Project Orekhov Background

Strong Work, Strong Results Project Relevance

Hemiplegic cerebral palsy (CP) is a movement disorder caused by a non-progressive injury to the developing brain [1]. While the brain injury responsible for this disorder is non-progressive, the 1 in 500 children born with hemiplegic CP experience a progressive loss of mobility throughout their lifespan [2]. This loss of mobility is most commonly a function of increased muscle stiffness and associated weakness [3].

Evidence suggests that interventions targeting strength and range of motion delay progressive deficits to mobility typical of the disease [4]. Robotic interventions for rehabilitation of cerebral palsy have focused primarily on addressing gait biomechanics and the energetic cost of walking [5] – [7]. However, hemiplegic CP affects an entire side of the body (e.g. hemisphere), not just the lower limb [8]. While many engineering solutions exist that address upper limb mobility and strength deficits in cerebral palsy, few (if any) have been verified to assist patients with the disease [9].

Project Orekhov aims to assist people with CP, and other types of differently abled people. Team Orekhov will accomplish this task by developing an assistive wearable orthotic that supplements grip strength and augments pre-existing range of motion in the hand. In this context, “range of motion” includes finger extension, finger flexion, ulnar deviation, and “swan neck” deformities of the distal fingers.

Project Archives

Link to project documentation via Mendeley:


[1] N. Wimalasundera and V. L. Stevenson, “Cerebral palsy,” Pract. Neurol., vol. 16, no. 3, pp. 184–194, Jun. 2016.

[2] O. Verschuren, A. R. P. Smorenburg, Y. Luiking, K. Bell, L. Barber, and M. D. Peterson, “Determinants of muscle preservation in individuals with cerebral palsy across the lifespan: a narrative review of the literature.,” J. Cachexia. Sarcopenia Muscle, vol. 9, no. 3, pp. 453–464, 2018.

[3] S. Merete Braendvik and K. Roeleveld, “The role of co-activation in strength and force modulation in the elbow of children with unilateral cerebral palsy.”

[4] D. L. Damiano and S. L. DeJong, “A systematic review of the effectiveness of treadmill training and body weight support in pediatric rehabilitation.,” J. Neurol. Phys. Ther., vol. 33, no. 1, pp. 27–44, Mar. 2009.

[5] Z. F. Lerner, B. C. Conner, and N. M. Remec, “Adaptation of Gait Energetics to Ankle Exoskeleton Assistance Within and Across Visits: A Clinical Case Series,” in 2019 Wearable Robotics Association Conference, WearRAcon 2019, 2019, pp. 46–50.

[6] Z. F. Lerner, T. A. Harvey, and J. L. Lawson, “A Battery-Powered Ankle Exoskeleton Improves Gait Mechanics in a Feasibility Study of Individuals with Cerebral Palsy,” Ann. Biomed. Eng., vol. 47, no. 6, pp. 1345–1356, Jun. 2019.

[7] F. Patané, S. Rossi, F. Del Sette, J. Taborri, and P. Cappa, “WAKE-Up Exoskeleton to Assist Children With Cerebral Palsy: Design and Preliminary Evaluation in Level Walking,” IEEE Trans. Neural Syst. Rehabil. Eng., vol. 25, no. 7, pp. 906–916, 2017.

[8] R. Gupta and R. E. Appleton, “Cerebral palsy: Not always what it seems,” Arch. Dis. Child., 2001.

[9] P. et. al Heo, “Current Hand Exoskeleton Technologies for Rehabilitation and Assistive Engineering,” Int. J. Precis. Eng. Manuf., vol. 13, no. 5, pp. 807–824, 2012.