This work was supported in part by OSU&#8217;s CCTS Program through TL1TR001069 award to Dr. Borstad.&#160; We would like to acknowledge Amelia Siles, DPT, NCS for her valuable measurement insights and Sarah Alexander for her assistance with editing the final draft of this manuscript.

1. Design and Fabrication of Visual Screen and HASTe (See &#34;Table of Materials&#34;&#160;for All Required Equipment and Materials):
<ol>
	<li>Assemble Visual Screen (Figure 1):
	<ol>
		<li>Cut four pieces of 0.5-inch PVC pipe (material a) to 10 inches (these form the base of the screen). Cut three pieces of 0.5-inch PVC pipe to 20 inches (these form the upright portion of the screen).</li>
		<li>Insert two pieces of 10-inch pipe into both PVC Tee&#8217;s (parallel openings) (material b). Insert two pieces of 20-inch pipe into each of the remaining holes of the PVC Tee&#8217;s (perpendicular to the 10-inch pieces). Insert PVC elbows (material c) on each of the open ends of the 20-inch pipes.</li>
		<li>Insert each end of the third 20-inch PVC pipe into each of the open PVC elbows. Do not glue PVC joints if easier folding/storage of visual screen is desired. Glue PVC joints for a permanent visual screen, if desired. Drape pillow case (material d) over top pipe. Secure with binder clips (material e) or safety pins.</li>
	</ol>
	</li>
</ol>
<img alt="Figure 1" src="/files/ftp_upload/53178/53178fig1.jpg" /> 
Figure 1: Set-up of the HASTe. Participants should be seated at a table. The visual screen between the participant and the test objects. The objects for one trial are removed from the test kit and offered to the participant in the following order: test object first, then each of the three possible matches, in the order indicated in Appendix 1: Administration Instructions and Score Sheet. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/53178/53178fig1large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<ol start="2">
	<li>Assemble HASTe Testing Kit (includes 9 test objects, a duplicate set of 9 sample objects, and 3 example objects) (Figure 2)
	<ol>
		<li>Cut 21 pieces of 1.5-inch diameter PVC pipe (material f) into 4-inch lengths. Cut cork (material g) into 21 strips, each 4 x 7 inches. Overlay each cork over PVC to ensure no overlap at seam or ends of pipe.</li>
		<li>Trim excess cork flush to edge. Coat each of the 21 pieces of pipe (one-by-one) with all purpose cement (material h) and wrap with cork.</li>
		<li>Measure and cut six 4 x 7-inch pieces of self-adhesive laminate (material i) and six 4 x 7-inch pieces of brown paper (material j). Trim excess. Wrap six pieces with self-adhesive laminate.</li>
		<li>Coat six pieces with all purpose cement and wrap with brown paper wrapping. Coat one piece with all purpose cement and wrap with sandpaper (material k). Coat two pieces with all purpose cement and wrap with glossy cardstock (material l).</li>
		<li>Measure and lay out eight pieces of clay (material m), each weighing 2.2 ounces. Measure and lay out six pieces of clay, each weighing 3.2 ounces. Measure and lay out seven pieces of clay, each weighing 4.2 ounces.</li>
		<li>Mold two 2.2-ounce, 3.2-ounce, and 4.2-ounce pieces of clay into a solid block to fill the diameter of the pipe. Insert each into the center of a pipe covered in brown paper wrapping. Repeat step with pipes covered with cork and self-adhesive laminate.</li>
		<li>Mold two 2.2-ounce pieces of clay into a solid block to fill the diameter of the pipe. Insert one into the center of a pipe covered in glossy cardstock and one into the pipe covered in sand paper.</li>
		<li>Mold one 4.2-ounce piece of clay into a solid block to fill the diameter of the pipe. Insert into the center of a pipe covered in glossy cardstock .</li>
		<li>Fill each pipe to capacity with closed-cell packing foam (material n). Weigh components to ensure accuracy of weight to 0.1 ounce.</li>
		<li>Coat each end cap (material o) with all purpose cement and firmly insert into both ends of each pipe.</li>
		<li>Label each object with weight (on the bottom) and number (on the top) as to be visible to the examiner.</li>
		<li>Cover test objects 1T, 2T and 3T with cork, then brown paper, and weigh to 6, 7, and 8 ounces, respectively. Cover test objects 4T, 5T, and 6T only and weigh to 6, 7, and 8 ounces, respectively. Cover test objects 7T, 8T, and 9T with cork, then self-adhesive laminate, and weigh to 6, 7, and 8 ounces, respectively.</li>
		<li>Label sample objects 1-9 (exact duplicates of the test objects).</li>
		<li>Label the three example objects A, B, and C. Cover example objects A and B with glossy card stock (weighing 6 and 8 ounces, respectively). Cover example object C in sand paper (weighing 6 ounces). (Example objects are not shown in Figure 2.)</li>
		<li>Sore and transport all test items in a plastic storage box (material p).</li>
	</ol>
	</li>
</ol>
<img alt="Figure 2" src="/files/ftp_upload/53178/53178fig2.jpg" /> 
Figure 2: Organization of the HASTe Test Objects. The test objects are ordered 1-9 and marked with a &#8216;T&#8217;. The nine sample objects, which participants match to the test objects by weight or texture, are also numbered 1-9 and ordered, as shown.
2. Administration of HASTe:
<ol>
	<li>Seat participants at a standard height table (~29 inch) and chair (~18 inch). Adjust the heights such that the participant can rest and move the test arm comfortably on the table. Place the test arm under a visual screen, as shown in Figure 3, to prevent participant from seeing the test arm, the objects, or the examiner. 
	Note: Test the less impaired upper extremity first, if the participant being tested has a more impaired upper extremity.</li>
	<li>Instruct participant to grasp and lift the example objects to freely determine differences between weight and texture. Provide feedback for the two demonstration trials only.</li>
	<li>Administer two demonstration trials prior to scoring. Have participant compare objects A and B to illustrate differences in weight. Have participant compare objects A and C to illustrate differences in texture.</li>
	<li>Do not offer feedback on the patient&#8217;s performance during trials of the scored test. Do not assist the patient with manual exploration of the objects. Organize test materials for all 18 trials by keeping objects in numerical order. (Figure 2)</li>
	<li>Provide verbal instructions to the participant: &#8220;Use one hand to manually explore the test object first. Then, explore each of the three possible matches, which vary by either weight or texture but never both within one trial.&#160; Find the match. Touch each object as many times as needed to determine the answer. There will be 18 trials. With a maximum of 5 min for each trial.&#8221;</li>
	<li>Repeat test instructions during test administration at the discretion of the examiner or upon request of the participant. Do not inform participant as to which object property (weight or texture) they are matching within a trial.</li>
	<li>Slide objects to and away from the participant&#8217;s hand, per the participant&#8217;s request, if his or her elbow or shoulder movement prevents them from moving between objects (Figure 3).</li>
	<li>Have the participant indicate their choice verbally or by pointing to their choice upon finding the match. Administer the next trial.&#160;Do not have participant describe, in any manner, the object properties or explain why they chose the match that they did.</li>
	<li>Score the test by determining the number of correct matches from a total of 18 trials per hand. Use Appendix 1: Administration Instructions and Score Sheet and the overall organization shown in Figure 2 in order to reduce examiner error.</li>
	<li>Analyze and interpret HASTe scores as a measure of haptic performance with the following considerations. &#160; 
	Note: The intervals between ranks on the HASTe, an ordinal scale, may not be consistent and may not be known. However, like many clinical measures, it may be meaningful and appropriate to apply statistical inference as though the data were interval, as shown in Figure 4.</li>
</ol>

<img alt="Figure 3" src="/files/ftp_upload/53178/53178fig3.jpg" /> 
Figure 3: Offering the HASTe Objects to the Participant. The objects can be placed in the participant&#8217;s hand, but the examiner should avoid assisting the participant with object manipulation.

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	<li>Nakayama, H., Jgtgensen, H., Stig, K., Raaschou, H. O., Olsen, T. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recovery+of+upper+extremity+function+in+stroke+patients:+the+Copenhagen+Stroke+Study.">Recovery of upper extremity function in stroke patients: the Copenhagen Stroke Study.</a> Age (SD). 74, 12 (1994).</li><li>Carey, L. M., Matyas, T. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Frequency+of+discriminative+sensory+loss+in+the+hand+after+stroke+in+a+rehabilitation+setting.">Frequency of discriminative sensory loss in the hand after stroke in a rehabilitation setting.</a> Journal of Rehabilitation Medicine. 43, 257-263 (2011).</li><li>Winward, C. E., Halligan, P. W., Wade, D. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Somatosensory+recovery:+A+longitudinal+study+of+the+first+6+months+after+unilateral+stroke.">Somatosensory recovery: A longitudinal study of the first 6 months after unilateral stroke.</a> Disability &amp; Rehabilitation. 29, 293-299 (2007).</li><li>Sullivan, J. E., Hedman, L. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sensory+Dysfunction+Following+Stroke:+Incidence,+Significance,+Examination,+and+Intervention.">Sensory Dysfunction Following Stroke: Incidence, Significance, Examination, and Intervention.</a> Topics in Stroke Rehabilitation. 15, 200-217 (2008).</li><li>Connell, L. A., Lincoln, N. B., Radford, K. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Somatosensory+impairment+after+stroke:+frequency+of+different+deficits+and+their+recovery.">Somatosensory impairment after stroke: frequency of different deficits and their recovery.</a> Clinical Rehabilitation. 22, 758 (2008).</li><li>Winward, C. E., Halligan, P. W., Wade, D. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Current+practice+and+clinical+relevance+of+somatosensory+assessment+after+stroke.">Current practice and clinical relevance of somatosensory assessment after stroke.</a> Clinical rehabilitation. 13, 48-55 (1999).</li><li>Torre, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Somatosensory-related+limitations+for+bimanual+coordination+after+stroke.">Somatosensory-related limitations for bimanual coordination after stroke.</a> Neurorehabilitation and neural repair. , (2013).</li><li>Nichols-Larsen, D. S., Clark, P. C., Zeringue, A., Greenspan, A., Blanton, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Factors+influencing+stroke+survivors'+quality+of+life+during+subacute+recovery.">Factors influencing stroke survivors' quality of life during subacute recovery.</a> Stroke. 36, 1480-1484 (2005).</li><li>Borstad, A. L., Nichols-Larsen, D. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessing+and+treating+Higher-level+Somatosensory+Impairments+Post+Stroke.">Assessing and treating Higher-level Somatosensory Impairments Post Stroke.</a> Topics in Stroke Rehabilitation. 21, 290-295 (2014).</li><li>Byl, N., Leano, J., Cheney, L. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Byl-Cheney-Boczai+Sensory+Discriminator:+reliability,+validity,+and+responsiveness+for+testing+stereognosis.">The Byl-Cheney-Boczai Sensory Discriminator: reliability, validity, and responsiveness for testing stereognosis.</a> Journal of Hand Therapy. 15, 315-330 (2002).</li><li>Lincoln, N. B., Jackson, J. M., Adams, S. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+and+revision+of+the+Nottingham+Sensory+Assessment+for+stroke+patients.">Reliability and revision of the Nottingham Sensory Assessment for stroke patients.</a> Physiotherapy. 84, 358-365 (1998).</li><li>Carey, L. M., Nankervis, , et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> , (2006).</li><li>Ayres, A. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Sensory integration and praxis test (SIPT). , (1989).</li><li>Kalisch, T., Tegenthoff, M., Dinse, H. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improvement+of+sensorimotor+functions+in+old+age+by+passive+sensory+stimulation.">Improvement of sensorimotor functions in old age by passive sensory stimulation.</a> Clinical Interventions in Aging. 3, 673 (2008).</li><li>Meyer, S., Kattunen, A. H., Thijs, V., Feys, H., Verheyden, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+do+somatosensory+deficits+in+the+arm+and+hand+relate+to+upper+limb+impairment,+activity,+and+participation+problems+after+stroke?+A+systematic+Review.">How do somatosensory deficits in the arm and hand relate to upper limb impairment, activity, and participation problems after stroke? A systematic Review.</a> Physical Therapy. 94, (2014).</li><li>Williams, P. S., Basso, D. M., Case-Smith, J., Nichols-Larsen, D. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+the+Hand+Active+Sensation+Test:+reliability+and+validity.">Development of the Hand Active Sensation Test: reliability and validity.</a> Arch. Phys. Med. Rehabil. 87, 1471-1477 (2006).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> International Classification of Functioning, Disability and Health (ICF). , (2001).</li><li>McDonnell, M. N., Hillier, S. L., Miles, T. S., Thompson, P. D., Ridding, M. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+combined+afferent+stimulation+and+task-specific+training+following+stroke:+a+pilot+randomized+controlled+trial.">Influence of combined afferent stimulation and task-specific training following stroke: a pilot randomized controlled trial.</a> Neurorehabilitation and neural repair. 21, 435-443 (2007).</li><li>Byl, N. N., Pitsch, E. A., Abrams, G. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+outcomes+can+vary+by+dose:+learning-based+sensorimotor+training+for+patients+stable+poststroke.">Functional outcomes can vary by dose: learning-based sensorimotor training for patients stable poststroke.</a> Neurorehabilitation and neural repair. 22, 494 (2008).</li><li>Carey, L., Macdonell, R., Matyas, T. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=SENSe:+Study+of+the+Effectiveness+of+Neurorehabilitation+on+Sensation+A+Randomized+Controlled+Trial.">SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation A Randomized Controlled Trial.</a> Neurorehabilitation and neural repair. 25, 304-313 (2011).</li></ol>

The authors declare they have no competing financial interests.

Evidence suggests that similar to motor recovery following stroke, somatosensory recovery requires task specific training. 18,19,20 Therefore, if we aim to improve the hands performance as a haptic receptor, haptic impairments must be identified. 15 The opportunity to quantify haptic ability in the clinic and laboratory has been limited, to some extent, based on the availability of valid and reliable outcome measures. &#160;The large number of stroke survivors with somatosensory impairments warrants the need for valid and reliable clinical outcome measures, which identify impairments and inform individualized rehabilitation programs. The HASTe is such a measure.
While the HASTe is not appropriate for individuals with severe upper extremity motor impairments, it is useful to evaluate individuals with moderate to mild motor impairments. &#160;These are the same individuals, research suggests, who have good potential to resume meaningful upper limb use after stroke. Measuring haptic ability using a reliable and valid 18-point scale affords the opportunity to identify impairments (fewer than 13 of 18 correct matches) and to quantify improvements, thought to be a change of greater than 3 matches. 16 The HASTe may be appropriate to use in both research and clinical settings. The match to sample design minimizes the opportunity for tester bias. It can be fabricated with inexpensive, common materials. Critical steps in fabrication include accurate measurement of the cork, self-adhesive laminate, and brown paper coverings to ensure that the seams and edges meet but do not overlap (protocol step 1.2.2). Material overlap would result in inconsistencies between objects and premature wear of the objects. A second critical step in the fabrication process is accurately measuring object contents to 0.1 ounce and using packing foam to ensure that materials do not shift in the cylinder during handling (protocol step 1.2.9).
It is possible that the greatest threat to HASTe validity is if the participants do not understand or remember the test instructions throughout the administration of the test. In the second study, no example objects were provided to the participants, which may have resulted in greater variability in healthy participant scores. We suggest this may have resulted in confusion regarding test instructions. This is useful to illustrate the importance of using example objects to clarify the study paradigm. While participants should not be instructed as to which object property (weight or texture) they are matching to within each trial, it is critical that they understand that, within each trial, they will only match based on one property, as one property is kept constant within every trial. For further clarification, these instructions can be repeated during the test at the discretion of the examiner or the request of the participant (protocol step 2.6).
The HASTe is unique when compared to other similar measures. &#160;&#160;The Stereognosis component of the Revised Nottingham Sensory Assessment, 11 the Byl-Chyney-Boczai Sensory Discriminator (BCB), 10 and the Functional Tactile Object Recognition Tests fTORT, 12 while valid and reliable for stroke, all require visual or verbal matching to a comparison item. Thus, these measures may be confounded by cognitive or language impairments. &#160;The manual form perception test, a subset of the Sensory information and praxis test, 13 and the Haptic Object Recognition Test (HORT) 14 involve form matching but do not require texture or weight discrimination, undeniably important aspects of haptic performance. Neither the manual form perception test nor the HORT have been validated in the population with stroke.
The principle limitation of the HASTe is the administration time, which averages between 15 and 20 min per hand. A second limitation is that severe motor impairments preclude participation, as participants must be able to grasp and lift the test objects. Finally, the HASTe measures only two aspects of haptic touch, weight and texture discrimination. The HASTe has several advantages. First, the HASTe&#8217;s 18-point scale provides more information about haptic performance than dichotomous descriptions of somatosensory performance such as &#8220;intact&#8221; and &#8220;impaired&#8221; routinely used in the clinic. &#160;Second, the test is inexpensive and relatively easy to construct. Third, the administration methods limit the possibility of tester bias. Finally, the test has good test-retest reliability (ICC .77), diagnostic accuracy (area under the ROC curve mean = 0.92), sensitivity (0.857) and specificity (1.0). The HASTe may be sensitive to subtle changes in haptic performance of the ipsilesional hand, yet performance does not appear to be affected by age. In the future it may be useful to validate the HASTe for use with other populations of individuals with sensorimotor impairments such as peripheral nerve injury or spinal cord injury.
A final word is to remind the reader that the HASTe, like other standardized measures of human performance, will provide the most meaningful data if the protocol for fabrication and administration of the test are followed precisely. &#160;

Imagine the feel of a loved one&#8217;s hand. It is calloused or smooth? Strong or delicate? Warm or cool? Do you hold it in a handshake or with fingers intertwined? If you have evoked a memory, it is likely grounded in your ability to use movement of your hands to solicit somatosensory information, which is called haptic touch, or active sensation. Characteristics that can be determined with haptic touch include size, shape, weight, texture, surface compliance, and temperature. &#160;Haptic receptors include proprioceptors, which are found in the skin, muscles, tendons, and joints, as well as cutaneous receptors, both of which are activated during manual exploration of objects. Different hand actions aid in the determination of object characteristics. For example, repeatedly performing a lateral rubbing motion across an object may expose texture properties, or lifting the object in the hand may reveal object weight. Therefore, both manual dexterity and somatosensation are vital to haptic performance and the human experience.
Following stroke, both somatosensory and motor impairments contribute to diminished haptic performance. 1 Poststroke motor impairments are common and well defined, with approximately 70% of stroke survivors experiencing some level of paresis. 1 Somatosensory impairments after stroke are also common, occurring in 47-89% 2-4 of individuals. Researchers agree that both cutaneous and proprioceptive impairments are common after stroke. For a thorough characterization of the consequences of stroke on somatosensory domains the reader is referred to the works by of Carey et al., 2 Connell et al., 5 and Sullivan. 4
Somatosensory impairments contribute to diminished rehabilitation outcomes, 6 upper limb coordination, 7 function and quality of life.8 However, quantification of somatosensory impairments, especially active sensation, is lacking in clinical practice in part due to the fact that somatosensory loss is less apparent and more difficult to quantify than motor impairments.9 Measures which have been developed to quantify active sensation include the Byl-Chyney-Boczai Sensory Discriminator (BCB), 10 the stereognosis component of the Revised Nottingham Sensory Assessment, 11 the Functional Tactile Object Recognition Tests (fTORT), 12 &#160;the Manual Form Perception Test (a subset of the Sensory Information and Praxis Test), 13 and the Haptic Object Recognition Test (HORT). 14 Although these measures are available, a recent systematic review, which sought to describe how somatosensory impairments in the arm and hand relate to upper limb problems following stroke, concluded that clinicians and researchers currently lack valid and reliable tests of somatosensation. 15 Therefore, addressing the availability of clinically useful and parametrically sound measures of haptic performance is essential.
The Hand Active Sensation Test (HASTe) is an 18-item match-to-sample test of weight and texture discrimination, originally published by Williams and colleagues in 2006. 16 The HASTe is a measure of haptic touch and is sensitive to haptic impairments in individuals with stroke (indicated by fewer than 13 correct matches). As the HASTe seeks to measure haptic perception, as minimum criteria, individuals need the abilities to grasp and lift with the hand and arm and follow the test instructions. In the International Classification of Functioning, Disability and Health (ICF) model, 17 the HASTe is considered an activity level measurement. The HASTe takes between 15-30 min to administer per hand tested. Advantages of the HASTe include that it is inexpensive, total of material prices for 2015 estimated at $100, and easy to construct and that it&#8217;s 18-point scale provides greater resolution regarding performance than more common dichotomous characterization of &#8220;intact&#8221; or &#8220;impaired&#8221;.
The purpose of this paper is to describe the design, fabrication and administration of the HASTe. While it is possible to infer the test set-up from the original HASTe publication, this paper provides detailed methods for fabricating a visual screen and a HASTe test kit, both to be used during testing. The equipment required for assembly, as well as a detailed list of all required materials is listed in the Table of&#160;Materials. A single sheet with instructions for administering and scoring the HASTe is also provided as the following:
APPENDIX 1: HASTe&#160; Administration Instructions and Score Sheet &#160;&#160;&#160; &#160;&#160;&#160; Participant ID#_______&#160; Date_______
Set Up:&#160; Seat the test participant at a table (table ~29 inches high and chair seat ~18 inches high) with, initially, the dominant or less impaired upper extremity resting on the table and placed under the assembled visual screen. During the test, keep all objects in numerical order to maintain organization.
Demonstration Trials:&#160; Administer two demonstration trials prior to scoring. Provide the participant with objects A and B, and instruct him/her to compare the objects&#8217; weights. Then, provide the participant with objects A and C, and instruct him/her to compare the objects&#8217; textures. Offer feedback only for the demonstration trials.
Scored Trials:&#160; There will be 18 trials scored per extremity, with a maximum of 5 min allowed for each. Instruct the participant to manually explore the specified test object (identified &#8220;test&#8221; in the tables below) with the dominant or less impaired hand, then explore each of the three possible object matches (numbered otherwise within each trial box below) with this same hand. The possible matches will vary by either weight or texture, but never by both within one trial.&#160; Instruct the participant to find the match of the original object and tell him/her they can touch each object as many times as needed to determine an answer.&#160; Do not inform the participant as to which object property (texture or weight) he or she is matching within a trial, and do not assist the participant with manual exploration of the objects. Indicate the participant&#8217;s final answer for each trial in the tables below by circling the number of that object. Test the more impaired upper extremity after the participant completes the test with the less impaired upper extremity. Using the tables below, score the test by determining the number of correct matches from a total of 18 trials per hand (one box per trial below).
Verbal Instructions to Participant: &#8220;Use one hand to manually explore the test object first. Then, explore each of the three possible matches, which vary by either weight or texture but never by both within one trial.&#160; Find the match. You can touch each object as many times as you need to determine your answer. There will be 18 trials. You have a maximum of 5 min for each trial.&#8221;
<img alt="Score card" src="/files/ftp_upload/53178/53178scorecard.jpg" />

<table><tbody><tr><td>Equipment Needed for Assembly</td><td></td><td></td><td></td></tr><tr><td>Tape measure</td><td></td><td></td><td>To measure lengths of materials</td></tr><tr><td>PVC saw</td><td></td><td></td><td>To cut PVC pieces to appropriate lengths given below</td></tr><tr><td>Scissors</td><td></td><td></td><td>To cut paper, cork and laminating material</td></tr><tr><td>Scale accurate to 0.1 ounce</td><td></td><td></td><td>To determine exact weight of test objects</td></tr><tr><td>Sharpie Permanent Marker</td><td></td><td></td><td>To label test item number and weight</td></tr><tr><td>Visual Screen Materials</td><td>Company</td><td>Catalog Number</td><td></td></tr><tr><td>0.5-inch PVC Pipe (Sch. 40 Plain-End Pipe)</td><td>Home Depot</td><td>530048</td><td>104 inches total, will be cut into four 10-inch and three 20-inch pieces</td></tr><tr><td>0.5-inch PVC Tee (Sch. 40 SxSxS Tee)</td><td>Home Depot</td><td>406005RMC</td><td>Two pieces</td></tr><tr><td>PVC Elbow (Lasco 0.5-inch Dia 90 degree PVC Sch 40 Side Outlet Elbow)</td><td>Home Depot</td><td>413005RMC</td><td>Two pieces</td></tr><tr><td>Pillowcase</td><td></td><td></td><td>One to be hung from the PVC frame as a visual shield</td></tr><tr><td>ACCO Binder Clips, Medium</td><td>amazon.com</td><td>72050</td><td>Two to hold the pillowcase to the PVC frame</td></tr><tr><td>Testing Kit Materials</td><td></td><td></td><td></td></tr><tr><td>1.5-inch PVC Sch. 40 DWV Plain End Pipe</td><td>Home Depot</td><td>531111</td><td>85 inches total, will be cut into 21 4-inch pieces</td></tr><tr><td>Quartet Cork Roll, 1/16-inch thick</td><td>amazon.com</td><td>NA</td><td>1 roll, 24x48 inches, will be cut into 42 4x7-inch pieces to cover all test and example items</td></tr><tr><td>Oatey all purpose cement for CPVC and PVC</td><td>Home Depot</td><td>308213</td><td>8 ounce can, to use to adhere cork, paper and end caps to PVC test items</td></tr><tr><td>Avery Self-Adhesive Laminating Roll</td><td>amazon.com</td><td>73610</td><td>One 24x600-inch roll, will be cut into six 4x7-inches pieces to cover cork on six test objects</td></tr><tr><td>Brown Builder&#039;s Paper</td><td>Home Depot</td><td>35140</td><td>One roll, will be cut into six 4x7-inch pieces to cover cork on six test objects</td></tr><tr><td>3M Pro Grade 9 Sandpaper</td><td>Home Depot</td><td>25060P-G</td><td>One piece 4x7 inches, to use to cover one example item</td></tr><tr><td>Ranger Glossy Cardstock</td><td>amazon.com</td><td>NA</td><td>One 8.5x11-inch, 10-Pack, white, will be cut into two 4x7-inch pieces to cover example items</td></tr><tr><td>Marblex-durable self modeling clay in moist form</td><td>amaco.com/shop/</td><td>X-242</td><td>One 5-pound package, used to achieve correct weights of test objects</td></tr><tr><td>Medium density polyethylene packing foam</td><td>amazon.com</td><td>NA</td><td>One foam sheet, 220 poly, charcoal, 2x24x18 inches, to fill the remaining space in test objects after clay has been inserted</td></tr><tr><td>Knock Out Plug for 1.5-inch PVC</td><td>Home Depot</td><td>85000</td><td>42 caps to seal the ends of the 21 test items</td></tr><tr><td>Sterilite 6-quart plastic storage box</td><td>Home Depot</td><td>16428960</td><td>One to store/transport test objects</td></tr></tbody></table>

design, fabrication, and administration of the hand active sensation test (haste)

The concept of personalizing neurologic rehabilitation, based on individual impairments, has experienced a recent surge. In parallel, the number of outcome measures of upper extremity motor performance has grown. However, clinicians and researchers lack practical, quantitative measures of the hand&#8217;s natural role as a receptor of the environment. The Hand Active Sensation Test (HASTe), developed by Williams and colleagues in 2006, is a valid and reliable measure of haptic performance. Though not available commercially, the HASTe can be fabricated from inexpensive materials, and it has been used successfully to identify impairments in haptic touch in individuals with stroke. (Williams, 2006). This paper presents the methods of design and fabrication of the HASTe testing kit, as well as a visual screen to be used during administration, and instructions for the tests administration and scoring.

Williams and colleagues published the original study, which established the reliability and validity of the HASTe, in 2006. Based on that study, individuals scoring fewer than 13 correct matches on the HASTe are considered to have impaired haptic performance, while those scoring between 13 and 18 are considered to have unimpaired haptic performance. 16 When an individual scores 6 or fewer correct matches, it is considered a chance score, based on the odds in an 18 trial/3 item match to sample design.
Test-retest reliability for the HASTe was strong across all groups (ICC3,1 = 0.77, Pearson r = 0.78). Internal consistency was also strong for the HASTe with a Cronbach coefficient of &#945; = 0.82. The mean accuracy score for the control group was 14.86 &#177; 1.53 and 8.46 &#177; 3.51 for stroke survivors (P &#60;0.001). Participants in both groups scored significantly higher (P&#160;&#60;0.001) on the 9 texture trials (6.36 &#177; 2.50) than the 9 weight trials (5.30 &#177; 2.31). Sensitivity was 0.857 and specificity was 1.0. 16
A second study (Borstad AL, unpublished data, 2015), which used the HASTe with 12 individuals with stroke and 12 age, gender and handedness matched control participants, found participants in both groups exhibited a wide range of haptic performance. Post-stroke participant scores on the HASTe ranged from 4 to 15 for the paretic hand and 8 to 16 for the non-paretic hand. Control participant scores ranged from 8 to 16 for the right hand and from 8 to 17 for the left hand. Between group differences in this sample were not statistically significant for either the paretic and matched hand or the non-paretic and matched hand (Table 1). Nine post-stroke participants (75%) had impaired haptic performance in their right hand (indicated by a score of fewer than 13 correct). In 8 of the 9 post-stroke participants with haptic performance considered impaired, when the contralesional hand was impaired, the ipsilesional hand was also impaired. This relationship was explored using a Pearson correlation coefficient. In this sample, there was a good correlation of HASTe scores between hands (r = 0.70, p &#60;0.001), but no relationship between HASTe scores and age. (Figure 4) Participants in this study provided written informed consent and the institutional biomedical review board approved the study.
<img alt="Figure 4" src="/files/ftp_upload/53178/53178fig4.jpg" /> 
Figure 4: HASTe Scores Correlate with the Opposite Hand but not Age. (Borstad AL, unpublished data, 2015) (A) The number of correct matches for the paretic hand and the matched hand of the control participants showed a good correlation with the other hands (Non-paretic or matched). (B) To examine the relationship between age and performance on the HASTe, the non-paretic and matched hands of the control particpants were used in a Pearson correlation with age. This relationship was not found to be significant.
<table border="0" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td></td>
			<td>Male</td>
			<td>Right Hand Dominant</td>
			<td>Age, Years&#160;</td>
			<td>Right hand was Paretic</td>
			<td>Chronicity, Months</td>
			<td>Paretic or matched HASTe&#160;</td>
			<td>Non-paretic or matched HASTe</td>
		</tr>
		<tr>
			<td>Poststroke (n = 12)</td>
			<td>5</td>
			<td>11</td>
			<td>64.3(12.2)</td>
			<td>5</td>
			<td>12.3(21.2)</td>
			<td>9.8 (2.8)</td>
			<td>11.2(2.5)</td>
		</tr>
		<tr>
			<td>Controls (n = 12)</td>
			<td>5</td>
			<td>11</td>
			<td>63.9(12.4)</td>
			<td>--</td>
			<td>--</td>
			<td>11.9(2.6)</td>
			<td>12.2(2.9)</td>
		</tr>
		<tr>
			<td colspan="2">Two-tailed t-test</td>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
			<td>p = 0.07</td>
			<td>p = 0.37</td>
		</tr>
		<tr>
			<td>Mean(SD)</td>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>
Table 1: Participant Description and Average HASTe scores (Borstad AL, unpublished data, 2015).

Watch this Scientific Journal Video about Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe at JoVE.com

Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe

The Hand Active Sensation Test (HASTe) is a valid and reliable measure of haptic performance, which has been used successfully to identify impaired haptic touch in individuals with stroke. The purpose of this paper is to describe the design, fabrication and administration of the HASTe.

Design, Fabrication, and Administration of the Hand Active Sensation Test (HASTe)

The concept of personalizing neurologic rehabilitation, based on individual impairments, has experienced a recent surge. In parallel, the number of ...

design-fabrication-administration-hand-active-sensation-test

Nanyang Technological University

Research

JoVE Journal

Medicine

9.1K Views.  The Ohio State University. The Hand Active Sensation Test (HASTe) is a valid and reliable measure of haptic performance, which has been used successfully to identify impaired haptic touch in individuals with stroke. The purpose of this paper is to describe the design, fabrication and administration of the HASTe. 

Video: Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe

The Crossmodal Congruency Task as a Means to Obtain an Objective Behavioral Measure in the Rubber Hand Illusion Paradigm

The rubber hand illusion (RHI) is a popular experimental paradigm. Participants view touch on an artificial rubber hand while the participants' own hidden hand is touched. If the viewed and felt touches are given at the same time then this is sufficient to induce the compelling experience that the rubber hand is one's own hand. The RHI can be used to investigate exactly how the brain constructs distinct body representations for one's own body. Such representations are crucial for successful interactions with the external world. To obtain a subjective measure of the RHI, researchers typically ask participants to rate statements such as "I felt as if the rubber hand were my hand". Here we demonstrate how the crossmodal congruency task can be used to obtain an objective behavioral measure within this paradigm.
The variant of the crossmodal congruency task we employ involves the presentation of tactile targets and visual distractors. Targets and distractors are spatially congruent (i.e. same finger) on some trials and incongruent (i.e. different finger) on others. The difference in performance between incongruent and congruent trials - the crossmodal congruency effect (CCE) - indexes multisensory interactions. Importantly, the CCE is modulated both by viewing a hand as well as the synchrony of viewed and felt touch which are both crucial factors for the RHI.
The use of the crossmodal congruency task within the RHI paradigm has several advantages. It is a simple behavioral measure which can be repeated many times and which can be obtained during the illusion while participants view the artificial hand. Furthermore, this measure is not susceptible to observer and experimenter biases. The combination of the RHI paradigm with the crossmodal congruency task allows in particular for the investigation of multisensory processes which are critical for modulations of body representations as in the RHI.

We demonstrate how an objective measure can be employed in the widely employed rubber hand illusion paradigm. This measure is obtained by modifying the well-established crossmodal congruency task. This task allows the investigation of multisensory processes which are critical for modulations of body representations as in the rubber hand illusion.

The rubber hand illusion (RHI) is a popular experimental paradigm. Participants view touch on an artificial rubber hand while the participants' own hidden ...

Behavior

Corticospinal Excitability Modulation During Action Observation

This study used the transcranial magnetic stimulation/motor evoked potential (TMS/MEP) technique to pinpoint when the automatic tendency to mirror someone else's action becomes anticipatory simulation of a complementary act. TMS was delivered to the left primary motor cortex corresponding to the hand to induce the highest level of MEP activity from the abductor digiti minimi (ADM; the muscle serving little finger abduction) as well as the first dorsal interosseus (FDI; the muscle serving index finger flexion/extension) muscles. A neuronavigation system was used to maintain the position of the TMS coil, and electromyographic (EMG) activity was recorded from the right ADM and FDI muscles. Producing original data with regard to motor resonance, the combined TMS/MEP technique has taken research on the perception-action coupling mechanism a step further. Specifically, it has answered the questions of how and when observing another person's actions produces motor facilitation in an onlooker's corresponding muscles and in what way corticospinal excitability is modulated in social contexts.

Single-pulse transcranial magnetic stimulation over the primary motor cortex, neuronavigation, and registration of electromyographic activity of hand muscles were used in this study to explore corticospinal excitability while participants were observing action sequences.

This study used the transcranial magnetic stimulation/motor evoked potential (TMS/MEP) technique to pinpoint when the automatic tendency to mirror someone ...

Quantitative Assessment of Cortical Auditory-tactile Processing in Children with Disabilities

Objective and easy measurement of sensory processing is extremely difficult in nonverbal or vulnerable pediatric patients. We developed a new methodology to quantitatively assess children&#39;s cortical processing of light touch, speech sounds and the multisensory processing of the 2 stimuli, without requiring active subject participation or causing children discomfort. To accomplish this we developed a dual channel, time and strength calibrated air puff stimulator that allows both tactile stimulation and sham control. We combined this with the use of event-related potential methodology to allow for high temporal resolution of signals from the primary and secondary somatosensory cortices as well as higher order processing. This methodology also allowed us to measure a multisensory response to auditory-tactile stimulation.

Objective and easy measurement of sensory processing is extremely difficult in nonverbal or vulnerable pediatric patients. We developed a new methodology to quantitatively assess infants and children&#39;s cortical processing of light touch, speech sounds, and the multisensory processing of the 2 stimuli, without requiring active subject participation or causing discomfort in vulnerable patients.

Objective and easy measurement of sensory processing is extremely difficult in nonverbal or vulnerable pediatric patients. We developed a new methodology ...

Testing Tactile Masking between the Forearms

Masking, in which one stimulus affects the detection of another, is a classic technique that has been used in visual, auditory, and tactile research, usually using stimuli that are close together to reveal local interactions. Masking effects have also been demonstrated in which a tactile stimulus alters the perception of a touch at a distant location. Such effects can provide insight into how components of the body's representations in the brain may be linked. Occasional reports have indicated that touches on one hand or forearm can affect tactile sensitivity at corresponding contralateral locations. To explore the matching of corresponding points across the body, we can measure the spatial tuning and effect of posture on contralateral masking. Careful controls are required to rule out direct effects of the remote stimulus, for example by mechanical transmission, and also attention effects in which thresholds may be altered by the participant's attention being drawn away from the stimulus of interest. The use of this technique is beneficial as a behavioural measure for exploring which parts of the body are functionally connected and whether the two sides of the body interact in a somatotopic representation. This manuscript describes a behavioural protocol that can be used for studying contralateral tactile masking.

Here we explore contralateral tactile masking between the forearms in which tactile detection thresholds are modulated by vibration applied to a remote site. The details of which remote sites have an effect can tell us about how the body is represented in the brain.

Masking, in which one stimulus affects the detection of another, is a classic technique that has been used in visual, auditory, and tactile research, ...

A Protocol of Manual Tests to Measure Sensation and Pain in Humans

Numerous qualitative and quantitative techniques can be used to test sensory nerves and pain in both research and clinical settings. The current study demonstrates a quantitative sensory testing protocol using techniques to measure tactile sensation and pain threshold for pressure and heat using portable and easily accessed equipment. These techniques and equipment are ideal for new laboratories and clinics where cost is a concern or a limiting factor. We demonstrate measurement techniques for the following: cutaneous mechanical sensitivity on the arms and legs (von-Frey filaments), radiant and contact heat sensitivity (with both threshold and qualitative assessments using the Visual Analog Scale (VAS)), and mechanical pressure sensitivity (algometer, with both threshold and the VAS). The techniques and equipment described and demonstrated here can be easily purchased, stored, and transported by most clinics and research laboratories around the world. A limitation of this approach is a lack of automation or computer control. Thus, these processes can be more labor intensive in terms of personnel training and data recording than the more sophisticated equipment. We provide a set of reliability data for the demonstrated techniques. From our description, a new laboratory should be able to set up and run these tests and to develop their own internal reliability data.

The goal of this procedure is to demonstrate a battery of quantitative techniques for sensory and pain measurement in humans. The equipment and techniques described are commonly found in pain clinics or are easy to obtain.

Numerous qualitative and quantitative techniques can be used to test sensory nerves and pain in both research and clinical settings. The current study ...

A Simple Non-invasive Method for Temporary Knockdown of Upper Limb Proprioception

Proprioception may be the least well measured of all contributors to the neural control of movement. New precise, reliable measures of proprioception are needed for clinical diagnosis of impairment, and to measure outcomes of proprioceptive training. The purpose of this simple, non-invasive method is to temporarily knockdown upper limb proprioception in healthy adults, to an extent that would be useful in the development and testing of upper limb proprioception measures. Knockdown models have two main advantages over studying humans with impaired proprioception: participant availability and the ability to control the extent of impairment across participants. Current published methods of temporary proprioception knockdown of the upper limb, such as ischemic nerve blocks and cryotherapy, are invasive, impractical, or uncomfortable for the participant. Here, vibration over the ulnar groove was used to reduce upper limb proprioception. High frequency vibration may reduce proprioceptive acuity by inhibiting pacinian corpuscle-induced input. The effect of vibration used in this protocol was confirmed using two quantitative measures. This method was simple to administer, comfortable for participants, and practical.

The goal of this protocol is to demonstrate a practical method to temporarily interfere with proprioception in the upper limb of healthy humans.

Proprioception may be the least well measured of all contributors to the neural control of movement. New precise, reliable measures of proprioception are ...

A Tactile Automated Passive-Finger Stimulator (TAPS)

Although tactile spatial acuity tests are used in both neuroscience research and clinical assessment, few automated devices exist for delivering controlled spatially structured stimuli to the skin. Consequently, investigators often apply tactile stimuli manually. Manual stimulus application is time consuming, requires great care and concentration on the part of the investigator, and leaves many stimulus parameters uncontrolled. We describe here a computer-controlled tactile stimulus system, the Tactile Automated Passive-finger Stimulator (TAPS), that applies spatially structured stimuli to the skin, controlling for onset velocity, contact force, and contact duration. TAPS is a versatile, programmable system, capable of efficiently conducting a variety of psychophysical procedures. We describe the components of TAPS, and show how TAPS is used to administer a two-interval forced-choice tactile grating orientation test.
Corresponding Author: Daniel Goldreich

A Tactile Automated Passive-Finger Stimulator TAPS

We describe a computer-controlled device for investigating the sense of touch: the Tactile Automated Passive-finger Stimulator (TAPS). We describe the components of TAPS, and show how TAPS is used to administer a two-interval forced-choice tactile grating orientation test.

Although tactile spatial acuity tests are used in both neuroscience research and clinical assessment, few automated devices exist for delivering ...

Biology

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

The split hand phenomenon refers to predominant wasting of thenar muscles and is an early and specific feature of amyotrophic lateral sclerosis (ALS). A novel split hand index (SI) was developed to quantify the split hand phenomenon, and its diagnostic utility was assessed in ALS patients. The split hand index was derived by dividing the product of the compound muscle action potential (CMAP) amplitude recorded over the abductor pollicis brevis and first dorsal interosseous muscles by the CMAP amplitude recorded over the abductor digiti minimi muscle. In order to assess the diagnostic utility of the split hand index, ALS patients were prospectively assessed and their results were compared to neuromuscular disorder patients. The split hand index was significantly reduced in ALS when compared to neuromuscular disorder patients (P&#60;0.0001). Limb-onset ALS patients exhibited the greatest reduction in the split&#160;hand index, and a value of 5.2 or less reliably differentiated ALS from other neuromuscular disorders. Consequently, the split&#160;hand index appears to be a novel diagnostic biomarker for ALS, perhaps facilitating an earlier diagnosis.

Dissociated atrophy of intrinsic hand muscles, termed the split hand, appears to be a specific feature of amyotrophic lateral sclerosis (ALS).&#160;Consequently, a novel neurodiagnostic test, termed the split hand&#160;index, was developed to quantify the clinical phenomenon of the split hand, which differentiated ALS from mimic disorders.

The split hand phenomenon refers to predominant wasting of thenar muscles and is an early and specific feature of amyotrophic lateral sclerosis (ALS). A ...

Tactile Semiautomatic Passive-Finger Angle Stimulator (TSPAS)

Passive tactile perception is the ability to passively and statically perceive stimulus information coming from the skin; for example, the ability to sense spatial information is the strongest in the skin on the hands. This ability is termed tactile spatial acuity, and is measured by the tactile threshold or discrimination threshold. At present, the two-point threshold is extensively used as a measure of tactile spatial acuity, although many studies have indicated that critical deficits exist in two-point discrimination. Therefore, a computer-controlled tactile stimulus system was developed, the tactile semiautomated passive-finger angle stimulator (TSPAS), using the tactile angle discrimination threshold as a new measure for tactile spatial acuity. The TSPAS is a simple, easily operated system that applies raised angle stimuli to a subject&#39;s passive fingerpad, while controlling movement speed, distance, and contact duration. The components of the TSPAS are described in detail as well as the procedure to calculate the tactile angle discrimination threshold.

Tactile Semiautomatic Passive-Finger Angle Stimulator TSPAS

Presented is the tactile semiautomated passive-finger angle stimulator TSPAS, a new way to assess tactile spatial acuity and tactile angle discrimination using a computer-controlled tactile stimulus system that applies raised angle stimuli to a subject&#39;s passive fingerpad, while controlling for movement speed, distance, and contact duration.

Passive tactile perception is the ability to passively and statically perceive stimulus information coming from the skin; for example, the ability to ...

Development of a Novel Task-oriented Rehabilitation Program using a Bimanual Exoskeleton Robotic Hand

A robot-assisted hand is used for the rehabilitation of patients with impaired upper limb function, particularly for stroke patients with a loss of motor control. However, it is unclear how conventional occupational training strategies can be applied to the use of rehabilitation robots. Novel robotic technologies and occupational therapy concepts are used to develop a protocol that allows patients with impaired upper limb function to grasp objects using their affected hand through a variety of pinching and grasping functions. To conduct this appropriately, we used five types of objects: a peg, a rectangular cube, a cube, a ball, and a cylindrical bar. We also equipped the patients with a robotic hand, the Mirror Hand, an exoskeleton&#160;hand that is fitted to the subject&#8217;s affected hand and follows the movement of the sensor glove fitted to their unaffected hand (bimanual movement training (BMT)). This study had two stages. Three healthy subjects were first recruited to test the feasibility and acceptability of the training program. Three patients with hand dysfunction caused by stroke were then recruited to confirm the feasibility and acceptability of the training program, which was conducted on 3 consecutive days. On each day, the patient was monitored during 5 min of movement in a passive range of motion, 5 min of robot-assisted bimanual movement, and task-oriented training using the five objects. The results showed that both healthy subjects and subjects who had suffered a stroke in conjunction with the robotic hand could successfully grasp the objects. Both healthy subjects and those who had suffered a stroke performed well with the robot-assisted task-oriented training program in terms of feasibility and acceptability.

This study reports the development of a novel robot-assisted task-oriented program for hand rehabilitation. The developmental process consists of experiments using both healthy subjects and subjects who have had a stroke and suffered from subsequent motor control dysfunction.

A robot-assisted hand is used for the rehabilitation of patients with impaired upper limb function, particularly for stroke patients with a loss of motor ...

Design, Fabrication, and Administration of the Hand Active Sensation Test (HASTe)

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