{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:23:23Z","timestamp":1791811403053,"version":"4.3.4"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomimetics"],"abstract":"<jats:p>This study developed and evaluated a novel upper-limb rehabilitation device that integrates piano playing into task-oriented occupational therapy, addressing the limitations of traditional continuous passive motion (CPM) training in patient engagement and functional recovery. The system features a bi-axial sliding platform for precise 61-key positioning and a ten-link, four-loop robotic hand for key striking. A hierarchical control framework incorporates MIDI-based task mapping, finger optimization using an improved Hungarian algorithm, and impedance\u2013admittance hybrid control for adaptive force\u2013position modulation. An 8-week randomized controlled trial demonstrated that the experimental group significantly outperformed the control group, with a 74.7% increase in Fugl\u2013Meyer scores (50.5 \u00b1 2.5), a 14.6-point improvement in the box and block test (BBT), a 20.2-s reduction in nine-hole peg test (NHPT) time, and a 72.6% increase in rehabilitation motivation scale (RMS) scores (55.4 \u00b1 3.8). The results indicate that combining piano playing with robotic rehabilitation enhances neuroplasticity and engagement, significantly improving motor function, daily activity performance, and rehabilitation adherence. This mechanical-control synergy introduces a new paradigm for music-interactive rehabilitation, with potential applications in home-based remote therapy and multimodal treatment integration.<\/jats:p>","DOI":"10.3390\/biomimetics10040200","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T10:53:54Z","timestamp":1742900034000},"page":"200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Development and Evaluation of a Novel Upper-Limb Rehabilitation Device Integrating Piano Playing for Enhanced Motor Recovery"],"prefix":"10.3390","volume":"10","author":[{"given":"Xin","family":"Zhao","sequence":"first","affiliation":[{"name":"School of Arts and Design, Yanshan University, Haigang District, Qinhuangdao 066000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Arts Department of Qinhuangdao Vocational and Technical College, Beidaihe District, Qinhuangdao 066100, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Organization and Publicity Office of the CPC Qinhuangdao Vocational and Technical College Committee, Beidaihe District, Qinhuangdao 066100, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Design, Kyungpook National University, Daegu 41566, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinxu","family":"Yu","sequence":"additional","affiliation":[{"name":"College of Mechanical and Automotive Engineering\/Hangzhou Bay Automotive Engineering, Ningbo University of Technology, Ningbo 315211, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Yuan","sequence":"additional","affiliation":[{"name":"School of Arts and Design, Yanshan University, Haigang District, Qinhuangdao 066000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1001\/jama.2017.22036","article-title":"Guidelines for Adult Stroke Rehabilitation and Recovery","volume":"319","author":"Gittler","year":"2018","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3706","DOI":"10.1161\/STROKEAHA.121.034348","article-title":"Timing and Dose of Upper Limb Motor Intervention After Stroke: A Systematic Review","volume":"52","author":"Hayward","year":"2021","journal-title":"Stroke"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1186\/s12984-023-01250-4","article-title":"A Bidirectional Fabric-Based Soft Robotic Glove for Hand Function Assistance in Patients with Chronic Stroke","volume":"20","author":"Lim","year":"2023","journal-title":"J. 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