Summary

The hand is a complex mechanical system, providing the human being with the manipulative capacity required to interact with his physical environment and to carry out activities of daily living (ADL), giving him the autonomy for a full functional life. Different pathologies and injuries can affect the function of the hand, from occupational accidents and pathologies to neurological diseases, generating a decrease in the ability to carry out ADLs to a greater or lesser extent. The WHO establishes that the assessment of dysfunction must be objective and based on the ability to perform ADLs. However, in current clinical practice this dysfunction is evaluated without taking into account objective biomechanical parameters or indicators related to the ability to perform ADLs. Similarly, current rehabilitation is not usually based on the ability to perform ADLs, and in no case the progress is monitored based on improvements in terms of ADL abilities. In recent times, serious Virtual Reality (VR) games have been proposed for rehabilitation. These games allow the patient to be "hooked", in addition to allowing "tele-rehabilitation". These new techniques allow working not only on ranges of movement, but also make it possible to cover recovery in a more holistic way, also working on coordination, proprioception or dexterity. However, the link with the ability to perform ADLs is not clear in this case either. To do this, it would be necessary to see what biomechanical parameters, which quantify the ability to perform AVD, could be incorporated into VR gaming techniques.

The proposed project aims to contribute to the use of biomechanical indicators of functional normality based on the ability to perform ADLs, both to assess the impact of the function and to favour its rehabilitation. The project is based on the experience of the research team in the experimental characterization of the kinematics and muscular activity of the human hand during the performance of ADLs, as well as the use of dimensional reduction techniques that will reduce the number of signals required to be recorded, as well as the number of representative activities to consider. All of this is essential to ensure the feasibility of the clinical application, as it will involve a reduced number of sensors (which will limit the price of the equipment), and a reduced test time. These tests will use function indicators based on the recording of kinematics, muscle activation and grasping forces. It will try to relate all these indicators with the ability to perform ADL. Finally, the use of kinematic indicators in rehabilitation with serious Virtual Reality games will be evaluated. To ensure the clinical usefulness of the project, collaboration with the rehabilitation service of the Provincial Hospital of Castellón, with which researchers have worked previously, as well as with Unión de Mutuas, with whom an collaboration agreement has also been signed, is considered essential.