Wearable assistive article

Abstract

A rehabilitative or mobility-assistive wearable article for assistive, rehabilitative or physiotherapeutic support for affecting the mobility of one or more motive member (or appendage) of a user relative to a supporting body of the user is described. The article may comprise a fitting element for fitting to at least a portion of the motive member and an actuation element that is discrete from and / or is removably attachable to and / or is adjustable relative to the fitting element.

Description

[0001] Wearable Assistive Article

[0002] FIELD OF THE INVENTION

[0003] The present invention relates to the field of assistive, rehabilitative and therapeutic wearable articles and, in particular, to a wearable article, components thereof, and to methods of use thereof.

[0004] BACKGROUND OF THE INVENTION

[0005] The effect of neurological or physical damage resulting from injury, stroke, traumatic brain injury, spinal cord injury as well as conditions such as multiple sclerosis and Parkinson’s disease, include certain effects on motor function, including of the limbs and commonly, in the case of stroke, upper limb motor dysfunction.

[0006] The rehabilitation process for patients with impaired upper limb motor function after a stroke is typically long and not particularly efficacious in many instances.

[0007] Rehabilitative devices, including wearable devices, for use in relation to rehabilitation or physiotherapy of impaired motor function are known, including such devices with actuators to assist or resist certain movements.

[0008] For example, Panagiotis, P. et al (2015) ‘Soft robotic glove for combined assistance and at-home rehabilitation’, Robotics and Autonomous Systems, Vol 73, p135-143 discloses a soft robotic glove designed to augment hand rehabilitation for individuals with functional grasp pathologies.

[0009] A soft robotic glove for assistance and rehabilitation of hand impaired patients is disclosed by H. K. Yap et al (2017) ‘A Fully Fabric-Based Bidirectional Soft Robotic Glove for Assistance and Rehabilitation of Hand Impaired Patients’, IEEE Robotics and Automation Letters, Vol 2, No 3, p1383-1390. The soft robotic glove is designed to assist hand impaired patients in rehabilitation exercises and in performing activities of daily living. Basic ‘control modes’ are proposed by H. K. Yap et al, wherein an actuator(s) is activated constantly during an assisted hand motion.Existing solutions for rehabilitative devices for use in the rehabilitation or physiotherapeutic treatment of impaired motor function in limbs have shortcomings, both in a clinical setting and in terms of remote therapy.

[0010] The present inventors have devised solution to certain shortcomings in the state of the art.

[0011] PROBLEM TO BE SOLVED BY THE INVENTION

[0012] It is an object of the invention to provide a rehabilitative or mobility-assistive wearable article for assistive, rehabilitative or physiotherapeutic support that is suitable for use in the clinical setting and in a remote therapy setting.

[0013] It is a further object of the invention to provide a rehabilitative or mobility-assistive wearable article that has improved user fitting for improved user therapeutic performance.

[0014] SUMMARY OF THE INVENTION

[0015] In accordance with a first aspect of the invention, there is provided a rehabilitative or mobility-assistive wearable article for assistive, rehabilitative or physiotherapeutic support for affecting the mobility of one or more motive member (or appendage) of a user relative to a supporting body of the user, the article comprising a fitting element for fitting to at least a portion of the motive member and an actuation element that is discrete from and / or is removably attachable to and / or is adjustable relative to the fitting element.

[0016] In a second aspect of the invention, there is provided a rehabilitative or mobility-assistive wearable glove for assistive, rehabilitative or physiotherapeutic support for affecting the mobility of one or more digits of a user, wherein the rehabilitative glove comprises an actuation element and a core glove, wherein the core glove comprises a motive portion comprising one or more digit receiving members (e.g. a mitt portion and / or one or more finger portions and / or a thumb portion) for fitting to the digits of a user’s hand, and comprises a metacarpus portion for fitting over or around the metacarpus part of a user’s hand, and wherein the actuation element is discrete from and / or is removably attachable to and / or is adjustable relative to the core glove portion.In a third aspect, there is provided a wearable article for use in rehabilitation of the thumb, the article preferably comprising: one or more wearable elements comprising a wearable thumb portion (or component) and a wearable metacarpus portion for fitting over or around the metacarpus part of a user’s hand; a biasingsplint.

[0017] In a fourth aspect, there is provided a rehabilitative or mobility-assistive wearable glove comprising one or more digit-receiving members having a proximal openingforthe receipt of a digit, wherein the proximal opening is biased to an open position to facilitate donning.

[0018] In a fifth aspect, there is provided a method of fitting and / or donning a rehabilitative or mobility-assistive wearable glove such as that of second or third or fourth aspects above, the method comprising one or a combination of the following steps: providing a core glove having a metacarpus portion and one or more digit-receiving members; providing an actuation element, discrete from and removably attachable to the core glove, the actuation element having one or a plurality of finger actuating members; inserting the user’s fingers into the digitreceiving members of the core glove; attaching a distal end of the finger actuating members to a distal end of the digit receiving members; with the user’s hand in a fist arrangement, extending the finger actuating members over the back of the fist; and attaching the proximal end of the finger actuating members to the metacarpus portion of the core glove.

[0019] In a sixth aspect, there is a provided a method of rehabilitation of or assistance of the mobility of a motive member (or appendage) of a user relative to a supporting body of the user.

[0020] In a seventh aspect, there is provided a wearable element for use as a fitting element of an article of the first aspect or a core glove of the second or third aspects of the invention, the wearable element configured for fitting to at least a portion of a motive member of the user and configured for removable attachment to and / or adjustability with an actuation element.

[0021] In an eighth aspect, there is provided an actuation element for use in a wearable article or glove of the first, second or third aspects described above, the actuation element being configured for removable attachment to and / or adjustment relative to a fitting element or core glove of the wearable article or glove.In a ninth aspect, there is provided a splint for use in a wearable article or glove of the first, second or third aspects described above, the splint being a rigid element and configured for removable and / or adjustable attachment to a fitting element or core glove of the wearable article or glove and / or an actuation element of the wearable article or glove.

[0022] In a tenth aspect, there is provided a glove (or other fitting element) which is formed of a textile having a first longitudinal stretch ratio and a second transverse stretch ratio, wherein the first longitudinal stretch ratio is less than the second transverse stretch ratio.

[0023] In an eleventh aspect of the invention, there is provided a kit for a rehabilitative glove from which to assemble a rehabilitative glove for fitting to any of a number of users having a range of hand sizes, the kit comprising:

[0024] a plurality of core gloves of different sizes ranging from a smallest size to a largest size (preferably all suitable for adults), each core glove comprising a metacarpus portion and a finger motive portion comprising one or more digitreceiving members, the core glove having a distal attachment point at a distal portion of the digit-receiving members and one or a plurality or a continuous longitudinally extending proximal attachment point on the metacarpus portion; and a discrete single-sized finger actuation element having one or more finger actuating members, which one or more finger actuating members are sized to be disposable in relation to the largest size of the plurality of core gloves to overlap the metacarpus portion and the one or more attachment points thereon and to extend to the distal portion of the digit receiving members, wherein the finger actuation element is provided with a distal fixing for attaching to the digital attachment point on any one of the plurality of core gloves and one or a plurality of a continuous longitudinally-extending proximal fixings for adjustably attaching to the one or more proximal attachment points on the metacarpus portion of any one of the core gloves.

[0025] ADVANTAGES OF THE INVENTION

[0026] The wearable article for assistive, rehabilitative or physiotherapeutic support according to embodiments of the present invention enables the use of separate fitting elements or core gloves and actuation elements, which provide ahygiene and cost advantage in a clinical setting; and enables a single size of actuation element to be used in combination with a number of discrete-sized fitting elements (or core gloves) to achieve an accurate fitting for a range of user (hand) sizes; and provides improvements in donning and doffing of the wearable article.

[0027] BRIEF DESCRIPTION OF THE DRAWINGS

[0028] Figures 1A, 1 B, 1C and 1 D shows a rehabilitative glove according to one aspect of the invention as worn by a user and in perspective view on a closed hand (Figure 1 A), a view from the top (i.e. back of the hand) in partially opened configuration (Figure 1B), in a view from the bottom (i.e. front, or palm, of the hand) in a closed configuration, and in a front perspective view in open configuration;

[0029] Figure 2 shows a top perspective view of a core glove of an embodiment of the glove of one aspect of the invention, as worn by a user, in open hand configuration;

[0030] Figure 3 shows a top perspective of a core glove of an embodiment with fitted splint according to one embodiment of one aspect of the invention, as worn by a user, in closed hand configuration;

[0031] Figures 4Ato 4E show a core glove of one embodiment of a rehabilitative glove of one aspect of the invention in bottom view, top front perspective view, a close-up view of the top front perspective view, a back view and a perspective back view form the rear end showing the fingers;

[0032] Figures 5Ato 5D show a splint of one embodiment of a rehabilitative glove of one aspect of the invention in bottom view, a first top perspective view, a second perspective view and an end view;

[0033] Figure 6A shows a perspective view of an actuation element of one embodiment of a rehabilitative glove of one aspect of the invention, with extended air supply tube attached;

[0034] Figure 6B shows a top view of an actuation element of one embodiment of a rehabilitative glove of one aspect of the invention, with coiled air supply tube attached; and

[0035] Figure 7 shows a perspective view of a consol for use with the wearable article of the invention.DETAILED DESCRIPTION OF THE INVENTION

[0036] The invention concerns a rehabilitative or mobility-assistive wearable article for assistive, rehabilitative or physiotherapeutic support for affecting the mobility of one or more motive member (or appendage) of a user relative to a supporting body of the user. The wearable article comprises a fitting element and an actuation element, which actuation element is discrete from and / or may be removably attachable to and / or is adjustable relative to the fitting element.

[0037] The invention also concerns each of a fitting element and an actuation element for use in the wearable article.

[0038] The invention further concerns a method of rehabilitation of or assistance of the mobility of a motive member (or appendage) of a user relative to a supporting body of the user.

[0039] The wearable article is preferably for use in relation to any motive member of a user relative to a supporting body of the user, which motive member moves, or more particularly, articulates, relative to the supporting body. The motive member may optionally be a relatively proximal member relative to a relatively distal supporting body, but, more typically, the motive member is relatively distal to a relatively proximal support body (in other words, the motive member may typically be more peripheral than the support body and articulates or bends relative to the support body). Optionally, the support body may be the shoulder and the motive member is the upper arm, or the support body is the upper arm and the motive member is the forearm, or the support body is the forearm and the motive member is the hand, or the support body is the metacarpus and the motive member comprises the digits or one or more fingers or the thumb. Optionally the supporting body is the proximal phalanx of a finger, or the middle phalanx, and the motive member is middle phalanx and / or the distal phalanx. Optionally, the supporting body is the femur and the motive member is the lower leg, or the supporting body is the lower leg and the motive member is the foot, or the supporting body is the foot and the motive member is one or more toes. The supporting body, as mentioned, may optionally be distal relative to the motive member, in some instances, such as if the supporting body is the forearm and the motive member is the upper arm, but it is preferred that the motive member is more distal than the supporting body. Ineach case, the motive member is separated from the supporting body by a joint that may articulate.

[0040] In a particularly preferred embodiment, the supporting body is the metacarpus portion of the hand and the motive member includes one or more fingers and / orthe thumb.

[0041] In a particularly preferred embodiment, the wearable article is rehabilitative or mobility-assistive wearable glove in which the fitting element is a core glove and the actuation element is discrete from and / or removably attachable to and / or adjustable relative to the core glove. According to this embodiment, the core glove has a motive portion comprising one or more digit-receiving members, such as a mitt portion and / or one or more finger portions (or fingers) and / or a thumb portion (or thumb) for fitting to the digits of a user’s hand, and comprises a metacarpus portion for fitting over or around the metacarpus part of a user’s hand.

[0042] The wearable article is typically for use in assistive, rehabilitative or physiotherapeutic support for affecting the mobility of one or more motive member relative to the supporting body, typically associated with the movement of or muscles associated with the joint between the supporting body and the motive member.

[0043] It is commonplace after injury or stroke for a patient to experience a loss of mobility or a loss of strength relating to a particular movement about a joint. For example, the ability to extend or flex a hinge-type joint (such as an elbow, knee, knuckle and phalanx joints) orto flex, extend abduct or adduct a ball and socket type joint (such as a shoulder) or the thumb, may be impaired.

[0044] The wearable article may be configured to provide assistive support, by which it is meant that the actuation element is configured to provide a force to the motive member against an anchor of or biased relative to the supporting body, to assist the user in achieving the desired movement (e.g. flexion or extension or abduction) and thereby assists the mobility of the motive member. Alternatively, the wearable article may be configured to resist a movement of the motive member of the user, such as an extension or flexion movement by providing a resistive force, opposing the desired movement of the motive member, anchored against or biased relative to the supporting body.Preferably, the fitting element comprises a motive portion for fitting to a motive member and a support portion for fitting to a supporting body. The motive portion and the support portion may take any suitable form, but are preferably configured to be retained on the respective motive member and supporting body and are configured to articulate relative to one another. The articulation of the motive portion and support portion of the fitting element may be achieved by the motive portion and support portion being discrete elements, but it is preferred that they are connected (e.g. by a connecting portion) or form a unitary fitting element. Such a connecting portion is preferably flexible to enable bending of the connecting portion during any extension or flexion movements. In any case, the form of the motive portion and the support portion of the fitting element may include compression sleeves (e.g. elasticated sleeves), clamp elements, or fabric or textile elements with webbing or straps to secure and support them on the motive member and / or supporting body.

[0045] The actuation element may be any suitable actuation element that has at least one actuating member which is configured to extend along at least a portion of a length of a motive member and a portion of a supporting body.

[0046] Preferably, the at least one actuating member further extends from the supporting body to the motive member across or over a joint separating the supporting body and the motive member and which it is intended to influence the articulation of or movement in relation to, more preferably over the outside or top of the joint.

[0047] Preferably, the at least one actuating member further extends from the supporting body to the motive member.

[0048] Preferably, the actuating member is configured to adopt, upon actuation, a first actuated arrangement having an extended or straight profile and / or a second actuated arrangement having a flexed or curved profile. The actuation element may optionally be configured, prior to actuation such that the actuating member has a passive configuration in which it adopts a profile corresponding to a resting or initial relative arrangement of the supporting body and motive member of the user, e.g. a flexed arrangement (or curved profile) and, upon actuation, to adopt an actuated arrangement, e.g. an extended or straight profile, so causing the relative arrangement of the supporting body and motive member of the user to extend. For example, where the supporting body is a femur and the motive body isthe lower leg, the actuation element comprises at least one actuating member that extends along a portion of the femur and a portion of the length of the lower leg, over the knee, and the actuating member adopts a passive flexed configuration being the profile of the user’s knee being bent, upon actuation it moves to adopt an extended or straight configuration, thereby assisting a user in straightening their leg about the knee. Similarly, for example, where the supporting body is a metacarpus of the hand and the motive members are the fingers, the actuation element comprises at least one actuating member that extends along a portion of the metacarpus and a portion of the length of the fingers, over the knuckles (and optionally other joints of the fingers), and the actuating member adopts a passive flexed configuration being the profile of the user’s hand or fist being bent or flexed, upon actuation it moves to adopt an extended or straight configuration, thereby assisting a user in straightening their fingers. In an alternative embodiment, the actuation element may optionally be configured, prior to actuation such that the actuating member has a passive configuration in which it adopts a profile corresponding to a resting or initial relative arrangement of the supporting body and motive member of the user, e.g. an extended arrangement (or straight profile) and, upon actuation, to adopt an actuated arrangement, e.g. a flexed arrangement or curved / bent profile, so causing the relative arrangement of the supporting body and motive member of the user to flex. For example, according to this option, where the supporting body is a femur and the motive body is the lower leg, the actuation element comprises at least one actuating member that extends along a portion of the femur and a portion of the length of the lower leg, over the knee, and the actuating member adopts a passive extended configuration being the profile of the user’s knee being held straight, upon actuation it moves to adopt a flexed or bent configuration, thereby assisting a user in bending their leg about the knee. Similarly, for example, where the supporting body is a metacarpus of the hand and the motive members are the fingers, the actuation element comprises at least one actuating member that extends along a portion of the metacarpus and a portion of the length of the fingers, over the knuckles (and optionally other joints of the fingers), and the actuating member adopts a passive extended configuration being the profile of the user’s hand being straight with the fingers extended, upon actuation it moves to adopt a flexed or bentconfiguration (having a curved profile), thereby assisting a user in flexing their fingers.

[0049] The actuation element may be configured to adopt, upon actuation, a first actuated arrangement having an extended or straight profile, whereupon it may be used to assist a user in extending or straightening the motive member relative to the supporting member (or to resist the user in flexing or bending the motive member relative to the supporting member). Alternatively, the actuation element may be configured to adopt, upon actuation, a second actuated arrangement having an flexed or curved profile, whereupon it may be used to assist a user in flexing or bending the motive member relative to the supporting member (or to resist the user in extending or straightening the motive member relative to the supporting member). Optionally, the wearable article is configured such that the actuation element may be actuated to either adopt a first actuated arrangement or a second actuated arrangement.

[0050] Optionally the wearable article may be configured such that the actuation element may be actuated to adopt a selected configuration between a fully extended and a fully flexed configuration, optionally at discrete pre-determined degrees of flexion or extension or within a continuity or range of flexion or extension between fully extended and fully flexed configurations.

[0051] Optionally, and alternatively or additionally, an actuation element may comprise an abduction or adduction actuation element, which may comprise one or more abduction or adduction actuating member, which is configured for disposal between a motive member having an abduction / adduction motion and a portion of a supporting body, optionally on a plane that is parallel with the plane of abduction / adduction (i.e. an abduction / adduction actuating plane) of the motive member (or the joint about which the motive member abducts / adducts) which is typically orthogonal to its bending / rotating axis.

[0052] In one embodiment, in which the actuation element comprises an abduction actuation element having an abduction actuating member, the abduction actuating member may be configured to adopt, upon actuation, an abducted arrangement in which the abduction actuating member is expanded along its abduction plane. In another embodiment, in which the actuation element comprises an adduction actuation element having an adduction actuating member,the adduction actuating member may be configured to adopt, upon actuation, an adducted arrangement in which the adduction actuating member is contracted along the abduction plane. Optionally, an actuation element may comprise an abduction / adduction actuating member which is capable of providing and abducted and an adducted arrangement, or an actuation comprises an abduction actuating member and an adduction actuating member arranged in parallel, or an actuation element may comprise one of an abduction actuating member or and adduction actuating member, depending upon the type of actuation desired.

[0053] The actuation element may optionally be configured, prior to actuation such that the abduction and / or adduction actuating member has a passive configuration in which it adopts a profile corresponding to a resting or initial relative arrangement of the supporting body and the motive member of the user, e.g. an adducted arrangement (or contracted profile) and, upon actuation, to adopt an abducted arrangement, e.g. an expanded profile, so causing the relative arrangement of the supporting body and motive member of the user to abduct.

[0054] For example, where the supporting body is a torso and the motive body is the upper arm, the abduction / adduction actuation element comprises at least one abduction actuating member that is disposed between a portion of the torso (typically proximal to the shoulder joint) and a portion of the upper arm (typically proximal to the shoulder joint) in an abduction actuating plane, and the abduction actuating member adopts a passive contracted configuration being the profile of the user’s upper arm being adducted about the shoulder, upon actuation it moves to adopt an abducted or expanded configuration, thereby assisting a user in abducting their upper arm through the shoulder. Similarly, for example, where the supporting body is a metacarpus of the hand and the motive member is the thumb, the actuation element comprises at least one abduction actuating memberthat is disposed between a portion of the metacarpus and a portion of the thumb, in an abduction actuating plane, and the abduction actuating member adopts a passive contracted configuration in which the user’s thumb is adducted about the carpometacarpal joint, upon actuation it moves to adopt an abducted or expanded configuration, thereby assisting a user in abducting their thumb through the carpometacarpal joint.In an alternative embodiment, the actuation element may optionally be configured, prior to actuation such that the abduction and / or adduction actuating member has a passive configuration in which it adopts a profile corresponding to a resting or initial relative arrangement of the supporting body and motive member of the user, e.g. an abducted arrangement (or expanded profile) and, upon actuation, to adopt an adducted arrangement, e.g. a contracted profile, so causing the relative arrangement of the supporting body and motive member of the userto adduct.

[0055] For example, where the supporting body is a torso and the motive body is the upper arm, the abduction / adduction actuation element comprises at least one adduction actuating member that is disposed between a portion of the torso (typically proximal to the shoulder joint) and a portion of the upper arm (typically proximal to the shoulder joint) in an abduction actuating plane, and the adduction actuating member adopts a passive expanded configuration being the profile of the user’s upper arm being abducted about the shoulder, upon actuation it moves to adopt an adducted or contracted configuration, thereby assisting a user in adducting their upper arm through the shoulder. Similarly, for example, where the supporting body is a metacarpus of the hand and the motive member is the thumb, the actuation element comprises at least one adduction actuating memberthat is disposed between a portion of the metacarpus and a portion of the thumb, in an abduction actuating plane, and the adduction actuating member adopts a passive contracted configuration in which the user’s thumb is abducted about the carpometacarpal joint, upon actuation it moves to adopt an adducted or contracted configuration, thereby assisting a user in adducting their thumb through the carpometacarpal joint.

[0056] The nature (i.e. flexion or extension or abduction or adduction) and amount of actuation or the actuation element may be controlled by a controller that is connected to the actuation element, optionally through a user interface (that optionally is a remote user interface connected through a wireless connection or is a local user interface).

[0057] The actuation element may be any suitable actuation element. For example, the actuation element may comprise one or a plurality of robotic exoskeleton members as actuating members. Preferably, however, the actuationelement comprises one or a plurality of pneumatic actuators, preferably soft pneumatic actuators.

[0058] Preferably, the actuating member is anchored in relation to both the supporting body and the motive member in order for the actuation of the actuating member to affect the mobility of the motive member relative to the supporting body. More preferably, the actuating member is anchored relative to the motive member at a distal portion of the extent of actuating element that extends along at least a portion of a length of a motive member (in respect of a bending or extending actuator) or may be anchored anywhere along the length of a motive member which is configured for adduction / abduction about a respective joint (in respect of an abducting or adducting actuator).

[0059] Description of actuation elements and actuating members hereinafter is directed primarily to actuating members configured for flexion or extension, unless it is specifically directed to abduction or adduction. Features that are described in relation to actuation element or actuating members may also be considered features of such members specific to abduction or adduction where (or to the extent that) the context allows.

[0060] Preferably, the actuation element is attached to or is removably attachable to the fitting element. More preferably, the actuation element, and more preferably the or each actuating member, is attached to or, more preferably, removably attachable to both a motive portion and a support portion of the fitting element. Preferably, the actuation element or actuating member is attached or removably attachable to the motive portion at a distal portion or distal end of the actuation element or actuating member. Preferably, the actuation element or actuating member is attached or removably attachable to a distal portion of the motive portion of the fitting element. Optionally, the actuation element or actuating member is attached or is removably attachable to the motive portion of the fitting element at multiple points along the length of a motive actuation portion of the actuation element or actuating member, the motive actuation portion of the actuation element or actuating member being that portion arranged to extend along at least a portion of the mobile member of the user. Optionally, the actuation element or actuating member is attached or is removably attachable to the motive portion of the fitting element continuously over a longitudinal extent of the motiveactuation portion of the actuating member, which longitudinal extent is a major part of the length of the motive actuation portion. Optionally, the actuating member is attached or is removably attachable to the motive portion of the fitting element solely at a distal portion, preferably a distal end, of the motive actuation portion of the actuating element.

[0061] In the case of an abduction / adduction actuation member, it may optionally be attached to or removably attachable to the motive portion at any point along the length of the motive portion of the fitting element, e.g. a proximal end or, more preferably, at a distal end or at an intermediate position at a distal portion or distal end of the motive portion. Optionally, the abduction / adduction actuation element or actuating member is attached or is removably attachable to the motive portion of the fitting element continuously an edge or more than one edge of the motive actuation portion of the actuating member.

[0062] Preferably, the actuation element, and more particularly, the or each actuating member is anchored in relation to the supporting body by being attached or removably attachable to a support portion of the fitting element. Preferably a support actuation portion of the actuation element, being that portion of the actuation element, or more particularly the actuating member, that is configured to extend over the supporting body of the user, is attached or removably attachable to the support portion of the fitting element and optionally at one attachment position, at multiple attachment positions or over a continuous extended attachment position.

[0063] Preferably, the actuation element, and more preferably the one or more actuating members, is adjustably attached or adjustable relative to the fitting element, in relation to one or other or both of the support portion of the fitting element and the motive portion of the fitting element.

[0064] By allowing the actuation element to be adjustable relative to the fitting element, an actuation element of a single size may be used for users of slightly different size.

[0065] The actuation element may be attachable to the fitting element directly and / or indirectly. By indirect attachment, it is meant that the actuation element may be directly attached or attachable to a discrete third element, which itself is directly attached or attachable to the fitting element.According to a preferred embodiment (and another aspect), there is provided a splint for use in a wearable article as defined above. The splint is or comprises a substantially rigid element and is configured for use in relation to a supporting body and the actuation element. Preferably, the splint provides an anchoring base, in relation to the supporting body, for the actuation element. The splint is not intended to be used to support a broken bone or to be positioned across a joint. Preferably, it is used in relation to the support portion of the fitting element and in relation to the actuation element. The splint may optionally be integral with (e.g. incorporated within) or attached to the support portion of the fitting element or the actuation element and is preferably removably attachable to the other of the support portion of the fitting element and the actuation element. More preferably, however, it is a discrete rigid element (the aforementioned discrete third element) that is removably attachable to each of the support portion of the fitting element and the actuation element. Preferably, it is removably and adjustably attachable to the fitting element and / or the actuation element.

[0066] The splint may have a generally planar form or may have a shape that conforms generally to the supporting body to which the support portion of the fitting element is to be fitted, or it is otherwise adapted to conform to a body part to which is it so be fitted.

[0067] In the preferred embodiment in which the splint is a discrete third element, separate from, but removably attachable to, the fitting element and the actuation element, the splint is preferably adjustably attachable or positionable relative to the support portion and / or the actuation element, whereby the position of the splint may be adjusted to allow proper fitting of the actuation element relative to the fitting element.

[0068] The splint may be attachable to the body portion of the fitting element and / or the actuation element by any suitable means, but preferably it is attachable by way of a hook and loop fixing arrangement.

[0069] In a generally preferred embodiment of the invention (and as another aspect), the wearable article is rehabilitative or mobility-assistive glove for assistive, rehabilitative or physiotherapeutic support for affecting the mobility of one or moredigits of a user. The wearable glove, according to this general embodiment, comprises an actuation element and, as the fitting element, a core glove.

[0070] The invention will be described hereinafter in relation to this preferred general embodiment in which the wearable article is a wearable glove. Preferred and optional features described hereinafter will be described in terms of how they may be used in relation to the wearable glove, but it should be understood that, where the context allows, such features should be considered as described in relation to any wearable article according to the invention more generally or to any specific wearable article for any supporting body and motive member for which the article provides assistive, rehabilitative or physiotherapeutic support.

[0071] The terms rehabilitative and mobility-assistive and assistive will be used interchangeably hereinafter in relation to the glove of this preferred embodiment.

[0072] The core glove comprises a motive portion which may comprise a thumb motive portion and / or a finger motive portion, preferably both. The motive portion preferably comprises one or more digit-receiving members, which may be a mitt portion and / or one or more finger portions (or fingers) (in the case of a finger motive portion) and / or a thumb portion (in the case of a thumb motive portion) for fittingto the digits of a user’s hand. The core glove further comprises a metacarpus portion for fitting over or around the metacarpus part of a user’s hand, which represents the support portion of the core glove.

[0073] The actuation element is removably attachable to and / or adjustable relative to the core glove portion.

[0074] The actuation element of the rehabilitative glove may comprise one or more actuating members in the form of digit actuating members, which may be configured in relation to one or more digits (e.g. anyone or more of the four fingers and the thumb) of a user. Thus, the actuation element may comprise one or more actuating members configured in relation to the motive portion of the core glove, and more particularly the digit-receiving members, for example in relation to a mitt of the core glove which is configured to fit to multiple (e.g. four) fingers of a user or one or more finger portions of the core glove which are configured to fit to corresponding individual fingers of a user’s hand or a thumb portion of the core glove configured to fit to a thumb of a user’s hand. Preferably the actuation elementcomprises one or more finger actuating members, which are preferably configured or configurable for use in relation to the finger motive portion the core glove.

[0075] Alternatively or additionally, the actuation element comprises a thumb actuating member, which is preferably configured or configurable for use in relation to a thumb motive portion of the core glove.

[0076] Where it is desired that the rehabilitative glove is configured to actuate the fingers and the thumb of a user, an actuation element may comprise one or more finger actuating members and a thumb actuating member.

[0077] Alternatively, two discrete actuation elements may be used together - a finger actuation element having one or more finger actuating members and a thumb actuation element having a thumb actuating member.

[0078] The or each actuation element is preferably removably attachable to the core glove by any suitable means, directly or indirectly, and is preferably adjustable or adjustability attachable. The rehabilitative glove preferably comprises at least two distinct and separable (or separate) elements - the actuation element, which provides the force for the rehabilitative purposes (whether that is an assistive force or a resistive force in relation to a desired movement of the hand, such as flexion or extension, or in the case of a thumb, an abduction or adduction), and the core glove, which is the portion that the user may wear on their hand and which has a mitt or finger / thumb portions for receiving the user’s digits and a metacarpus portion which is configured to extend over at least a portion of the metacarpus of the user’s hand (being the portion between the wrist and the knuckles). In preferred embodiments, the rehabilitative glove further comprises a splint, which may be integral with either the core glove or the actuation element, but is preferably a third discrete element that is removably (and preferably adjustably) attachable to the metacarpus portion of the core glove and preferably also to the actuation element (e.g. a proximal or support actuation portion of the actuation element), especially an actuating member.

[0079] The actuating members of the actuation element are preferably configured, when the actuation element is attached to the core glove (and, e.g. when the rehabilitative glove is beingworn), to extend from a metacarpus portion of the core glove to a motive portion of the core glove.Preferably, the finger actuating members of the actuation element extend from a metacarpus portion of the core glove to a distal portion or end of the finger motive portion of the core glove, thereby extending over the knuckles, when worn and along the digits of the user. The finger actuating members of the actuation element may preferably be secured to the core glove at at least two locations - a first, proximal, location on the metacarpus portion of the core glove and a second, distal, location on the finger motive portion of the core glove, preferably a distal portion or distal end of the finger motive portion (e.g. at the fingertips). The attachment of the finger actuating members to one or other or both of these two locations may be adjustable in position (preferably in a proximal to distal direction). Optionally, there may be a retention means intermediate between the proximal and distal locations, which may form secure attachments (releasable attachments) or merely guides.

[0080] Preferably, a thumb actuating member of the actuation element may be disposed between a metacarpus portion of the core glove to any position along the length of the thumb portion, but preferably at an intermediate or medial position or a distal position.

[0081] By having discrete and separable core glove and actuation elements of the rehabilitative glove in a clinical setting, the actuation element may be re-used for multiple patients (since it does not touch or is worn by a patient), while the core glove may be re-used and kept by a single patient (or disposed of after each use). This reduces the cost associated with a clinic-based treatment or therapy session.

[0082] Furthermore, by the discrete and separable core glove and actuation element of the rehabilitative glove being adjustable relative to one another, a secure fit to the user’s hand can be achieved, with a minimal number or range of sizes of actuation element. The core glove can be provided in a pre-determined range of sizes for the user and when worn by a user can typically be adjusted to fit byway of fitting straps. A characteristic of actuators acting on a hand between a flexed and an extended configuration is that the actuation element, which typically comprises elongate actuating members (as finger actuating members) configured to extend from the back of the hand (the back of the metacarpus) and along the backs of the fingers to the fingertips must move between a curved profile, when the fingers of the user are flexed, and a straight profile, when the fingers of the user are extended - thelength of the actuation element that may be required in the flexed configuration may be slightly greater than in the extended configuration, which can lead to some looseness of fitting. If the fit of the actuation element and actuating members to the user’s hand (and to the core glove) is too loose, this can lead to a less than optimal performance and can reduce the performance of the rehabilitative glove, especially at the fully flexed and fully extended ends of their range. It is advantageous, therefore, to ensure as close a fit as possible of the actuation element and the actuating members to the user’s hand. By providing a core glove for the user to wear on their hand and an actuation element that is removably adjustable or adjustable relative to the core glove, a secure fit can be achieved. For example, as mentioned above, where the finger actuating members are attached (permanently or removably attached) at a distal portion thereof to the motive portion of the core glove (e.g. to a distal end or distal portion of the finger portions of the core glove), the user wearing the core glove may flex their hand and then, with at least some tension in the actuation element and actuating members, guide the proximal end of the actuation element over the back of the user’s digits and fist to secure to a corresponding fixing point on (or relating to) the metacarpus portion of the core glove, while still under tension. In this way, the actuation element and actuating members can have a perfect or near perfect fit to the user’s hand. By having a range (and preferably a continuous range) of positions on the back of the metacarpus portion of the core glove in relation to which the actuation element and actuating members can be attached, a single size of actuation element can be adapted to provide a secure fit to a range of user hand sizes. Thus, only a small number of discrete sizes of actuation element need be provided - e.g. a child size and an adult size (ora small adult size and a large adult size) - from which, for any particular patient, the closest size may be selected and then when fitting to the user, the adjustable attachment of the actuation element to the metacarpus portion of the glove may ensure a secure fit. It should be noted that, in principle, the adjustability in fit of the actuation element and actuating members to the user’s hand may be achieved by first securing the proximal portion of the actuating elements in relation to the metacarpus portion of the core glove and then, ideally with the hand in a flexed configuration, the distal portion(s) of the actuating members can be attachedto one of a range (preferably a continuous range) of positions on the or each finger portion of the core glove, again under slight tension, to ensure a good fit.

[0083] In a preferred embodiment, the rehabilitative glove comprises a core glove, a splint removably (and preferably adjustably) attachable to a support portion of the core glove and an actuation element removably (and optionally adjustably) attachable, at a proximal portion thereof, to the splint and at a distal portion thereof, to a motive portion of the core glove.

[0084] Preferably, the glove can be reconfigured to fit a range of hand sizes by adjusting the position of attachment of the splint on the metacarpus portion of the core glove and / or by adjusting the position of attachment of the actuation element to the splint.

[0085] In a preferred embodiment of the preferred general embodiment of the invention (and in a further aspect of the invention) there is a core glove configured for fitting to at least a portion of the digits of the userand configured for removable attachment to and / or adjustability with an actuation element. As discussed above, the core glove preferably has a motive portion for fitting to the digits of the user and a support portion, which may be described as a metacarpus portion, for fitting to or around the metacarpus part of a user’s hand (i.e. between the wrist and the knuckles).

[0086] The motive portion of the core glove and the metacarpus portion of the core glove may be connected to one another, or may be discrete elements together making up the core glove. Preferably the motive portion and the metacarpus portion are connected to one another. Optionally, and preferably, the motive portion and the metacarpus portion are permanently connected or integral with one another, making the core glove a unitary article, or alternatively, the motive portion and metacarpus portion may be removably connected to one another via one or more connectors, e.g. with snap fixtures, hook and loop connectors, or a zip.

[0087] The motive portion is configured to fit to one or more of the digits of the user. It may comprise a finger motive portion, which may have one or more digitreceiving members in the form of a mitt to fit up to four fingers of the user in a single digital recess and / or one or a plurality of finger portions for receiving a user’s individual fingers and, in any case, preferably the motive portion comprises a thumb portion for receiving a user’s thumb.Where the motive portion comprises a mitt, it is preferred that it extends the full length of the backs of the fingers from its distal extremity (e.g. at the fingertips) to the knuckles, where it is preferably connected to the metacarpus portion, but more preferably does not extend the full length of the front of the fingers, instead extending from the distal extremity thereof (e.g. the fingertips) to a mitt hem defining the mitt opening which may be a curved hem which defines an opening to the mitt and a mitt pocket being the mitt defined by the front portion thereof, which mitt is unconnected at the front thereof to the metacarpus portion. The mitt pocket may extend from the finger tips to about one-third to three-quarters of the length of the fingers, preferably from about one-half to three quarters of the length of the fingers, e.g. extends to between the distal interphalangeal joint (DIP joint) and the metacarpophalangeal joint (MCP joint, or knuckle). Preferably, the hem of the mitt pocket, in an adult-sized core glove, is configured to be from 0.5 to 2 cm from the palmar digital crease of the user’s hand, preferably from 1 to 1.5 cm therefrom.

[0088] Where the motive portion comprises one or a plurality of finger portions for receiving individual user’s fingers, it is preferred that each finger portion has a finger back that extends the full-length of the backs of the fingers from their tips (e.g. at the fingertips of the user) to the knuckles, where they are preferably connected to the metacarpus portion (at a metacarpus backhand, being the material of the core glove configured for disposal on the back of the user’s hand), but more preferably do not extend the full length of the front of the fingers. Instead, at the front of core glove, each finger portion preferably extends from the fingertip to a finger opening (defined by a hem or opening rim of the finger portion), which finger openings are preferably between the DIP joint and the palmar digital crease and preferably may be between the MCP joint and the palmar digital crease, preferably from 0.5 to 1.5 cm from the palmar digital crease. The finger portions are preferably not connected, at the front thereof (e.g. from the hems of the finger portions) to the metacarpus portion of the core glove.

[0089] From one to four finger portions may be included in the core glove, but preferably four finger portions are provided.The finger portions and thumb portions distal from the proximal openings thereof, preferably are closed tubes, closed at the finger tips and configured to fully enclose the distal end of the digits.

[0090] In each case, whether the motive portion comprises a mitt or one or more individual finger portions, it is preferred that the motive portion further comprises a thumb portion for receiving a thumb. Again, it is preferred that the back of the thumb portion extends to the proximal end thereof to the metacarpophalangeal joint (MMC joint) of the thumb at which point it is preferably connected to the metacarpus backhand (the back portion of the support portion of the core glove), while, preferably, the front of the thumb portion extends at least to the interphalangeal joint of the thumb.

[0091] The provision of finger openings and a mitt opening facilitates donning of the core glove, for users with motor dysfunction, thereby improving the effectiveness of the rehabilitative glove and increasing the likelihood of compliance.

[0092] In a preferred embodiment (and another aspect) of the invention, there is a glove comprising one or more digit-receiving members having a proximal opening for the receipt of a digit, wherein the proximal opening is biased to an open position to facilitate donning. The digit-receiving members may, for example, be a mitt or may be finger portions or a thumb portion, each having respectively a mitt opening, finger openings and a thumb opening being the proximal opening(s) of this embodiment, preferably defined by a hem (or opening rim) at the front side of the mitt and finger portions and thumb portion respectively (and as described above).

[0093] Accordingto this embodiment, the proximal opening may be biased to an open position by any suitable biasing means. By biasingto an open position, it is meant that the proximal openings to the digit receiving members remain open even when externally unsupported and in the absence of a received finger, despite the material of a glove portion typically being flexible and inclined to collapse in the absence of a received finger. An open position is considered to be when the front edge of the opening or hem is separated from the inner surface of the finger back to an extent that a user can insert at least a fingertip. Preferably, the proximal openings are biased to an open position that is at least 50% of its fully open position, the fully open position being the configuration when digits are fully received in the digit receiving members, more preferably to at least 75% of its fullyopen position and most preferably at least 85%. The biasing means may be, for example, a stiffened hem that extends about the opening rim (e.g. at least 70% around, preferably at least 90% around), which may be formed of a double rolled hem or a rolled hem with a stiffened textile insert. Alternatively, the biasing means may comprise, for example, a resilient tab of, for example, a plastic material mounted on the internal surface of the edge the proximal openings (e.g. on the internal surface of the hems), or on the opposing internal surface of the finger back at the proximal openings, and configured to extend into the digit receiving members but biased to abut the opposing inner surface of the digit receiving members. For example, the resilient tab may be formed of a resilient strip of material folded in two, with one portion being affixed to the internal surface of the digit receiving member and the other portion tending to project away, thereby biasing the digit receiving members open. Alternative, the biasing means may be a curved member that extends about at least a portion of the front of the proximal opening (e.g. about the hem) and preferably about the entirety of the front of the opening. The curved member may be curved rod or ring that is rigid or resiliently flexible and may be formed of metal or plastic or natural or synthetic rubber. A curved rod may extend about the opening or front portion of the opening (e.g. the hem of the opening). A ring may extend around the front of the opening (e.g. through the hem of the opening) and then extend either internal or external across the back (e.g. fingerback) of the opening. If external, the ring may be attached to the back or outer surface of the digital receiving portion proximal to the proximal opening (e.g. at the fingerback on back or outer surface thereof) or may be unattached to the fingerback. In either case, the ring or curved member, which should have a radius similar (e.g. within 10-20%) of the radius of the proximal opening, serves to bias the proximal opening to an open configuration. Preferably, the biasing means is an O-ring (e.g. of rubber or silicone). A similar biasing means may be provided for the proximal opening in the thumb receiving member (e.g. thumb portion of the core glove).

[0094] Optionally, the core glove may further comprise pull tabs provided on the motive portion, e.g. on the digit receiving members, especially where finger and thumb portions, with proximal openings on the front thereof, are provided, as described above. The pull tabs may be located on the front of the finger or thumb portion proximal to the proximal opening, e.g. on a hem or edge defining theproximal opening. With this arrangement, a user may use the pull tabs to open the proximal openings (e.g. when they are not biased open) and / or, during donning of the core glove, use the tabs to pull the finger portions and thumb portion onto the fingers and thumb to the full extent. Alternatively or additionally, and in any case preferably, the pull tabs may be located at the fingerback. They may extend from the finger backs, proximal to the proximal openings of the finger or thumb portions. Optionally, they are fixed to the fingerbacks of the finger or thumb portions.

[0095] Alternatively, in an embodiment described above in which a ring (e.g. an O-ring) is used to bias open the proximal openings of the finger or thumb portions, and which ring extends around the outside (the back) of the finger portion, the pull tab may be affixed to the portion of the ring that extends around the outside. This enables a user to pull the front of the finger or thumb portions (e.g. at the proximal openings or hems) onto the fingers or thumb using a pull tab presented at the back of the finger or thumb portions. This is particularly beneficial for users donning the core glove when they have spasticity in their fingers that cause clenching, since it is difficult to access the front of the fingers during donning. A further benefit of the pull tabs provided on opening-biasing rings extending around the back of the finger portions, according to one embodiment, is that, where the rings are resiliently stretchable rings (e.g. rubber O-rings) and the proximal opening is proximal to the PIP joint of the fingers, during donning of the finger portions onto a clenched fist, the pull tab may be used, once the finger portion is fully on the finger, to stretch the resiliently stretchable ring over the PIP joint, which will serve to hold the finger portions in position on the fingers while the remainder of the glove is being fitted.

[0096] Thus, in a further aspect of the invention, there is provided a glove comprising one or more digit-receiving members having a proximal opening for the receipt of a digit, which is provided with one or more pull tabs to facilitate the donning of the glove, the pull tabs being provided to the front of the digit receiving members proximal to the proximal opening or to the back of the digit receiving members proximal to the proximal opening, in order to facilitate donning.

[0097] The core glove according to this general embodiment, as discussed above, comprises a metacarpus portion for fitting over or around the metacarpus part of a user’s hand, which represents the support portion of the core glove.Preferably the metacarpus portion comprises a metacarpus backhand, which extends to cover at least a portion of the back of the hand of the user. Preferably, the metacarpus backhand extends the width of the back of the hand and extends from the wrist to the knuckles. The metacarpus backhand may be formed of an array of connected bands extending longitudinally and laterally, but is preferably a continuous element. The metacarpus backhand is preferably joined to the motive portion (e.g. the finger portions and the thumb portion) at the metacarpophalangeal joints (MCP joints), whereby in a preferred embodiment, the fingerbacks extend from the metacarpal backhand at the MCP joints.

[0098] The metacarpus portion may optionally have a palm element, which may optionally, when worn by a user, extend across the palm from a lateral ulnar edge of the metacarpal backhand to a radial lateral edge of the metacarpal backhand and optionally longitudinally to the wrist and optionally to the MCP crease. In preferred embodiments of the invention, where the finger and thumb portions are provided with proximal openings that are open at the front of the glove, a palm element is not joined with the finger portions and preferably is not joined with the metacarpus backhand between the fingers.

[0099] Preferably the metacarpus portion does not have a palm element, other than as provided by a metacarpus strap which may be attachable to each of, or permanently connected to one or both of, the lateral ulnar edge and the radial lateral edge of the metacarpus backhand. Preferably, the metacarpus strap extends from and is permanently connected to the lateral ulnar edge proximal to the MCP crease and is removably attachable to a fixing means provided on the metacarpus backhand proximal to the radial lateral edge and the MCP joints or to a fixing tab extending from the metacarpus backhand at that position or to a fixing means provided on the outer surface of a proximal end of the metacarpus strap (the strap being of a length to extend across the palm and then back over the metacarpus backhand such that the distal end of the strap may contact the proximal end of the strap). The fixing means and fixing tab are preferably provided with a hook and loop fixing pad to cooperate with a corresponding hook and loop fixing pad provided on the terminal end of the metacarpal strap and, preferably, extending along a length of the metacarpal strap to enable adjustability of fitting. The metacarpal strap may be made of a non-stretch material, but preferably comprises at least a portion of aresiliently stretchable material (e.g. elastic). Consequently, the metacarpal strap may extend over the support actuation portions of finger actuating members that are disposed on (and attached to) the metacarpal backhand, which may serve to hold the finger actuation members in place while the stretchable portion accommodates inflation of the actuating members.

[0100] Preferably, the core glove comprises a wrist strap for securing the glove to a wrist. Preferably, the wrist strap may be made of a non-stretch material and serves to lock the glove in place on the hand. The wrist strap preferably comprises a backhand wrist portion that extends from the metacarpal backhand and is permanently attached thereto and extending laterally from the backhand wrist portion a strap element configured to be secured around the wrist and attached to the backhand wrist portion, where a suitable fixing means (e.g. a hook and loop connection pad) is provided to cooperate with a fixing means on the distal end of the laterally extending strap element. Also provided at the wrist of the glove, there is preferably provided a system strap which may also extend around the wrist and be configured to attach to the back surface of itself using hook and loop or other fixings. The system strap is preferably configured to extend over the actuation element or elements that are disposed on and are attached to the metacarpus backhand, in order to hold the actuation elements in place. The system strap is preferably an elastic strap in order to accommodate inflation of the actuating members of the actuation element.

[0101] The core glove, as is discussed above, is provided with fixings or fixing points for use in the securing the actuation element thereto, either directly or indirectly, and preferably at at least a first proximal location (a proximal fixing) on the metacarpus portion of the core glove and at a second distal location (a distal fixing) on the motive portion of the core glove preferably a distal portion or distal end of the motive portion, which is preferably in the form of digit-receiving members, more preferably being finger portions and a thumb portion (e.g. at the tips thereof).

[0102] In a preferred embodiment of the invention comprising a plurality of finger portions and a thumb portion, the distal fixings may be provided by any suitable fixing means, such as press studs, snap fastenings, or hook and loop fixings. Optionally, the distal fixings are provided by hook and loop fixings with a hook and loop fixing pad being provided on front and / or back and / or tip of the fingerportions and thumb portion for cooperative fastening to a corresponding hook and loop fixing pad on a distal end of the actuation element. In this manner, the position of attachment of the actuation element to the finger portions and thumb portion may be adjusted. Optionally, the distal fixings are provided by press studs, and, in particular, either sockets or studs, which are preferably provided on securing tabs extending from the tips of the finger portions and thumb portion, for cooperating with corresponding sockets or studs provided on distal portions of the actuation element.

[0103] The proximal fixings according to a preferred embodiment of this general embodiment are provided on the metacarpal backhand. For example a fixing arrangement, preferably a hook and loop fixing pad, may be provided that extends over a portion, preferably at least 30% of the area of the metacarpus backhand and more preferably a major portion, the fixing pad preferably extending the majority of the longitudinal distance from wrist to MCP joint on the metacarpus backhand and preferably also the majority of the lateral distance across the metacarpal backhand.

[0104] This enables, according to one embodiment, one or more actuating members to be secured at a range of possible positions on the metacarpal backhand using a corresponding fixing arrangement, preferably one or more metacarpal hook and loop fixing pads, thereby enabling adjustable fitting of the actuation element to the core glove.

[0105] According to another embodiment, this enables a splint to be mounted on the metacarpus backhand at a range of possible positions on the metacarpal backhand using a corresponding fixing arrangement, preferably one or more metacarpal hook and loop fixing pads on a metacarpal mounting surface of the splint, thereby enabling adjustment of the positioning of the splint on the metacarpus backhand. Further accordingto this embodiment, one or more actuating members may be attached to an opposing surface of the splint which opposing surface of the splint and the actuating members are provided with a cooperating splint fixing arrangement, which may optionally be an actuation hook and loop fixing pad formed on the opposing surface of the splint and one or more splint hook and loop fixing pads provided on the actuating members. Preferably, the relative size of the cooperating hook and loop fixing pads on the splint and on theactuating members is such as to enable adjustable attachment of the actuating members to the splint (and thus adjustment of the actuating members relative to the core glove). The hook and loop fixing pads described herein may optionally be formed of Velcro™.

[0106] In a preferred embodiment of this general embodiment, there is a splint attached or for attachment to the core glove and the actuation element, the splint preferably being a discrete element that is removably and adjustably attachable to both the core glove (the metacarpal portion thereof) and the actuation element (the actuating members thereof).

[0107] Preferably, the splint has a generally rigid base that may be planar or may be shaped or curved to conform with the curve of the back of a user’s hand. The rigid base may be any suitable shape. Preferably, the base has an elongate shape for use in mounting in a longitudinal configuration onto the metacarpal backhand, with a curve being defined in a transverse direction. The length of the base is preferably at least 30% of the length of the back of the hand of the user (e.g. from wrist to MCP joint) and of the length of the metacarpal backhand of the core glove (from proximal edge to backhand distal edge) and more preferably at least 50% (e.g. preferably from 5 to 10 cm, more preferably 6 to 8 cm). Preferably, the base has a base radial lateral edge, which is generally straight and runs substantially the length of the base (and is therefore preferably the length of the base as set out above), which base radial lateral edge is for general alignment with the radial lateral portion or side of the hand.

[0108] The width of the base may change along its length in a preferred embodiment, whereby the base is preferably wider toward its distal end and narrower towards its proximal end. Preferably, the width of the base at the distal edge is at least 50% of the width of the back of the hand of the user and of the metacarpal backhand of the core glove, more preferably at least 70% and preferably up to about 90% of the width thereof. Preferably, the width of the base at its distal edge (the base distal edge) is from 5 to 7 cm. The width of the base at the proximal end may be any suitable width that fits according to the length of the base.

[0109] Preferably, the base proximal edge is a little less than the width of the user’s wrist and is preferably at least 30% of the width of the user’s wrist and the width of the proximal edge of the metacarpal backhand, more preferably at least 50%.Optionally, the proximal edge of the base has a length of from 1 to 6 cm, preferably about 2 to 4 cm.

[0110] A base ulnar lateral edge extends from the base distal edge to the base proximal edge, opposite to the base radial lateral edge and may define any suitable shape but generally tapers from distal to proximal.

[0111] In use, the base of the splint is preferably orientated on the metacarpal backhand of the core glove such that a lower concave surface contacts the metacarpus backhand with the base distal edge in general alignment with the backhand distal edge (i.e. where the fingerbacks extend from the metacarpus backhand) and the base radial lateral edge is generally aligned with the radial lateral edge of the user’s hand and the metacarpal backhand, e.g. aligned with the second or index metacarpal

[0112] The base of the splint may be secured to the metacarpal backhand by fixings, preferably hook and loop fixings on a first (lower or inner) surface of the base (which is preferably the concave surface) and cooperating hook and loop fixings on the outer surface of the metacarpal backhand. The hook and loop fixings on the metacarpal backhand may extend over at least 30% of the area of the metacarpus backhand, more preferably at least 50% and optionally at least 70% to allow for adjustable fitting of the splint. The hook and loop fixings on the lower surface of the base may comprise multiple hook and loop fixings or an extended splint hook and loop fixing pad. In any case, it is preferred that the hook and loop fixings are disposed about and preferably extends to a majority of the area of the lower surface of the rigid base, preferably at least 70% and more preferably at least 90%. Preferably a single splint hook and loop fastening pad is disposed about the majority of the area of the base of the splint in order to provide a robust fixing to the core glove.

[0113] A second (upper or outer) surface of the base (which is typically convex) is preferably provided with fixings (actuator fixings) for attachment of an actuation element and, more preferably, actuating member with corresponding fixings provided on the actuation element. Again, it is preferred that multiple or extended fixings are provided on the upper surface of the base in order for the leverage the actuating elements need to impart its force to the user’s fingers can be supported. Preferably, the actuator fixings on the second surface of the baseextend at least 50% and more preferably at least 75% of the length of the base and preferably at least 90%. In one embodiment, the actuator fixings are an actuator hook and loop pad. Preferably, the actuator fixings are disposed at least 50% and more preferably at least 75% of the width of the base and preferably at least 90%. Thus, the attachment of the actuator can be adjusted to fit the user.

[0114] In a preferred embodiment, the splint is provided with at least one upright rigid projection, projecting from the first (upper or outer, i.e. dorsal) surface of the base of the splint to serve as a support for a thumb actuation member. Any suitable shape of upright rigid projection may suffice, provided that corresponding means of engaging with that projection is provided on the thumb actuation member. Preferably the upright rigid projection is an elongate member disposed longitudinally on the base, preferably in the form of a fin (a dorsal fin) that preferably has a generally constant extent of projection along its length and generally upright proximal and distal edges (e.g. orthogonal to an upper edge of the fin).

[0115] The upright projection is preferably disposed proximal to the radial lateral edge of the base and, when in the form of an elongate projection or fin, orientated to be generally parallel therewith).

[0116] The upright projection preferably provides an abutting surface (or reaction face) for a thumb actuating member whereby, upon actuation, the abutting surface provides a reaction face against which the actuated thumb actuating member may be supported when it expands along its abduction plane and thereby can apply an abduction force to the thumb, in order to affect the mobility of the thumb e.g. to effect a palmar abduction motion of the thumb of the user. Such a motion may have a rehabilitative or physiotherapeutic purpose or may be useful for simply moving the thumb out of the way for the purpose of treating the fingers.

[0117] One or more side faces of the upright projection may be provided with fixing means (e.g. hook and loop fasteners) for securing the thumb actuator thereto (via corresponding fixing means on the thumb actuator). Where the upright projection is an elongate member or fin, the side faces thereof are preferably provided with hook and loop fastening pads.

[0118] In a preferred embodiment, in which the upright projection is a dorsal fin, it preferably extends longitudinally in a generally distal to proximal direction, that is a general direction from base proximal edge toward base distaledge and preferably in an orientation generally normal to the base distal edge (e.g.

[0119] 15 degrees either side of normal or more preferably at right angles thereto). The extent of projection is any suitable amount necessary to have wrapped therearound or to retain an element of a thumb actuation member for the purpose of a biasing or leveraging support in affecting the mobility of a user’s thumb, but for example, may be from 0.5 cm to 3 cm and preferably 1 to 2 cm. The dorsal fin may be located toward the base distal edge of the rigid base. The dorsal fin may be about 2.5 to 5 cm in length. Preferably a strap-receiving slot is provided at a lower edge of the dorsal fin where it projects from the base as a distal portion thereof, for receiving a securing strap, such as the metacarpus strap of the core glove described in certain embodiments above.

[0120] The splint may be formed of any suitable material but is preferably of a plastic material which is substantially rigid. Optionally, the plastic material is reinforced with fillers or fibres.

[0121] The core glove, according to this preferred general embodiment (in which the wearable article is a rehabilitative glove) may be formed of any suitable material, but is required to be sufficiently flexible to allow it to be worn as a glove, to conform to a user’s hand and for the motive portions to be flexed and extended. The material of the finger and thumb portions (the finger portion material) may optionally be the same or different to the material of the metacarpal portion (the metacarpal material). Optionally, the metacarpal material may be selected to be stiffer than the finger portion material. Optionally, the metacarpal material is thicker or has more layers than the finger portion material.

[0122] The core glove material may be any suitable material, for example it may be a woven or non-woven fabric or textile, preferably a woven fabric.

[0123] Preferably the material of the core glove is non-stretchable or, more preferably, is stretchable to a low degree. By being stretchable to a low degree, the core glove may be worn by users of slightly different hand size, and the glove will conform to the user’s hand. The impact of any low degree of stretchability on performance can be managed by the use of securing straps such as the metacarpal and wrist straps of a preferred embodiment of the core glove, which can serve to stretch the metacarpal backhand when the straps are secured, thus rendering a well-fitted core glove. Preferably the stretch ratio of the metacarpal material (e.g.the material of the metacarpal backhand) is no more than 1.2, more preferably no more than 1.1 and still more preferably no more than 1.05, with the proviso that the degree of stretch achieved by stretching the metacarpal backhand will be moderated by the fact that a proportion of the metacarpal backhand on which there is disposed a hook and loop fastening pad, which preferably is formed on nonstretch material. The stretch ratio of the finger portion material is preferably no more than 1.2, more preferably no more than 1.1 and still more preferably no more than 1.05, the finger portion material optionally being more stretchable than the metacarpal material.

[0124] Optionally, in order to enable a good fit across the population range with a minimal number of glove sizes, whilst minimising longitudinal stretch that might otherwise affect the performance of the actuating members, the core glove may be formed of materials that have dimensionally variable stretch ratios - for example, it is preferred that the transverse stretch ratio of the metacarpal backhand is greater than the longitudinal stretch ratio of the metacarpal backhand. This may be achieved by textile material having a crossgrain stretch ratio that is greater than a straight grain stretch ratio and orientating the textile fabric accordingly.

[0125] In one embodiment, the transverse stretch ratio of the metacarpal backhand may be 1.25 to 2, preferably 1.4 to 1.6 while the longitudinal stretch ratio of the metacarpal backhand may be 1 to 1.4, preferably 1.05 to 1.2. Preferably, the transverse stretch ratio may be at least 1.05, preferably at least 1.2 and optionally at least 1.5 or 2 times the longitudinal stretch ratio, preferably no more than 5 times the longitudinal stretch ratio, still more preferably no more than 2.5 times the stretch ratio.

[0126] Optionally, the transverse stretch ratio of the metacarpal backhand may be from 1.05 to 2 times greater than the longitudinal stretch ratio, more preferably 1.2 to 1.5 times greater than the longitudinal stretch ratio.

[0127] In a particularly preferred embodiment, the core glove material is formed of a multi-layer composite textile fabric having two woven fabric sandwiching a non-woven fabric and having a transverse stretch ratio that is greater than the longitudinal stretch ratio.

[0128] As discussed above, the actuation element may be any suitable actuation element. Optionally, the actuation element may comprise any one or anycombination of two or more (where the context allows) of pneumatic, hydraulic, electric, magnetic, thermal, and mechanical actuating members, but preferably comprises one or a plurality of pneumatic actuators, preferably soft pneumatic actuators.

[0129] Preferably, the actuating members are configured to actuate, assist and / or resist the movement of the motive member of the user, when securely mounted onto the core glove. Preferably, the actuation element comprises a bending actuator (e.g. the actuating members are configured to move in a bending trajectory) or is a straightening actuator.

[0130] Preferably, a soft pneumatic actuator comprises an internal chamber or chambers and an actuator wall that encloses the internal chamber or chambers.

[0131] Preferably, the soft pneumatic actuator is an inextensible and / or inelastic soft pneumatic actuator. An inextensible and / or inelastic soft pneumatic actuator generally does not stretch as it (e.g. as its internal chamber) is pressurised with a gas. As an inextensible and / or inelastic soft pneumatic actuator is inflated / pressurized, it may move or displace due to the geometry of the actuator.

[0132] An inextensible and / or inelastic soft pneumatic actuator preferably has an actuator body that comprises an inextensible material, such as an inextensible sheet material. Examples of inextensible materials include plastic fabrics, e.g. nylon-based or polyester-based fabrics, such as knitted fabrics.

[0133] Inextensible materials may optionally be coated with thermoplastic, such that the material is generally gas impermeable.

[0134] Preferably, an inextensible and / or inelastic soft pneumatic actuator comprises two strips or sheets of inextensible sheet material attached to each other and forming a cavity therebetween. In one option, an airtight bladder may be inserted into the cavity. In a second option, the inextensible sheet material is inherently airtight and the cavity itself acts as an airtight bladder (or inner chamber).

[0135] Example inextensible soft pneumatic actuators, comprising flexible thermoplastic polyurethane-coated fabrics, are disclosed by H. K. Yap et al (2017) ‘A Fully Fabric-Based Bidirectional Soft Robotic Glove for Assistance and Rehabilitation of Hand Impaired Patients’, IEEE Robotics and Automation Letters, Vol 2, No 3, p1383-1390.Optionally, and less preferred than the soft pneumatic actuator being formed of an inextensible material, the soft pneumatic actuator is an extensible and / or elastic soft pneumatic actuator. In this option, the soft pneumatic actuator (or the actuator body, or an actuator wall of the actuator body) comprises a resilient (e.g. elastic) and / or ‘soft’ material. Preferably, at least a portion or portions of the actuator body is / are configured to expand and / or contract when an inner chamber(s) of the soft pneumatic actuator is pressurised / depressurised. Expansion and / or contraction of the actuator body causes the soft pneumatic actuator to move, preferably in a predefined trajectory.

[0136] Preferably, a soft pneumatic actuator may move by lengthening, shortening, straightening, bending, twisting, widening or expanding, narrowing or contracting or any combination of two or more thereof. For example, a soft pneumatic actuator may move in a predefined bending, twisting, extending, shortening, extend-twisting or bend-twisting trajectory. Herein, reference to a pneumatic actuator being in fluid communication with a gas pump preferably means an internal chamber of the pneumatic actuator is in fluid communication with the gas pump.

[0137] Preferably, a soft pneumatic bending actuator bends when it is pressurised and straightens (and optionally bends in an opposite direction) when it is depressurised, or vice versa. Preferably, a soft pneumatic actuator is configured to bend to correspond to flexion movement of an articulating body part, such as of a digit or digits of a hand.

[0138] Preferably, a soft pneumatic straightening actuator straightens when it is pressurised and becomes flexible (or non-rigid) when it is depressurised.

[0139] Preferably, the soft pneumatic actuator is configured to straighten to correspond to extension movement of an articulating body part, such as a digit or digits of a hand.

[0140] In a preferred embodiment of the present invention, the rehabilitative glove comprises, as the one or more finger actuating members, one or more soft pneumatic straitening actuators.

[0141] Preferably, the soft pneumatic actuator is configured to have a range of motion corresponding to the range of motion of a digit or digits of a hand.Preferably, the actuator body of a finger actuating member is elongate (i.e. has a generally elongate shape). Preferably, the actuator body is sized for positioning on top (i.e. on the dorsal side) of a digit or digits of a hand.

[0142] Preferably, the actuator body has a length of at least 5 cm, more preferably at least 7 cm, for example at least 9 cm. Preferably, the actuator body has a length of at most 20 cm, more preferably at most 18 cm, still more preferably at most 16 cm, for example at most 14 cm. Preferably, the actuator body has a length of from 5 cm to 20 cm, more preferably from 7 cm to 18 cm, still more preferably from 9 cm to 16 cm, for example around 12 cm.

[0143] Preferably, the actuator body has a width of at least 0.5 cm, more preferably at least 1 cm, still more preferably at least 1.5 cm, for example at least 2 cm. Preferably, the actuator body has a width of at most 6 cm, more preferably at most 5 cm, still more preferably at most 4 cm, for example at most 3 cm. Preferably, the actuator body has a width of from 0.5 cm to 6 cm, more preferably from 1 cm to 5 cm, still more preferably from 1.5 cm to 4 cm, most preferably from 2 to 3 cm, for example around 2.5 cm.

[0144] Preferably, the actuator body has a height of at least 0.5 cm, more preferably at least 1 cm, e.g. at least 1.5 cm. Preferably, the actuator body has a height of at most 5 cm, more preferably at most 4 cm, still more preferably at most 3 cm, for example at most 2 cm. Preferably, the actuator body has a height of from 0.5 cm to 4 cm, more preferably from 1 cm to 3 cm, for example from 1.5 cm to 2 cm, e.g. of 1.7 mm.

[0145] Preferably, the actuator body is configured to be straight and / or flexible (e.g. may flex with any degree of freedom) when the internal chamber is at atmospheric pressure.

[0146] The soft pneumatic actuator (preferably, the internal chamber of the actuator body) is preferably in fluid communication with a gas pump. In one option, the soft pneumatic actuator is in fluid communication with a gas pump manifold which is in turn in fluid communication with a gas pump.

[0147] Preferably, a conduit, such as a hose or tube, fluidly connects the soft pneumatic actuator and a gas pump. Preferably, the conduit is flexible. An example conduit is an air hose.Preferably, the actuation element comprises a plurality of digital actuating members, preferably one for each of the four fingers and one for the thumb.

[0148] Optionally, the plurality of digital actuating members are configured for actuation together. Alternatively, at least a thumb actuating member is configured for actuation independent from the finger actuating members.

[0149] Optionally, a plurality or each finger actuating member is configured for independent actuation.

[0150] By way of non-limiting reference, but as an example, a typical adult user may have a hand size according to the following: a palm length (from wrist to OPT crease) of from 8 to 13 cm, preferably from 9.5 to 12.5 cm; a backhand length (from wrist to OPT joint) of from 7.5 to 12 cm, preferably from 8 to 11 cm; hand width (at CPT joint) of from 7 to 10 cm, preferably 8 to 9.5 cm; and wrist width of from 5 to 8 cm, preferably 6 to 7 cm.

[0151] The article as previously described may be removably attachable to the fitting element. The article as previously described may be fixedly attached to the fitting element. The article, whether removably attached, or releasably attached, or fixedly attached to the fitting element, can be combined with any other embodiments as previously described.

[0152] The invention will now be described in more detail, without limitation, with reference to the accompanying Figures. Features common throughout the figures share reference numbers.

[0153] In Figures 1 Ato 1 D, there is shown a rehabilitative or mobility-assistive wearable article in the form of a rehabilitative glove 1 worn on a user’s hand 3 in various configurations - a perspective view with hand closed in Figure 1A, a top view with hand partially open in Figure 1 B, in bottom view with hand closed in Figure 1C, and a perspective bottom view with hand open in Figure 1 D. The glove 1 has a core glove 5 which is worn over the user’s digits 7 and about the metacarpus 9 of the hand 3 and / or about the wrist 11 and has an actuation element 13 for providing the actuation of the digits of the user wearing the glove 1.

[0154] The core glove 5, shown worn by a user without the actuation element in Figure 2 and not worn in Figures 4Ato E, has a motive portion 15 made up of four fingers or finger portions 17 and a wearable thumb portion 19 for fitting onto adistal end of the four fingers and thumb respectively of a user’s hand 3. The four finger portions 17 and thumb portion 19 all extend from a metacarpus portion 21 for fitting over or around the metacarpus 9 of the user’s hand (3) (the metacarpus 9 being the part of the hand between a wrist 11 and the digits 7). The metacarpus portion 21 of the core glove 5 has a metacarpus backhand 23, which is configured to extend laterally to cover the back of the hand and extend from the wrist to the knuckles of the hand 3 of the user, and extending from the metacarpus backhand 23 are metacarpus strap 25, wrist strap 27 and system strap 28.

[0155] There is no palm or front to the core glove 5. The backs of the finger portions 17 and wearable thumb portion 19 are continuously connected to the metacarpus backhand 23 by the same fabric material of the finger portions 17. The front of the finger portions 17 have proximal finger openings 43 and proximal thumb opening45.

[0156] Extending from the fingertips 29 of finger portions 17 are securing tabs 31 provided with sockets 33, on a top or back surface 32 of the tabs 31 , for securing to studs 35 (provided on the distal ends of actuation element 13) to form press stud snap fastenings 37. Provided on the outer / upper surface 39 of metacarpus backhand 23 is a hook and loop fixing pad 41 (of Velcro™).

[0157] To fit or don the core glove, a user will insert their fingers into the finger portions 17 via proximal finger openings 43 and their thumb into the wearable thumb portion 19 via proximal thumb opening 45. To facilitate donning, the proximal finger openings 43 are biased to an open position with biasing members 47 in the form of O-rings which extend through hems 49 formed in a bottom or front edge of the proximal finger openings 43 and around the outer or top surface 52 of the fingerbacks 51 , where the O-rings extend through receiving loops 53 of pull tabs 55. Thereby, the proximal finger openings 43 are biased open. Once the user has placed one or more fingers into the proximal finger openings 43, they can turn the hand and pull the finger portions 17 onto their fingers using pull tabs 55 that extend from receiving loops 53 on the fingerbacks 51. The wearable thumb portion 19 can then be fitted on the user’s thumb. The metacarpus backhand 23 can then be pulled over the back of the user’s hand and the wrist strap 27, which extends laterally from a distal portion of the metacarpus backhand 23, may be wrapped around the wrist and secured via wrist strap hook and loop fastener 55 having ahook and loop fastener pad along a portion of the wrist strap 27 and on a top surface of a proximal portion of the metacarpus backhand 23. The core glove is thereby secured in place.

[0158] A splint 57 is shown in Figures 5Ato 5D and in Figure 3 attached to the core glove 1. The splint 57 has a relatively rigid base 59 which as illustrated in Figure 5D has a curved profile to generally conform with the curve of the back of a user’s hand. The rigid base 59 of the splint 57 serves the purpose of, when affixed to both the core glove 5 (at the metacarpus backhand 23 thereof) and the actuator element 13, providing a base or support against which the force generated by the actuator element 13 may leverage the motive member, in this case the fingers. The rigid base 59 of the splint 57 has a base distal edge 61 that has a length a little less than the width of the back of the hand near the knuckles (e.g. about 5 to 7 cm) and a base proximal edge 63 that has a length a little less than the width of a user’s wrist 11 (and typically from 1 to 4 cm). A base radial lateral edge 65 of the baes 59, which, in use, is to be orientated in general alignment with the radial lateral portion or side of the hand, extends from the base distal edge 61 to the base proximal edge 63 to an extent that is the major portion of the distance from knuckles (e.g. the fore edge of the knuckles) and the wrist (e.g. having a length of from 6 to 10 cm) and typically having a length greater than that of the base distal edge 61. The base radial lateral edge 65, which is a generally straight-line edge, is at an angle generally normal to the base distal edge 61 and typically in the range of 60 to 100 degrees. Base ulnar lateral edge 67 extends from the base distal edge 61 to the base proximal edge 63, opposite to the base radial lateral edge 65 and may define any suitable shape but generally tapers from distal to proximal.

[0159] In use, the rigid base 59 of splint 57 is affixed to the metacarpus backhand 23 (or upper / outer surface thereof) by any suitable means so that a lower, concave surface 69 of the rigid base 59 contacts the metacarpus backhand 23, with the base distal edge 61 arranged in general alignment with the user’s knuckles or a distal edge (backhand distal edge 73, being the point where fingerbacks 51 extend from the metacarpus backhand 23) of the metacarpus backhand 23, and the base radial lateral edge 65 is generally aligned with the radial lateral edge of the user’s hand, e.g. aligned with the second or index metacarpal.The rigid base 59 shown in Figures 3 and 5Ato D has a splint hook and loop fastening pad 75 disposed on the concave surface 69 to cover the major portion of the concave surface and the majority of its length, which may be secured to a corresponding hook and loop fixing pad 41 disposed on the upper or outer surface of the metacarpus backhand 23 (as shown in Figure 3), again covering at least 30% of the metacarpus backhand 23 and preferably the majority of the surface of the metacarpus backhand, including the majority of the width and length thereof. Having large such fixing pads (or multiple such fixing pads), the strength of connection provided by the joining of splint hook and loop fastening pad 75 and fixing pad 41 can keep the splint 57 secured to the core glove 5 sufficiently well for it to handle the forces the actuating element 13 will apply and enable the back of the hand 3 to be used as the base for leveraging that force against the digits 7. The extent of the surface area of the splint hook and loop fixing pads 75 also allows some degree of adjustment of the positioning of the rigid base 59 on the metacarpus backhand 23 of core glove 5, which can assist in improving the fit and sizing of the glove 1 for use in rehabilitation, without having to have a glove sized bespoke to a particular user, since small changes in size can otherwise affect the performance of the glove 1.

[0160] An actuation element 13, such as shown in Figures 1Ato D and as part of the actuation system 77 shown in Figures 6A and 6B may be secured to the core glove 5, and more particularly to the splint 57 secured to the core glove 5, by any suitable means to complete the glove 1.

[0161] Actuation system 77 is a pneumatic actuator system and includes a soft pneumatic actuator 79 a fluid (typically air) supply line 81 and a pump connector 83 for connectingto a suitable pump or pump arrangement. The soft pneumatic actuator 79 has an actuator support structure 85 and extending therefrom one (in the case of a mitt) or, in this case, a plurality of actuation members 87 having internal chambers (not illustrated), which actuation members 87 are configured to adopt a pre-defined configuration, e.g. flexed or extended, upon inflation or upon increasing the pressure within the internal chamber. (In the illustrated case, the actuation members 87 are configured to extend upon increase of gas pressure in the chambers within them). In the system 77 shown in the Figures, the fluid supply line 81 has five tubes 89, each for supplying fluid (e.g. air) toone of the actuation members 87, which, in principle, may allow them to be pressurized together or independently. In the soft pneumatic actuator illustrated, the plurality of actuation members 87 are each joined to the adjacent actuation member 87. As a result, in the illustrated system, the actuator element 13 cannot readily be used to actuate each actuation member 87 (and thus finger) independently, but as a group, as with a mitt. However, the actuation members 87 may be formed without the lateral joins to neighbouring actuation members 87 which would allow their independent flex and extension subject to the supply line being configured for use with a pump controlled to selectively pressurize respective actuation members.

[0162] The soft pneumatic actuator 79 may be configured with, on or extending from the same actuator support structure 85, the actuation members 87 described above and a thumb-actuation member 91 for use in affecting the movement of a user’s thumb 93. In the illustrated case, however, and in a preferred arrangement, there is provided a soft pneumatic thumb-actuator 95 which has a thumb-actuator support structure 97 from which extends a thumb-actuation member 91. The soft pneumatic thumb-actuator 95 may be a part of or joined to, the soft pneumatic actuator 79, or they may have a common support platform. Alternatively, and as illustrated in the Figures, the soft pneumatic thumb-actuator 95 is discrete from the soft pneumatic actuator 79, a discrete and separate article. In Figures 5A and 5B, the fluid supply line 81 includes a bundle of tubes 89 connecting each actuation member 87 and the thumb-actuation member 91 to pump connector 83. However, by connecting only the thumb-actuation member 91 of the soft pneumatic thumb actuator 95 to the pump connector 83, the soft-pneumatic thumb-actuator 95 may be used to provide assistive, rehabilitative or physiotherapeutic support to the thumb of a user in isolation. Similarly, in relation to the soft pneumatic actuator 79 being absent a thumb-actuation member 91 , the soft pneumatic actuator 79 may be used to provide assistive, rehabilitative or physiotherapeutic support to one or more fingers in isolation from the thumb.

[0163] The soft pneumatic actuator 79 may be affixed to the core glove 5, directly or indirectly, whereby each actuation member 87 is connected to at least two points and preferably only at a distal phalanx part 99 (or the fingertips 29, being the distal end of the distal phalanx parts 99) of the finger portions 17 of the coreglove 5 and at the metacarpus backhand 23 of the core glove 5. Optionally, in cases where the actuation members 87 are independently moveable (i.e. not attached along their lengths to neighbouring actuation members 87), they may be secured in alignment with the finger portions 17 of the core glove 5 by one or more slidable sleeves extending around the finger portions 17.

[0164] Actuation member tips 101 , at the distal end of each of the actuation members 87, are provided with, on a first face 103 of the actuation members 87, studs 35 to form press stud snap fastenings 37 in cooperation with corresponding sockets 33 provided on the tabs 31 off the finger portions 17 of core glove 5. These respective sockets 33 and studs 35 may be snapped together to secure the actuation members 87 to the fingertips 29 of the core glove 5. The user’s hand may then be flexed before completing the attachment of the soft pneumatic actuator 79 to the core glove 5 in order to maximise the distance around the curve of the flexed hand that the actuation members 87 need to be able to extend. The soft pneumatic actuator 79 and actuation members 87 may then be pulled taut over the curve of the flexed digits and toward the wrist 11 of the user over the top / back of the hand 3 and then secured, in this taut configuration, to the metacarpus backhand 23 of the core glove 3. This ensure that even where the core glove 5 may not be a perfect fit for the wearer, given there can be provided a discrete number of glove sizes for a continuous range of hand sizes, and even where the soft pneumatic actuator 79 may only be provided in one size (or a small and discrete number of sizes covering a range), the selected core glove 5 combined with a soft pneumatic actuator 79 secured to the fingertips 29 and metacarpus backhand 23 while taut will provide a perfect fit for each individual user. This is important because when well-fitted as described, the extension force of the actuation members 87 on the user’s fingers will be effective as soon as the actuation members 87 are inflated (or internal pressure increased). The soft pneumatic actuator 79 and actuation members 87 thereon may be secured to the metacarpus backhand 23 indirectly by securing it to a splint 57 itself secured to the metacarpus backhand 23 by way of cooperating splint hook and loop fastening pads 75 as described above. Thus, the soft pneumatic actuator 79 and actuation members 87 have actuator fastening strips 105 of a hook and loop-type form, which extend longitudinally along at least a proximal portion of the first face 103 of actuation members 87, which may then besecured to a cooperating actuator fastening pad 107 (of hook and loop fastener form) provided on the outer, convex surface 71 of the rigid base 59 of splint 57.

[0165] Completion of the fitting of the glove 1 is by then wrapping metacarpus strap 25, that extends outwards from a lateral ulnar edge 109 of the metacarpal backhand 23 proximal to the backhand distal edge 73, about the palm 111 of the hand 3

[0166] As is apparent in Figure 1 A, for example, the length of the actuating members 87 must be such as to extend across or over all the joints that it is intended to influence the movement of (in this case straighten, or extend) and in this case the actuating members extend from the distal phalanx to the metacarpus, thus extending across the knuckles and the two joints of the fingers. As such, in use for the purpose of assisting the extension of the fingers in a patient, and fitted in the manner described above, the glove 1 worn by the user starting with the hand in a flexed state, the pump may be caused to inflate and increase the pressure in the chamber(s) of the actuation members 87, the actuation members 87 tend toward an actuated configuration in which they are elongate and extended. Since a proximal portion of the actuation members 87 are secured to splint 57 that is firmly secured to the metacarpus backhand 23 of the glove portion 5, in order to adopt the actuated configuration, the distal portions of the actuation members 87 must extend to adopt the elongate tubular shape of the actuated configuration. The force of this tendency toward the actuated configuration is then leveraged on the digits of the user that are within the finger portions 17 of the core glove 5 causing them or assisting them in extending. It will be understood that the actuator members 87 and the soft pneumatic actuator 79 may also (or instead) be configured to facilitate flexing of the fingers of the hand of the user and an alternative process for doing so adopted accordingly.

[0167] As illustrated in Figures 3 and 5Ato 5D, splint 57 further comprises a dorsal fin 113, an upright rigid projection, projecting from the concave face 71 of the splint 57 in order to serve as a support for a thumb-actuation member 91 of, e.g. a soft pneumatic thumb actuator 95. The dorsal fin 113 extends longitudinally in a generally distal to proximal direction, that is a general direction from base proximal edge 63 toward base distal edge 61 and preferably in an orientation generally normal to the base distal edge 61 (e.g. 15 degrees either side of normal or morepreferably at right angles thereto). Ideally, the dorsal fin 113 is orientated generally in alignment with the secondary metacarpal and ideally projecting upward from the base radial lateral edge 65. The dorsal fin 113 as illustrated in the Figures is projects outward from the rigid base 59 at an angle generally normal to the upper or convex face 71 of the rigid base 59, taking a portion of the convex face 71 proximal to the base radial lateral edge 65 as a point of reference The dorsal fin 113 is generally oblong, having a constant extent of projection along its length. The extent of projection is any suitable amount necessary to have wrapped therearound or to retain an element of a thumb actuation member 91 or soft pneumatic thumb actuator 95 for the purpose of a biasing or leveraging support in affecting the mobility of a user’s thumb, but as in the Figures may be from 0.5 cm to 3 cm and preferably 1 to 2 cm. The dorsal fin 113 may be located toward the base distal edge 61 of the rigid base 59 (preferably in the distal half, or at least centred in the distal half thereof). As illustrated, the dorsal fin may be about 2.5 to 5 cm in length. As illustrated in Figures 5Ato 5D, the dorsal fin 113 projects (upward) from the base radial lateral edge 65 via a connecting portion 115, which extends from a proximal end of the dorsal fin 113 to about two-thirds of the way along its length, leaving a slot 117 between a distal portion 119 of the dorsal fin 113 and a distal portion of the base radial lateral edge 65, typically of about 1 to 2 cm in length. This slot 117 may be suitable for receiving a securing strap, such as the metacarpus strap 25.

[0168] The dorsal fin 113 as described above and illustrated in the Figures is useful, along with a soft pneumatic thumb actuator 95 in affecting the mobility of a thumb, in need, for example of rehabilitative, assistive or physiotherapeutic support. In the arrangement illustrated, the glove 1 may be useful for affecting a palmar abduction motion of the thumb of a user.

[0169] The soft pneumatic thumb actuator 95 shown in Figures 1 Ato 1 D and 6Aand 6B (noting that the former is for a right hand and the latter for a left hand has a thumb actuator support structure 97 that is narrow and elongate with an elongate fixing pad 121 (of the hook and loop or other suitable adhesive form) along its length for cooperation with corresponding fin fixing pads 123 disposed along the length on each opposing face of dorsal fin 113. Extending outward from one half of the long edge of the thumb actuator support structure 97 is the thumb-actuation member 91. The thumb actuation member 91 has an actuator distal edge 125 that extendsout to an ultimate point 127 at an angle of from 70 to 110 degrees and has along its length a first elongate fixing tab 131 , running along the length of the actuator distal edge and having three thumb studs 133 suitable for snap fixing to corresponding sockets of a snap fastener. An actuator proximal edge 129 extends outward at a similar angle to the actuator distal edge 125, but curving about halfway along its length to meet the ultimate point 127 and having at an outer portion a second elongate fixing tab 135, again running along the length of the actuator proximal edge 129, but at an angle of about 45 to 60 degrees to the first elongate fixing tab 131. This second elongate fixing tab 135 also has three thumb studs 133.

[0170] The soft pneumatic thumb actuator 95 may be attached to the splint 57 first, by affixing a proximal half of the elongate fixing pad 121 to a fin fixing pad 123 on an ulnar face 137 of the dorsal fin 113 and then bending the projecting remainder of the elongate thumb actuator support structure 97 around a distal end of the dorsal fin 113 and affixing the distal half of the elongate fixing pad 121 to the radial face 139 of the dorsal fin. The thumb actuation member 91 will then be extending upwards from the proximal half of the thumb actuator support structure 97 and can be bent outward over a top edge 141 of the dorsal fin 113, and pulled down until taut.

[0171] Two thumb-fixing tabs 143 are provided on thumb portion 19, extending in opposing directions partway along the thumb portion 19 of core glove 5, each thumb-fixing tab 143 having a thumb socket 145 for cooperating with one of the thumb studs 133 to form a snap fixing. When the thumb-actuation member 91 is pulled taut as described above, the thumb sockets 145 are each snap fixed to one of the two strips of thumb studs 133 for the purpose of properly fitting the thumbactuation member 91 to the core glove 5 for that particular user.

[0172] In use, in this particular system, upon actuation of the soft pneumatic thumb actuator 95, the thumb-actuation member 91 inflates causing the thumb to tend to a palmar abduction motion, thereby assisting the motion of the user’s thumb.

[0173] The pump connector 83 may be fitted to a corresponding consol connector 147 of a consol 149 which leads to a pump (not shown) within the consol 149 controlled by a CPU (not shown) and operated via a touch-screen user interfaceThe invention has been described with reference to preferred embodiments. However, it will be appreciated that variations and modifications can be effected by a person of ordinary skill in the art without departing from the scope of the invention.

Claims

CLAIMS:

1. A rehabilitative or mobility-assistive wearable article for assistive, rehabilitative or physiotherapeutic support for affecting the mobility of one or more motive member (or appendage) of a user relative to a supporting body of the user, the article comprising a fitting element for fitting to at least a portion of the motive member and an actuation element that is discrete from and is removably attachable to the fitting element, and optionally wherein the actuation element is adjustable relative to the fitting element.

2. An article as claimed in claim 1 , wherein the fitting element comprises a motive portion for fitting to a motive member and a support portion for fitting to a supporting body.

3. An article as claimed in claim 2, wherein the motive portion and support portion may be connected by a connecting portion.

4. An article as claimed in any one of claims 1 to 3, wherein the actuation element is removably attachable to the fitting element or a portion thereof.

5. An article as claimed in claim 4, wherein the actuator is removably attachable to a motive portion and to a support portion of the fitting element.

6. An article as claimed in any one of the preceding claims, wherein the actuation element is adjustably attachable to or adjustable relative to the fitting element.

7. An article as claimed in claim 6, wherein the actuation element is adjustably attachable to or adjustable relative to a motive portion and / or a support portion of the fitting element.

8. An article as claimed in any one of the preceding claims, wherein the actuation element comprises at least one actuating member which is configured to- 46 -extend along at least a portion of a length of a motive member and a portion of a supporting body.

9. An article as claimed in claim 8, wherein the actuation element is configured to adopt, upon actuation, a first actuated arrangement having an extended or straight profile and / or a second actuated arrangement having a curved or flexed profile.

10. An article as claimed in any one of the preceding claims, wherein the actuation element is a pneumatic actuating element, preferably a soft pneumatic actuator.

11. An article as claimed in any one of the preceding claims, which further comprises a splint, which preferably is planar or shaped or is configured to conform with the supporting body of a user.

12. An article as claimed in claimed in claim 11 , wherein the splint is discrete from the fitting element and the actuation element, is integral with at least a portion of the fitting element or is integral with the actuation element.

13. An article as claimed in claim 11 , wherein the splint is discrete from the fitting element and the actuation element and is configured to be removably attachable to a support portion of the fitting element and is preferably removably attachable to the actuation element, and preferably wherein the splint is adjustably attachable or positionable relative to the support portion and / or the actuation element, wherein the splint, in use, provides an anchoring base for the actuation element.

14. An article as claimed in any one of the preceding claims, which is a rehabilitative or mobility-assistive wearable glove for assistive, rehabilitative or physiotherapeutic support for affecting the mobility of one or more digits of a user, wherein the rehabilitative glove comprises the actuation element and, as the fitting element, a core glove, wherein the core glove comprises a mitt portion and / or one or- 47 -more fingers for fitting to the digits of a user’s hand, which represent the motive portion of the core glove, and comprises a metacarpus portion for fitting over or around the metacarpus part of a user’s hand, which represents the supporting body portion of the core glove, and wherein the actuation element is removably attachable to and / or adjustable relative to the core glove portion.

15. A rehabilitative glove as claimed in claim 14, wherein the actuation element comprises a plurality of digit actuating members, preferably one for each of the four fingers and one for the thumb.

16. A rehabilitative glove as claimed in claim 15, wherein each of the digit actuating members are capable of and are preferably configured for independent actuation.

17. A rehabilitative glove as claimed in anyone of claims 14 to 16, wherein the actuator is a soft pneumatic actuator having a plurality of ports, each supplying a separate digital actuating member.

18. A rehabilitative glove as claimed in anyone of claims 14 to 17, which further comprises a splint, the glove configured for arrangement of the splint on the back of the user’s hand.

19. A rehabilitative glove as claimed in claim 18, wherein the splint is discrete from each of the core glove and the actuation element and is configured for removable attachment to the core glove and the actuation element and / or for adjustably positioning relative to the core glove and / or the actuation element.

20. A rehabilitative glove as claimed in claim 19, wherein the splint is removably attachable to the metacarpus portion of the core glove at one or a range of positions on the metacarpus portion (e.g. byway of hook and loop connectors).- 48 -21. A rehabilitative glove as claimed in claim 19 or claim 20, wherein the actuation element is removably attachable to the splint at one or a range of positions along a length of the splint (e.g. by way of hook and loop connectors).

22. A rehabilitative glove as claimed in any one of claims 19 to 21 , wherein the glove can be reconfigured to fit a range of hand sizes by adjusting the position of attachment of the splint on the metacarpus portion of the core glove and by adjusting the position of attachment of the actuation element to the splint.

23. A rehabilitative glove as claimed in any one of claims 19 to 22, wherein the splint comprises a base that is planar or configured to cooperate or conform with the back of a user’s hand and projecting out from the base an elongate upright member which, in the assembled glove, may be orientated generally parallel with the user’s fingers, the upright member serving to provide a support member for biasing against palmarabduction.

24. A rehabilitative glove as claimed in anyone of claims 14 to 23, wherein the motive portion of the core glove comprises a plurality of distal tip portions for fitting over the tip of the fingers of a user and wherein the actuation portion is configured for releasable attachment to each of the distal tip portions.

25. A rehabilitative glove as claimed in anyone of claims 14 to 24, wherein the motive portion of the core glove comprises one or a plurality of finger portions having a proximal opening for receiving the fingers when donning, wherein at least one of the fingers is biased to an open configuration.

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