Mechanism and Machine Theory 104 (2016) 177–189

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Mechanism and Machine Theory

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

Synthesis of a Watt II six-bar linkage in the design of a hand

rehabilitation robot
Erkin Gezgin a,⁎, Pyung-Hun Chang b, Ahmet Faruk Akhan c
a
Department of Mechatronics Engineering, Izmir Katip Celebi University, Turkey
b
Department of Robotics Engineering, Daegu Gyeongbuk Institute of Science and Technology, Republic of Korea
c
Department of Biomedical Technologies, Izmir Katip Çelebi University, Turkey

a r t i c l e i n f o a b s t r a c t

Article history: As a result of neurological disorders such as stroke, brain and spinal cord injuries, disability in
Received 18 September 2015 body regions might occur. In case of similar situations, rapid therapeutic training in early stages
Received in revised form 30 May 2016 has chance to prevent permanent disability by retraining motor movements. In regular treat-
Accepted 31 May 2016
ments, therapists help to carry out regular exercises to train motor movements of the disabled
Available online 9 June 2016
region. However, continuous increase in cases, tough working conditions, dependability on ex-
pertise and human body limitations make the procedures cumbersome and ineffective. Incor-
Keywords: porating robots into therapeutic training not only allows executing treatments in a delicate
Mechanism synthesis
repeatability but also opens new possibilities in terms of exercise types and speeds. In the
Watt II six-bar mechanism
light of recent developments in robotic rehabilitation this paper presents the design of a
Robotic rehabilitation
Body guidance synthesis hand rehabilitation robot for human four fingers that solely targets hand disabilities by utilizing
real grasping motion data of the forefinger into kinematic synthesis of Watt II six-bar linkage.
During the design geometrical synthesis was used for the first loop in order to attain continu-
ous input rotation and the body-guidance synthesis was used for the second loop for the end
effector to follow the desired trajectory in desired orientations.
© 2016 Elsevier Ltd. All rights reserved.

1. Introduction

Disability in body regions after stroke is mainly caused by the destruction of neural command generation and integration. The
impairment of neural commands reduces or even eliminates the functions of muscle tissue that highly effects motor task perfor-
mance of limbs. In order to increase the quality of daily lives of the patients that undergo these effects after stroke, restoration of
disabled functions as much as possible becomes an important and even vital task in some conditions. In the light of this, physical
rehabilitation aims to restore disabilities of body through education and therapy. As it requires a therapist to assist a patient, re-
habilitation is a long and cumbersome procedure to reach homogeneous treatment between sessions. In order to reduce the
amount of rehabilitation time and increase the overall quality with respect to the session repeatability, many robotic devices
are recently introduced to encourage robotic rehabilitation.
In the field of robotic rehabilitation, hand complex can be given as one of the most focused area of interest as it performs most
delicate tasks in daily life and any disability in the region causes a rapid decrease in human motion capability. Throughout the
near literature various designs have been implemented into the area for the training of the disabled hand complex after post
stroke. Hand rehabilitation devices can be classified under three main categories as point control devices, actuated objects, devices

⁎ Corresponding author.
E-mail address: erkin.gezgin@ikc.edu.tr (E. Gezgin).

http://dx.doi.org/10.1016/j.mechmachtheory.2016.05.023
0094-114X/© 2016 Elsevier Ltd. All rights reserved.
178 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189

that control multiple joints and exoskeletons [1]. In terms of movement patterns, ease of control, simplicity, costs and improve-
ment period each one of them has its own merits and setbacks.
Bouzit et al. [2] designed a force feedback glove for haptic interactions with virtual environments that uses an end point con-
trol scheme by using pneumatic actuators. Although it is not specifically designed for rehabilitation purposes, design was later in-
tegrated into rehabilitation. While the light design with direct drive actuators and having a mechanical structure that prevents
abnormal motions of the fingers are some of the advantages of the system, due to the placement of the actuators in the palm,
full grasping motion with the design is not possible. Xu et al. [3] designed a wearable device that utilizes pneumatic muscles
as actuators for robotic hand rehabilitation. Having two degrees of freedom, the rehabilitation system distinctly controls the fin-
gers and the thumb. On the other hand the system is only capable of controlling the extension motion, thus flexion motion occurs
by the help of gravity and hand spasticity when the forces exerted by pneumatic muscles decrease. Iqbal et al. [4] proposed a
novel hand exoskeleton device for tendon therapy exercises. Design has multi degrees of freedom that allow both flexion and ex-
tension actuations by the help of an optimized serial linkage that is capable of applying high levels of force perpendicular to the
phalanges. Popular hand rehabilitation systems in literature were also reviewed with respect to the degrees of freedom, actuator
types and force/torque capabilities in the research. Mohamaddan et al. [5] introduced a wire driven mechanism to be used in post
stroke patients for hand rehabilitation. Three consecutive prototypes were discussed in the research that shows the development
of the final prototype. Design is capable of controlling flexion and extension movements of the fingers by utilizing simple clips
that are attached to the finger phalanges and wire ends. Its simplicity as a wearable device is advantageous for being light weight
and compact. Another wire driven rehabilitation device is designed to train human hand after the stroke by Dovat et al. [6]. It is
formed as a table top design and capable of training various sizes of hands. The design utilizes a clutch system that allows inde-
pendent movements on the fingers by only a single actuator. The research also includes a detailed review of hand and finger re-
habilitation devices in a compact table with respect to their degrees of freedom, workspaces and force/torque outputs. Takahashi
et al. [7] proposed a robotic device with three degrees of freedom that allows grasping of real objects during hand rehabilitation
therapy. The design uses pneumatic actuators and capable of back drivability. It also combines grasping and releasing motions of
the hand with wrist extension and flexion. In the research it is claimed that using real objects throughout the training will have
positive effects on both increasing the patient motivation and enhancing the efficiency of the rehabilitation.
In order to have maximum coordination on rehabilitation, some researchers have used separate actuators to move individual
finger joints. Although better control on various hand training motions is achievable through the method, using multiple degrees
of freedom inevitably complicates the rehabilitation system in terms of mechanical design and control scheme. Worsnopp et al.
[8] proposed a finger exoskeleton to help simulating pinching motion for hand rehabilitation by using six actuators to control
three index finger joints independently. As the design of the exoskeleton utilizes a cable driven system, the extension and the
flexion control of the individual phalanges is possible by using dual actuators that are only able to pull the cables. Exoskeleton
has different built in sensors that permit using either force or position control schemes. Safety of the system was achieved by
using mechanical and software limits in order to prevent undesired motions during the training. Yamaura et al. [9] introduced
a dual component system that includes a data glove for the healthy hand and a wire driven exoskeleton for the paralyzed
hand. Three degrees of freedom prototype for the index finger was used during their trials. Acquiring the joint angle information
from the healthy hand and controlling the paralyzed hand by using proposed exoskeleton, self-rehabilitation training is achieved.
While the systems mechanical structure uses four bar mechanisms for individual joint activation, bending sensors are used in the
glove for motion data acquisition. Chiri et al. [10] presented a wearable multi degrees of freedom rehabilitation device. The design
allows a safe interaction between the patients hand and the device during the rehabilitation in terms of kinematics. Throughout
the study index finger module of the whole exoskeleton was described. Actuation of the module carried out by a wire driven sys-
tem that allows active extension and passive flexion. The authors also proposed a dynamic model of the module and validated it
by the experimental trials on five healthy subjects at the end of the study.
Utilization of the kinematic synthesis procedure is very handy to find the construction parameters of the mechanism that will
be designed for a given specific task. Kinematic synthesis allows the usage of lower mobility systems rather than having full de-
grees of freedom in the task subspace. Although doing so compromises the adaptability of mechanism to various task, it has ben-
efits such as reaching higher operation speeds, dealing with easy control schemes, and achieving energy efficiency by using less
actuators.
Sandor and Erdman [11] presented a kinematic synthesis problem of linkage design to duplicate the motion of human finger
by using Watt I six-bar linkage and four prescribed precision points in their book. Alizade and Kilit [12] presented the analytical
kinematic synthesis of spherical four bar mechanism with five precision points by using polynomial approximation. In their study,
the effects of selecting precision points were also considered and explained within the examples. In the later work Alizade and
Gezgin [13] increased the number of precision points in the kinematic synthesis of spherical four bar mechanism to six and
used various approximation methods as polynomial approximation, least square approximation and Chebyshev approximation
to compare the differences between them in error wise. Moreover, in their study nonlinear equations were linearized by utilizing
nonlinear parameters. Dede et al. [14] presented a method for the body guidance synthesis of four bar mechanism. In their study
synthesis procedure was carried out by dividing four bar mechanism into two serial chains.
Considering prior literature studies, this paper presents a synthesis methodology in the design of a single degree of freedom
hand rehabilitation device for human four fingers. During the series of grasping motion of a middle aged healthy subject, fingertip
trajectory data of the index finger were collected by using motion capture system. Utilizing this data, in order to follow the ac-
quired desired trajectory naturally by the end effector, body guidance kinematic synthesis was used to design the construction
parameters of the kinematic chain that forms one of the closed loops of the Watt II six-bar linkage. Construction parameters
 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189 179

for the remaining closed loop were designed by using geometrical synthesis to form a crank rocker kinematic chain in order to
achieve trajectory following by the continuous rotation of the input. Using single degree of freedom Watt II six-bar linkage not
only simplified the structure of the proposed rehabilitation device but also provided an easy control scheme, however control
part will not be discussed in this paper. Also utilizing crank-rocker mechanism in the first loop of the mechanism allowed higher
operation speeds (1.5 grasps per second) during rehabilitation due to the continuous rotational input. Having designed the mech-
anism, one of the main decisions on adapting Watt II six-bar linkage into either an exoskeleton or a standalone system was made
with respect to the following arguments:

• As the rehabilitation device that is planned to be designed will have higher operation speeds, it should have a stable base to
provide vibration free environment as much as possible.
• As the hand sizes will differ among the patients, various hand types should easily be attached to the rehabilitation device in
minimal time without causing stress to the patients.
• The rehabilitation device should be capable of training both the right and the left hand without interfering much to the
structure.
• Weight of the rehabilitation device should not exhaust the patients especially the elderlies during the treatment.

In the light of these overall rehabilitation device was planned to be a lightweight symmetrical standalone system instead of an
exoskeleton; so that, it can be carried to the sides of the patients and the training procedure will start while they are sitting on a
chair with their related hand attached to the device. Considering the fact that index finger motion data represents a limited model
to be generalized for various hand sizes with respect to different dimensions, self-adjusting hand attachment module that allows
three degrees of freedom attachment for each finger was implemented to the tip of the six-bar mechanism. Addition of this mod-
ule allowed the adaptability of proposed rehabilitation system for both different fingers in each hand and various hand sizes while
preserving the shape of the grasping trajectory. Patient hands will be attached to this module via the magnets from the fingertips
to achieve safe attachment. Also a torque sensor was attached to the system in order to monitor torque changes during the treat-
ment that also increases the safety and range of training possibilities by adding back drivability to the system otherwise it would
not be possible with the gearboxes used in the rehabilitation device.
The main purpose of this paper is not only to propose a new single degrees of freedom hand rehabilitation robot with high
operation speeds and natural trajectory but also to present a design procedure that emphasizes the importance of the kinematic
synthesis.

2. Acquisition of the trajectory data

In order to create a single degree of freedom rehabilitation device that is able to mimic natural hand grasping motion for the
post stroke patients, kinematic synthesis in mechanism design has great importance. Thus, as a starting point, fingertip trajectories
that will be the main constraint of the synthesis procedure should be acquired. As a result, Vicon motion capture system with
eight cameras (Fig. 1a) was used to carry out the task. For the sake of simplicity, index finger of a middle aged healthy subject
was marked by using five infrared reflectors (Fig. 1b) and he was asked to carry out the grasping motion with empty handed
ten times while the cameras were recording.
At the end of the procedure trajectory data of the IR reflector attached to the tip of the index finger was acquired from the
motion capture system and the fingertip spatial grasping data were transferred to the plane of extension and flexion by projection
(Fig. 2). Fig. 2 shows the data points of a single fingertip during the series of grasping motions (ten times). As seen clearly, the
data acquired actually presents the natural planar work space of the index fingertip during multiple grasping motions rather
than a single unique trajectory. From this point of view, the mechanism that is to be designed for the rehabilitation robot will
work naturally if and only if its end effector path lies on this workspace in its operation intervals for the index finger. In order
to ensure desired smooth operation and for the ease of selecting kinematic synthesis precision points, regression was applied
to the trajectory data. Using curve fitting tools in MATLAB second order polynomial f(x) = 0.01313x2 − 13.67x + 4420 was fit to
the trajectory data (Fig. 2).

Fig. 1. a) Vicon motion capture system with eight cameras, b) placement of IR reflectors on the index finger.
180 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189

Fig. 2. Trajectory data of the index fingertip during grasping sequence and the second order polynomial regression curve (f(x)=0.01313x2 −13.67x+4420).

Fig. 3. Kinematic structure of the Watt II six-bar linkage.

Although it will be mentioned later, it should be noted that the regression curve was used only to select precision points for
the kinematic synthesis, so it is not showing the exact path that the designed mechanism follows.

3. Structure of the mechanism and kinematic synthesis

One of the most important design constraints of the rehabilitation device that should be considered during this study was the
mobility of the mechanism that generates grasping motion. In order to reach higher operation speeds (1.5 grasps per second), re-
duce the number of motors to reduce weight and generate easy control scheme, single degree of freedom Watt II six-bar linkage
(Fig. 3) was decided to be synthesized in such a way that the first loop of the six-bar linkage provides repetitive continuous grasp-
ing motion in one directional continuous rotation of the input while the second loop of the six-bar linkage lets the end effector
follow the desired trajectory in prescribed orientations.
In order to design the construction parameters (link lengths, position and orientation of the fixed ground link etc.) of the sec-
ond loop of the proposed rehabilitation mechanism, body guidance kinematic synthesis was carried out as the design of the re-
lated loop requires trajectory following with specific finger orientations to assure safe and natural grasping motion.
Body guidance kinematic synthesis is used to design n construction parameters of the proposed mechanism by using n known
positions (Si → i =1 , 2 … , n) and orientations (αi → i = 1 , 2 … , n ) of the target platform as precision points that are taken from the
desired trajectory (Fig. 4). During the synthesis procedure increase in the number of unknowns results in non-linear design

Fig. 4. Body guidance synthesis and precision points of an end effector following a specific path with desired orientations.
 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189 181

Fig. 5. Division of four-bar mechanism into double serial arms with same end effector positions and orientations.

equations in many terms and makes the synthesis problem harder to be solved. In the interest of avoiding this fact some of the
construction parameter values could be assumed for the ease of solutions, however to reduce non-linearity during this work, four
bar mechanism (second loop) was assumed to be the assembly of two serial arms that have the same end effector position and
orientation (Fig. 5).
In order to start the whole synthesis procedure by forming the objective function, construction and variable parameters of the
serial arm were determined (Fig. 6). As seen in Fig. 6, while a , b ,c and ψ are the construction parameters to be designed, α ,ρ ,φ
and θ are the variable parameters. As the first input angle θ is not required for the body guidance synthesis, it should be omitted
from the final objective function.
Loop closure equation of the serial arm in Fig. 6 (c + a + b =ρ) can be written in the complex polar form as,

jψ jθ jα jφ
ce þ ae þ be ¼ ρe ð1Þ

Separating real and imaginary components Eq. (1) can be divided into two equations as,

c cosψ þ a cosθ þ b cosα ¼ ρ cosφ ð2Þ

c sinψ þ a sinθ þ b sinα ¼ ρ sinφ ð3Þ

In order to remove θ from the equation sets to form a single objective function, components that include θ are gathered in one
side of the both Eqs. (2) and (3), both sides are squared in each equation and then added with each other to get the final objec-
tive function as,

b2 −a2 þ c2 1 ρ2 c c
þ þ c cosψ cosα þ c sinψ sinα− cosψρ cosφ− sinψ ρ sinφ−ρ cosðφ−α Þ ¼ 0 ð4Þ
2b b 2 b b

Eq. (4) can also be written in polynomial form as,

P0 f 0 þ P1 f 1 þ P2 f 2 þ P3 f 3 þ P4 f 4 þ P5 f 5 − F ¼ 0 ð5Þ

Fig. 6. Serial arm with the construction (constant) and variable parameters.
182 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189

where,

2 2 2 2
b −a þ c 1 ρ c
P0 ¼ ; f 0 ¼ 1; P 1 ¼ ; f 1 ¼ ; P 2 ¼ c cosψ; f 2 ¼ cosα; P 3 ¼ c sinψ; f 3 ¼ sinα; P 4 ¼ − cosψ; f 4 ¼ ρ cosφ; P 5
2b b 2 b
c
¼ − sinψ; f 5 ¼ ρ sinφ; F ¼ ρ cosðφ−α Þ:
b

Due to the fact that there exist only four construction parameters (a , b , c and ψ), four precision point sets (αi , ρi , φi → i =
1 , 2 , 3 , 4) should be given in order to create four independent equations. Analyzing the Eq. (5), it can easily be seen that there
are six unknowns (Pi → i = 0 , 1 , 2 , 3 , 4 , 5) that includes four of the construction parameters. However two of these unknowns P4
and P5 are dependent to other parameters thus Eq. (5) is non-linear. It should be noted that if the four bar mechanism was
not assumed to be the assembly of two serial arms, number of nonlinear terms would be higher than two.
In order to solve all the unknowns with four precision points, Eq. (6) should be linearized [12,13,14]. Let P4 and P5 are non-
linear parameters λ1 and λ2 respectively as,

P 4 ¼ −P 1 P 2 ¼ λ1 ; P 5 ¼ −P 1 P 3 ¼ λ2 ð6Þ

and assume that all remaining unknowns are equal to

P i ¼ li þ mi λ1 þ ni λ2 →ði ¼ 0; 1; 2; 3Þ ð7Þ

Inserting Eq. (7) into Eq. (5) and separating the parts without non-linear parameters and the parts with different non-linear
parameters (λ1 ,λ2), 12 equations with 12 unknowns li , mi , ni → i = 0 , 1 ,2 , 3 will be reached as,
2n o 3
1 3
2 n 1 o3 3 2 n 1 o3 3
f f f
6 n j o0 7 6 n j o0 7 6 n j o0 7
6 2 3 7    6 2 3 7   6 2 3 7
6 f j 7 n o3 T n o4 T 6 f j 7 n o3 T n o4 T 6 f j 7 n o3 T n o4 T

6 n o0 7 j 6 7 j 6 7 j
6 3 3 7 lj ¼ F ; 6 n o03 7 m j ¼ f4 ; 6 n o03 7 n j ¼ f5 ð8Þ
6 f 7 0 1 6 f3 7 0 1 6 f3 7 0 1
6 j 7 6 j 7 6 j 7
4 n o0 5 4 n o0 5 4 n o0 5
4 3 4 3 4 3
fj fj fj
0 0 0

where in Eq. (8), fij and Fj are the values of functions fj and F that will be evaluated by the ith precision point sets αi , ρi , φi.
After the calculations of new unknowns li ,mi , ni → i = 0 ,1 , 2 , 3, Eq. (6) can be solved for nonlinear parameters λ1 and λ2. The
most vital part of the procedure is the fact that there will be multiple solution sets for the nonlinear parameters λ1 and λ2.
Using these solutions separately one can find multiple instances of construction parameters by using Eq. (5). Considering the suit-
able distinct solutions, two different synthesized serial arms can be assembled together in order to form a one degree of freedom
four bar mechanism. Adjusting the precision points (αi,ρi, φi → i = 1,2,3, 4), new construction parameters can be found in order to
refine the final trajectory of the synthesized mechanism. Following numerical examples will clarify the subject.

3.1. Numerical examples

Due to the fact that it will directly affect the design, selection of the precision points are so important. Various known methods
can be utilized in the selection procedure such as Chebyshev's spacing, equal spacing and random spacing. At the end, the selec-
tion of the precision points will affect the amount of error between the desired function and actual generated function by the syn-
thesized mechanism. Here two distinct numerical examples will be given and discussed.

Example 1. Let's use Chebyshev's spacing for the selection of precision points first. Before the procedure it should be noted that
the end effector positions ρi , φi can also be given in Cartesian coordinates as ρxi, and ρyi. Due to the fact that ρyi is the function of
ρxi with respect to the regression curve ðρyi ¼ 0:01313ρxi 2 −13:67ρxi þ 4420Þ, ρxi and αi will be sufficient as precision points to
solve the synthesis problem. As seen in Fig. 3, the regression curve lies in an interval of 460 ≤ ρx ≤ 595 mm. Grasping motion
will start in the vicinity of 595 mm when the hand is fully opened and end in the vicinity of 460 mm when the hand is fully
closed. Considering the orientations in these limit positions, fingertip orientations roughly lie in the interval of 170° ≤ α ≤ 350°.
In order to select the precision points with respect to the Chebyshev's spacing, following equation should be used,

1  1  ð2i−1Þπ
xi ¼ x þ x0 − x f −x0 cos i ¼ 1; 2; :::; n ð9Þ
2 f 2 2n

where n is the total number of precision points, xf and x0 are the final and the initial limits of the interval respectively and xi is
the value of ith precision point. Using Eqs. (5)–(9) following table was generated.

As seen in Table 1, only the third roots of the nonlinear parameters λ1 and λ2 are real, by using these values construction pa-
rameters of the 2 DoF serial arm can be found in Table 2.
 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189 183

Fig. 7. Dimensions and final trajectory of the mechanism after body guidance synthesis.

Fig. 8. Geometrical synthesis procedure for the first loop of the mechanism.

It is clear that only single possible solution is acquired. Owing to the fact that forming a four bar mechanism at least two dis-
tinct solutions are needed, the results found on Example 1 cannot be used for the purpose of this study.

Example 2. Due to the fact that Chebyshev's spacing did not give sufficient results in the prescribed intervals, another approach
was tried in the selection of precision points. As seen in Fig. 3, the regression curve passes through some dense parts of the tra-
jectory data scatter plot. Due to this precision points are decided to be selected along with the fingertip orientations from the in-
tervals of the dense parts 460 ≤ ρx1 ≤ 480 , 510 ≤ ρx2 , ρx3 ≤ 550, and 580 ≤ ρx4 ≤ 595. After the selection of precision points, following
table was generated by using Eqs. (5)–(8).

As seen in Table 3, all of the roots of the nonlinear parameters λ1 and λ2 are real, by using these values construction param-
eters of the 2 DoF serial arm can be found in Table 4.
In order to form a four bar mechanism, any two real solutions of 2 DoF serial arms can be used. Thus the results found on
Example 2 will give three distinct four bar mechanisms (1-2, 1-3, 2-3). In this study, solutions 1 and 3 were decided to be utilized
and the four bar mechanism was designed after the numerical rounding for ease of manufacturing (Fig. 7a).

Fig. 9. Synthesized Watt II six-bar linkage and its physical dimensions and 3D model.
184 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189

Fig. 10. Standalone mobile frame with Watt II six-bars attached symmetrically.

Using the real trajectory data, regression function and the kinematic synthesis procedures, final trajectory of the designed fore-
finger mechanism can be seen in Fig. 7b. It is important to mention that, in Fig. 7b regression curve and the synthesized mech-
anism path intersects (black circles) at four precision points ρxi , ρyi → i = 1 , 2 , 3 , 4, and at these points end effector orientation of
the mechanism becomes αi → i =1 , 2 , 3, 4.
After the second loop of the mechanism was designed, in order to attain continuous input rotation first loop of the mechanism

Fig. 11. Rehabilitation system with right angle T gearbox and the circular rod connecting left and right Watt II six bar linkages.

was decided to be a crank-rocker linkage that has an advance to return ratio Q = 1.2. Simple geometrical synthesis procedures
[15] were applied (Fig. 8) to find the remaining construction parameters of the system (d, e, f, O3x, and O3y).
As seen in Fig. 8, with respect to the initial and final positions of the end effector for grasping motion, swing of the second
loops input link was drawn showing the starting and end positions. Random point from the starting position of input link was
selected as A1 and its corresponding point on the end position was labeled as A2. From the point A1 an arbitrary line was
drawn and its parallel was transferred to the point A2. Using following equations angle ϕ was calculated.

α
Q¼ ; α ¼ 180 þ ϕ; β ¼ 180−ϕ ð10Þ
β

where, Q is the advance to return ratio of the mechanism, α is the total crank angle for the advance stroke (grasping) and β is the

Fig. 12. Brushless DC actuator shown at the bottom left and the torque sensor between the couplings.
 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189 185

Fig. 13. Right hand attachment module showing linear guides and magnetic rings attached on their top.

Fig. 14. 2 DoF right hand arm rest and the slots for positional adjustment.

total crank angle for the return stroke (opening). Using angle ϕ, another line was drawn from point A1 by rotating the first arbi-
trary line by the angle ϕ counter clock wise. The intersection between this line and the line that was both passing through A2 and
parallel to the arbitrary line revealed the pivot point (O3x, and O3y) of the crank. Measuring the distances |O3A1 | and |O3A2 |, final
construction parameters d, e, and f were calculated by solving following equations.

jO3 A1 j ¼ e þ d; jO3 A2 j ¼ e−d ð11Þ

In this study selection of the point A1and the arbitrary line was refined up to the point, where O2 and O3 lied on the same line
parallel to the x axis, the Grashof's Law was fulfilled by the construction parameters of the first loop to achieve crank-rocker link-
age. At the end of the synthesis procedures and numerical rounding for ease of manufacturing, final six bar mechanism has been
constructed in a simulation environment (Fig. 9) with respect to the calculated construction parameters.

Fig. 15. Hand grasping sequence utilizing hand attachment module, finger aligner and arm atele to prevent elbow motion.
186 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189

Fig. 16. Final constructed hand rehabilitation robot.

Fig. 17. Hardware verification setup by using three OptiTrack Flex 3 motion capture cameras.

Fig. 18. Attached IR reflector on the tip point of the end effector in order to track robot trajectory.
 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189 187

Fig. 19. Captured end effector trajectory (black points) that was compared with the regression curve (blue) and synthesis curve (red).

Table 1
Results of the Example 1.

i 0 1 2 3 4

ρxi – 465.138 mm 501.669 mm 553.331 mm 589.862 mm

αi – 176.851° 225.558° 294.442° 343.149°
li −91.81579 0.00027 513.32399 916.27065 –
mi 263.55502 −0.00139 11.80345 77.33742 –
ni −776.70462 −0.00025 −8.26310 −44.96866 –
λ1i – −7.22303–3.70286 j −7.22303 + 3.70286 j −5.69474 –
λ2i – −12.7552–6.16871 j −12.7552 + 6.16871 j −9.95306 –

4. Final design

Overall rehabilitation device was planned to be a lightweight system that should be compatible with the right and the left
hand at the same time without interfering much to the structure of the device. Considering this fact along with the arguments
mentioned in the introduction, instead of using exoskeleton, a symmetrical standalone system was decided to be created
where it can be carried to the sides of the patients and the training procedure will start while they are sitting on a chair with
their related hand attached to the device. Thus a mobile frame was designed with sigma profiles and two Watt II six bar linkages,
each will be responsible for individual hands, were planned to be attached to the sigma frames symmetrically (Fig. 10).
After the inspection of the design criterions, Watt II six bar linkages were manufactured by using aluminum alloy and attached
to the assembled frame. In order to reduce the number of actuators to one that should drive the system, 1:1 right angle T gearbox
was attached to the frame and its outputs were connected to the inputs of both mechanisms with spring couplings for easy align-
ment. Using this scheme not only the weight of the system was reduced but also its energy efficiency as well as its simplicity has
been preserved. Also to create stiffness, tip points of the mechanisms were connected by a circular rod with side screws for the
assembly of hand attachment modules (Fig. 11).
Similarly by the help of spring couplings the output of the gearbox was connected to a torque sensor to provide torque mon-
itoring during the treatment. Thus it is possible to switch between different training protocols in terms of control such as active
training. The sensor was connected to a Maxon brushless dc actuator (250 W, 5000 rpm, 331 mNm) with built in low backlash
planetary gearbox (43:1), encoder (500 cpt 3 channels) and hall effect sensor (Fig. 12). This configuration allows full grasping mo-
tion in a continuous rotation of the actuator without any need to change the direction in regular rehabilitation treatment as well
as partial training between predefined grasping angles by utilizing position control.
Due to the fact that hand size varies between patients, adjustable hand attachment module for the rehabilitation device was
also designed and manufactured by using rapid prototyping. The module includes four miniature linear guides with permanent
magnets caged to the carriages. Each finger supposed to be attached to the module by the help of magnetic rings. Attachment
module also allows minor rotation through the rod axis for adjustability and training comfort (Fig. 13).
In order to stabilize patient wrist during the rehabilitation training, arm rest was designed (Fig. 14). Having two translational
degrees of freedom on slots, similar to the attachment module it also allows easy positioning for various different conditions such
as comfort achievement due to size differences.

Table 2
Construction parameters of the Example 1.

ai bi ci ψi

1 39.4294 mm 92.7785 mm 1063.9 mm 60.2235°

188 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189

Table 3
Results of the Example 2.

i 0 1 2 3 4

ρxi – 469.4 mm 518.5 mm 543.6 mm 585.9 mm

αi – 164.1° 249.4° 244.4° 329.3°
li −600.03443 0.00116 455.99783 871.62253 –
mi −393.79434 −0.00024 −44.92667 19.11771 –
ni −420.15299 −0.00088 21.77137 −13.07169 –
λ1i – −11.5315 −9.02968 −7.05568 –
λ2i – −22.4634 −18.4055 −13.2536 –

Patients' hands are fixed to the arm rest by the help of lower arm atele to create additional stability. Moreover, due to the fact
that the rehabilitation device uses fingertip guidance, to prevent abnormal motions of fingers relative to each other, a wearable
finger aligner was also designed, where it is fixed to the middle finger while the other fingers can slide through the holes but
stay aligned by a given tolerance. Arm atele, finger aligner and their way of attachment can be seen in Fig. 15 that also shows
grasping motion sequence of the device used in healthy subject.
Overall hand rehabilitation robot for the human four fingers with the right hand module attached to the system can be seen in
Fig. 16 with its control and power box.

5. Hardware verification

In order to verify the end effector trajectory of the robot hardware, another motion capture setup was prepared by using three
OptiTrack Flex 3 motion capture cameras (Fig. 17). 250 mm calibration wand and calibration square was used to have the motion
capture setup calibrated.
As seen in Fig. 18, an infrared reflector was attached to the tip point of the end effector of the hand rehabilitation robot, and
the robot was placed on the capture volume in such a way that no infrared interference other than the markers would affect the
cameras.
While the hand rehabilitation robot was working on its nominal design speed, trajectory of the IR reflector was captured by
using OptiTrack Motive optical motion capture software. Trajectory data was exported from the software and it was shown as
a scatter plot on model simulation environment (Fig. 19).
Verification results revealed that the real trajectory of the hand rehabilitation robot are matching with the synthesis curve and
operates within the workspace of the grasping motion.

6. Discussions and conclusion

In this study one degrees of freedom rehabilitation system designed for the post stroke patients was partially presented along
with its main Watt II six bar kinematic structure and its design procedure via body guidance and geometrical synthesis methods.
The trajectory data used in kinematic synthesis was acquired by using motion capture system from the index fingertip during the
series of grasping motions of a middle aged healthy subject. Four precision points were used to synthesize the mechanism in
order to follow the natural grasping path. These precision points were selected from the regression curve that was acquired
from the trajectory data. In terms of general structure, overall system was designed as a standalone mobile device that can be
carried easily thanks to its lightweight construction. Using single torque sensor and single actuator with built in sensors, the re-
habilitation system allows the training of four fingers in both hands by using right and left hand attachment modules at a spec-
ified grasping sequence and control scheme. Also as a possibility, two patients can be trained at the same time with their different
hands attached to the system, if their conditions permit to do so.
As mentioned before rehabilitation system was designed from a single index fingertip trajectory of a healthy subject. At this
point it should be noted that, it is not possible for this trajectory to represent natural motions of other remaining fingertips of
the same subject as well as fingertip motions of different subjects with various hand sizes. However, the shape of the natural
path workspace should have nearly the same geometry, scaled down or up. In the light of this, in order to overcome the problem,
hand attachment modules were designed so that they include passive degrees of freedoms to compensate different fingertip mo-
tions. As seen in Fig. 14, these modules have mainly four linear guides that can translate freely. This structure allows both the
adjustment of the attachment points for various hand sizes and also provides the compensation of the fingertip motions to the

Table 4
Construction parameters of the Example 2.

ai bi ci ψi

1 64.9452 mm 42.0595 mm 1062.02 mm 62.8266°

2 81.1701 mm 51.0493 mm 1046.57 mm 63.8676°
3 60.4569 mm 68.6591 mm 1030.9 mm 61.971°
 E. Gezgin et al. / Mechanism and Machine Theory 104 (2016) 177–189 189

end effector trajectory. Moreover, to provide additional adjustment and compensation possibilities for various hand sizes, arm rest
was designed to include two translational degrees of freedom.
In current version of the system, fingers are attached to the modules by using neodymium magnets. These magnets provide
both additional safety in terms of easy detachment and compensation by the help of their passive axial rotations. Using the cur-
rent form of the manipulator, treatment trials are planned to be executed first on the stroke patients with mild spasticity as the
magnet forces will be enough to hold the fingers in position. With respect to the results of the first trials, treatments will be con-
tinued on stroke patients with more serious spasticity. As the clasping force of the fingers is higher for these patients, instead of
using magnetic force closed pairs, finger attachment rings with form closed pairs will be used to attach the fingertips. At this point
it should also be noted that, due to the crank-rocker structure of the designed Watt II six bar linkage, it is not possible for the
mechanism to go beyond the extreme positions of the end effector that were considered with respect to the human hand motion
limits by a factor for safety reasons. As a result during the treatment abnormal motions with respect to the grasping limits are
totally prevented. During the early trials on healthy subjects in controlled experiments to check the comfort issues, due to the
fact that the data used in kinematic synthesis as finger trajectories was acquired by using motion capture systems and by the
help of adjustability gained from the hand attachment modules and arm rest no comfort issues were declared from the subjects
during guided grasping motion even with higher targeted grasping sequences.
Future works of the current study include the controlled trials on the real stroke patients with mild and serious spasticity.
Using the results of the trials and sensory information, different adaptable treatment schemes will be proposed for various con-
ditions. One of the treatment schemes can be given as an example as below,

• After the stroke, patient hands will be trained in the rehabilitation system until the brain plasticity occurs. In this level, grasping
motion will be carried by the robot only.
• After the brain plasticity occurs, the patient will be asked to grasp his/her hand while attached on the rehabilitation system. In
this level the robot will contribute to the motion of grasping.
• At the final level of the treatment, when the patient have full control on grasping motion, he/she will again be asked to grasp
his/her hand while attached on the rehabilitation system. However this time the robot will apply resistance to the motion to
improve the treatment results.

Also the thumb module for the rehabilitation system will be designed as future works.

Acknowledgements

This work resulted during the collaborative research with Daegu Gyeongbuk Institute of Science and Technology (DGIST). This
work is supported by DGIST, and funded by the Ministry of Science, ICT & Future Planning Project Number: 14-BD-0401 of the
Republic of Korea. This work was also partially supported by the Research Fund of the İzmir Katip Celebi University. Project Num-
ber: 2013-2-FMBP-08. We also thank Asst. Prof. Özgün Başer to let us use OptiTrack motion capture system in his laboratory for
the hardware verification step.

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