A Tendon-Driven Wrist Abduction-Adduction Joint Improves Performance of a 5 DoF Upper Limb Exoskeleton -- Implementation and Experimental Evaluation

Wrist function is essential in performing activities of daily living (ADLs). However, there is limited experimental evidence on the functional impact of wrist Abduction-Adduction (Ab-Ad) joint assistance in upper limb exoskeletons (ULEs) for rehabilitation. This study evaluates the effect of implementing an active wrist Ab-Ad joint in a five degree of freedom (DoF) ULE, EXOTIC2 exoskeleton, to support individuals with severe motor impairments. Methods: A compact, lightweight wrist module with tendon-driven abduction and spring-driven adduction was integrated into the EXOTIC exoskeleton. Eight adults with no motor disabilities completed drinking and scratching tasks under randomized wrist-enabled and wrist-locked conditions along with a preliminary feasibility test in one individual with Amyotrophic lateral sclerosis (ALS). Kinematic and task performance metrics including wrist range of motion, task completion time, spillage and leveling metrics were assessed. Results: Implementing the wrist Ab-Ad DoF improved task success metrics. Spill incidence during the drinking task decreased from 56% to 3%, and leveling success for scratching task improved from 28% to 75%. Conclusion: Integrating wrist Ab-Ad assistance improved key functional task outcomes without increasing execution time. Significance: The study provides the experimental evidence that active wrist Ab-Ad control enhances task-level performance in exoskeleton-assisted ADLs.