Robotic Systems for Hand Rehabilitation—Past, Present and Future

Background: Cerebrovascular accident, commonly known as stroke, Parkinson’s disease, and multiple sclerosis represent significant neurological conditions affecting millions globally. Stroke remains the third leading cause of death worldwide and significantly impacts patients’ hand functionality, making hand rehabilitation crucial for improving quality of life. Methods: A comprehensive literature review was conducted analyzing over 300 papers, and categorizing them based on mechanical design, mobility, and actuation systems. To evaluate each device, a database with 45 distinct criteria was developed to systematically assess their characteristics. Results: The analysis revealed three main categories of devices: rigid exoskeletons, soft exoskeletons, and hybrid devices. Electric actuation represents the most common source of power. The dorsal placement of the mechanism is predominant, followed by glove-based, lateral, and palmar configurations. A correlation between mass and functionality was observed during the analysis; an increase in the number of actuated fingers or in functionality automatically increases the mass of the device. The research shows significant technological evolution with considerable variation in design complexity, with 29.4% of devices using five or more actuators while 24.8% employ one or two actuators. Conclusions: While substantial progress has been made in recent years, several challenges persist, including missing information or incomplete data from source papers and a limited number of clinical studies to evaluate device effectiveness. Significant opportunities remain to improve device functionality, usability, and therapeutic effectiveness, as well as to implement advanced power systems for portable devices.