex or DPex coupling tendons, motion relationship between the PIP and the MCP as well as
between the DIP and the PIP, would be presented as vertical segments, the X = 0 , 0 Y 90 , in Figs. 21 and 22, because as
mentioned in the Section 2 of this paper, the DIP joint would bend the rst, the PIP would not start to bend until the DIP reached
the limit (90 for the hand pattern), and the MCP joint would bend nally after the PIP joint stopped at its limit (90 ).

The stepper
Driving tendon

The rails

The winch Tension sensor Hand pattern

Fig. 18. Basic setup.

98 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

Rotary sensors

Tendons

Connection bars

Fig. 19. Joint angle measuring device for the nger assembly.

6.2. Force relationship experiment

The goal of this experiment is to evaluate the force performance of the tendon driven plan. It is important for further works
such as the selection of actuators and the development of control methods. In this stage, we focused more on exion than
extension because most hand functions are facilitated by various nger exions. As illustrated in Fig. 23, force performance
tests were executed with the hand pattern palm down on the test board while driving the index nger assembly against a press
sensor at its tip. The angle-measuring device mounted on the index nger transformed three joint angle values into proportional
voltage signals, while the press sensor transformed the force values from the ngertip. The tension sensor between the winch
and the major-exion driving tendon transformed the tension force values. These various voltage values were then acquired
by the DAQ, thus capturing the relationships between the input tension force along the driving tendon and the output pressing
force against the ngertip.
Fig. 23 also shows that the press sensor was mounted on a slope of a xture that was jacked up by a cushion block. By
using xtures with different slope angles and cushion blocks, the press sensor could be mounted at various heights relative to
the ngertip and with various orientations, matching various nger-bending situations. To facilitate this, various xtures and
cushion blocks with different slope angles and heights were 3D printed. Hence, force relationships were acquired in different
nger-bending situations.
During the experiment, we used the sum of the MCP, PIP and DIP joint angles to dene the nger bending situations, meaning
0 was a full extension of the index nger assembly while 90 was the ngertip pointed vertically to the ground. Thanks to the
adoption of stainless steel tendons, there was usually very little or no slide at the contact point between ngertip and the press
sensor; this ensured the accuracy of the data acquisition.
A series of repeated force tests was conducted for the force relationship experiment. Selected data series were collected in
Fig. 24 for contrast, in which the x axis plots the input tension force on the Major exion driving tendon, and y plots the output
pressing force at the nger tip; data points from different nger-bending situations are plotted with different symbols. Breaks
within data scatter curves with the same symbol were caused by the difference of pre-load force applied each time the test was
repeated for the same nger-bending situation. From 0 to 4000 g of input forces were applied, consistent with the measuring
scale of the tension force sensor between the winch and major-exion driving tendon.

Fig. 20. Experimental setup for driving kinematics tests.

 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102 99

100
PIP vs MCP scatters
Coupling simulation
80
Extension approx.

60

PIP value (degree)

40

20

MCP value (degree)

0
0 10 20 30 40 50 60 70

Fig. 21. Kinematics test result of PIP vs. MCP.

Eight scatter curves were acquired; it is obvious that the scatter points spread linearly in each curve, ignoring very few errors
points. It is also signicant that the slopes of the linear scatter curves increase when the nger bends, from 0.175 for 0 to 0.37
for 110 . When a 4000 gram input force was applied, approximately 700 to 1500 g of output pressing force was measured as the
nger bent from 0 to 110 . Table 6 lists the slope values for linear scatter curves for all eight nger-bending situations. Thus,
with a given input tension force, a larger output force could be acquired as the nger bent further, within the range of 0 and
110 . We did not continue the test beyond 110 , both because the experiment apparatus reached its physical limits at 110 , and
because a nger-bending situation beyond 110 left too little space between the nger phalanges to arrange the force sensor
conveniently.

7. Conclusion

The main purpose of this work was to develop a new lightweight, compact and portable exoskeleton structure for nger
motion assistance and rehabilitation by adding two coupling tendons to the traditional plan to avoid an incorrect driving ten-
dency. Anatomy analysis and a kinematics study of the human nger were performed before the development; bending angle
relationships among the MCP, PIP and DIP joints were analyzed as well. Detailed implementation is discussed, including the basic
theory of the joint motion coupling method, relevant formula derivations and mechanical design of the experimental device. A

60

DIP vs PIP scatter

50 Extension approx.
Coupling simulation
40
DIP value (degree)

30

20

10

PIP value (degree)

0
0 20 40 60 80 100

Fig. 22. Kinematics test result of DIP vs. PIP.

100 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

Fig. 23. Fundamentals of input-output force relationship test.

series of experiments was then conducted to examine and evaluate the developed joint motion coupling plan. Achievements of
this research work were as follows:

1) The two new coupling tendons worked as desired: the incorrect driving tendency of the traditional plan was completely
avoided, and the new coupled-tendon-driven plan can drive nger bending as naturally as a human nger.
2) The entire structure of the nger exoskeleton device is compact and lightweight and can be arranged to t a hand glove or
a ngerstall more easily than most bar-linkage exoskeleton structures.
3) The coupling tendons act only when the farther joint of the nger bends prior to the nearer; thus, if unexpected large
friction occurs between the coupling tendons and relative sheaths, the nearer joints will bend independently. This will not
happen in general applications.
4) As the nger bends farther, the output force increases for a given input tension force. From 17.5% to 37% of the input force
will be converted to output force over the exion range 0 to 100 .
5) The coupling method can be used for jointless exoskeleton devices in different sizes with the same design. When applying
on a new model,the thickness and the longitudinal size of the ventral side exoskeleton parts should be considered carefully.

1600
Bending situations

0 degree
1400
16 degrees
40 degrees
1200 45 degrees
60 degrees
73 degrees
1000 90 degrees
110 degrees

800
Output force (g)

600

400

200

Input force (g)

0
0 500 1000 1500 2000 2500 3000 3500 4000

Fig. 24. Force output vs. input relationship of the exoskeleton device.
 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102 101

Table 6
Slope values of linear data scatters from eight series of tests.

Finger situation (degree) Slope value

0 0.175
16 0.194
40 0.21
40 0.218
60 0.23
73 0.285
90 0.33
110 0.37

Acknowledgments

This paper was sponsored by the National Natural Science Foundation, No. 51505072 and The Fundamental Research Funds
for the Central Universities Projects, No. N130403008, from P.R. China. The authors also would like to thank Dr. Jaydev P. Desai
of the A. James Clark School of Engineering, University of Maryland, USA. Dr. Desai funded the early period of this research.

References

[1] R. Riener, M. Wellner, T. Nef, J. von Zitzewitz, A. Duschau-Wicke, G. Colombo, L. Lunenburger, A view on VR-enhanced rehabilitation robotics, Virtual
Rehabilitation, 2006 International Workshop on, IEEE, 2006, pp. 149154.
[2] H. Kawasaki, S. Ito, Y. Ishigure, Y. Nishimoto, T. Aoki, T. Mouri, H. Sakaeda, M. Abe, Development of a hand motion assist robot for rehabilitation therapy
by patient self-motion control, Rehabilitation Robotics, 2007. ICORR 2007. IEEE 10th International Conference on, IEEE, 2007, pp. 234240.
[3] S. Ito, H. Kawasaki, Y. Ishigure, M. Natsume, T. Mouri, Y. Nishimoto, A design of ne motion assist equipment for disabled hand in robotic rehabilitation
system, J. Frankl. Inst. 348 (1) (2011) 7989.
[4] S. Ito, Y. Ishigure, S. Ueki, J. Mizumoto, Y. Nishimoto, M. Abe, H. Kawasaki, A hand rehabilitation support system with improvements based on clinical
practices, 9th International Symposium on Robot Control, SYROCO, 2009, pp. 912.
[5] Y. Huang, K.H. Low, Initial analysis and design of an assistive rehabilitation hand device with free loading and ngers motion visible to subjects, Systems,
Man and Cybernetics, 2008. SMC 2008. IEEE International Conference on, IEEE, 2008, pp. 25842590.
[6] L. Dovat, O. Lambercy, R. Gassert, T. Maeder, T. Milner, T.C. Leong, E. Burdet, HandCARE: a cable-actuated rehabilitation system to train hand function
after stroke, IEEE Trans. Neural Syst. Rehabil. Eng. 16 (6) (2008) 582591.
[7] L. Dovat, O. Lambercy, R. Gassert, E. Burdet, T.C. Leong, HandCARE2: A novel cable interface for hand rehabilitation, Virtual Rehabilitation, 2008, IEEE,
2008, pp. 64-64.
[8] M. Mulas, M. Folgheraiter, G. Gini, An EMG-controlled exoskeleton for hand rehabilitation, Rehabilitation Robotics, 2005. ICORR 2005. 9th International
Conference on, IEEE, 2005, pp. 371374.
[9] J.-H. Bae, Y.-M. Kim, I. Moon, Wearable hand rehabilitation robot capable of hand function assistance in stroke survivors, Biomedical Robotics and
Biomechatronics (BioRob), 2012 4th IEEE RAS & EMBS International Conference on, IEEE, 2012, pp. 14821487.
[10] N.S.K. Ho, K.Y. Tong, X.L. Hu, K.L. Fung, X.J. Wei, W. Rong, E.A. Susanto, An EMG-driven exoskeleton hand robotic training device on chronic stroke
subjects: task training system for stroke rehabilitation, Rehabilitation Robotics (ICORR), 2011 IEEE International Conference on, IEEE, 2011, pp. 15.
[11] A. Wege, K. Kondak, G. Hommel, Mechanical design and motion control of a hand exoskeleton for rehabilitation, Mechatronics and Automation, 2005
IEEE International Conference, 1, IEEE 2005, pp. 155159.
[12] A. Wege, K. Kondak, G. Hommel, Development and control of a hand exoskeleton for rehabilitation, Human Interaction with Machines, Springer 2006,
pp. 149157.
[13] A. Wege, A. Zimmermann, Electromyography sensor based control for a hand exoskeleton, Robotics and Biomimetics, 2007. ROBIO 2007. IEEE
International Conference on, IEEE, 2007, pp. 14701475.
[14] B.L. Shields, J.A. Main, S.W. Peterson, A.M. Strauss, An anthropomorphic hand exoskeleton to prevent astronaut hand fatigue during extravehicular
activities, IEEE Trans. Syst. Man Cybern. Part A Syst. Humans 27 (5) (1997) 668673.
[15] B.H. Choi, H.R. Choi, A semi-direct drive hand exoskeleton using ultrasonic motor, Robot and Human Interaction, 1999. RO-MAN99. 8th IEEE International
Workshop on, IEEE, 1999, pp. 285290.
[16] ByungHyun Choi, H.R. Choi, SKK hand master-hand exoskeleton driven by ultrasonic motors, Intelligent Robots and Systems, 2000.(IROS 2000).
Proceedings. 2000 IEEE/RSJ International Conference on, 2, IEEE 2000, pp. 11311136.
[17] T.T. Worsnopp, M.A. Peshkin, J.E. Colgate, D.G. Kamper, An actuated nger exoskeleton for hand rehabilitation following stroke, Rehabilitation Robotics,
2007. ICORR 2007. IEEE 10th International Conference on, IEEE 2007, pp. 896901.
[18] Azzurra Chiri, Francesco Giovacchini, Nicola Vitiello, Emanuele Cattin, Stefano Roccella, Fabrizio Vecchi, Maria Chiara Carrozza, HANDEXOS: towards an
exoskeleton device for the rehabilitation of the hand, Intelligent Robots and Systems, 2009. IROS 2009. IEEE/RSJ International Conference on, IEEE 2009,
pp. 11061111.
[19] Marco Fontana, Andrea Dettori, Fabio Salsedo, Massimo Bergamasco, Mechanical design of a novel Hand Exoskeleton for accurate force displaying,
Robotics and Automation, 2009. ICRA09. IEEE International Conference on, IEEE 2009, pp. 17041709.
[20] Robert Riener, Tobias Nef, Gery. Colombo, Robot-aided neurorehabilitation of the upper extremities, Medical and Biological Engineering and Computing
43 (1) (2005) 210.
[21] HyunKi In, Kyu-Jin Cho, KyuRi Kim, BumSuk Lee, Jointless structure and under-actuation mechanism for compact hand exoskeleton, Rehabilitation
Robotics (ICORR), 2011 IEEE International Conference on, IEEE 2011, pp. 16.
[22] Arief P. Tjahyono, Kean C. Aw, Harish Devaraj, Wisnu Surendra, Enrico Haemmerle, Jadranka Travas-Sejdic, A ve-ngered hand exoskeleton driven by
pneumatic articial muscles with novel polypyrrole sensors, Industrial Robot: An International Journal 40 (3) (2013) 251260.
[23] Marco Cempini, Stefano Marco Maria De Rossi, Tommaso Lenzi, Mario Cortese, Francesco Giovacchini, Nicola Vitiello, Maria Chiara Carrozza, Kinematics
and design of a portable and wearable exoskeleton for hand rehabilitation, Rehabilitation Robotics (ICORR), 2013 IEEE International Conference on, IEEE
2013, pp. 16.
[24] Jiting Li, Shuang Wang, Ju Wang, Ruoyin Zheng, Yuru Zhang, Zhongyuan Chen, Development of a hand exoskeleton system for index nger rehabilitation,
Chinese Journal of Mechanical Engineering 25 (2) (2012) 223233.
102 J. Yang et al. / Mechanism and Machine Theory 99 (2016) 83102

[25] Pilwon Heo, Gu Gwang Min, Soo-jin Lee, Kyehan Rhee, Jung Kim, Current hand exoskeleton technologies for rehabilitation and assistive engineering,
International Journal of Precision Engineering and Manufacturing 13 (5) (2012) 807824.
[26] Vishalini Bundhoo, Edmund Haslam, Benjamin Birch, Edward J. Park, A shape memory alloy-based tendon-driven actuation system for biomimetic
articial ngers, part I: design and evaluation, Robotica 27 (01) (2009) 131146.
[27] Shunji Moromugi, Kousuke Kawakami, Katsutoshi Nakamura, Taichi. Sakamoto, Takakazu. Ishimatsu, A tendon-driven glove to restore nger function
for disabled, ICCAS-SICE, 2009, IEEE 2009, pp. 794797.
[28] Useok Jeong, Hyun-Ki In, Kyu-Jin Cho, Implementation of various control algorithms for hand rehabilitation exercise using wearable robotic hand,
Intelligent Service Robotics 6 (4) (2013) 181189.
[29] Gabriele Gilardi, Edmund Haslam, Vishalini Bundhoo, Edward J. Park, A shape memory alloy based tendon-driven actuation system for biomimetic
articial ngers, part II: modelling and control, Robotica 28 (05) (2010) 675687.
[30] Antonia Tzemanaki, Peter Walters, Anthony Graham. Pipe, Chris. Melhuish, Sanja. Dogramadzi, An anthropomorphic design for a minimally invasive
surgical system based on a survey of surgical technologies, techniques and training, The International Journal of Medical Robotics and Computer Assisted
Surgery 10 (3) (2014) 368378.
[31] Pamela K. Levangie, Cynthia C. Norkin, Joint structure and function: a comprehensive analysis, FA Davis 2011.
[32] Zhou Ma, Pinhas Ben-Tzvi, RML glovean exoskeleton glove mechanism with haptics feedback, Mechatronics, IEEE/ASME Transactions on 20 (2) (2015)
641652.
[33] Florian Hess, Philipp Frnstahl, Luigi-Maria Gallo, Andreas Schweizer, 3D Analysis of the proximal interphalangeal joint kinematics during exion,
Computational and Mathematical Methods in Medicine 2013 (2013)
[34] Alessandro Battezzato, Kinetostatic analysis and design optimization of an n-nger underactuated hand exoskeleton, Mechanism and Machine Theory
88 (2015) 86104.
[35] F-C. Su, You-Li Chou, Cheng-San Yang, Gau-Tyan Lin, Kai-Nan An, Movement of nger joints induced by synergistic wrist motion, Clinical Biomechanics
20 (5) (2005) 491497.
[36] Fuhai Zhang, Lei Hua, Fu Yili, Hongwei Chen, Shuguo Wang, Design and development of a hand exoskeleton for rehabilitation of hand injuries, Mechanism
and Machine Theory 73 (2014) 103116.
[37] Christopher L. Jones, Furui Wang, Robert Morrison, Niladri Sarkar, Derek G. Kamper, Design and development of the cable actuated nger exoskeleton
for hand rehabilitation following stroke, Mechatronics, IEEE/ASME Transactions on 19 (1) (2014) 131140.