Wilmington robotic exoskeleton: a novel device to maintain arm improvement in muscular disease.

Abstract

BACKGROUND:

Upper-extremity movement is limited in individuals with muscular weakness. This paper describes a novel, articulated upper-extremity orthosis, the Wilmington Robotic Exoskeleton (WREX), which helps people overcome this movement deficit.

METHODS:

This prospective, case-controlled study involved an ambulatory patient with arthrogryposis multiplex congenita and 2 nonambulatory patients with spinal muscular atrophy type II. The WREX uses elastic bands to negate the effects of gravity; it allows a person with neuromuscular weakness to move their arm in 3 dimensions. The WREX can be fixed on a brace for ambulatory patients and on the wheelchair for nonambulatory patients. Assessment was performed through motion analysis (with and without the WREX), clinical examination, and qualitative questionnaire.

RESULTS:

Motion analysis showed a marked improvement in upper-extremity function with the WREX. The questionnaire illustrated enhanced functionality with the WREX including self-feeding, fine motor control, and use of a television remote control. Enhanced functionality resulted in improved quality of life by increasing participation in school, raising self-esteem, and increasing social interaction. Two unexpected outcomes were increased security with trunk inclination and amelioration of the effects of contractures.

CONCLUSIONS:

The WREX provided an increase in functionality and improved the quality of life of the patients. The device has become an integral part of the lives of the 3 patients.

LEVEL OF EVIDENCE:

Level III in Therapeutic Studies-Investigating the Results of Treatment.

• Authors: Thierry Haumont, Tariq Rahman, Whitney Sample, Marilyn M King, Chris Church, John Henley, Shanmuga Jayakumar
• Journal: Journal of pediatric orthopedics (J Pediatr Orthop) 2011 Jul-Aug Vol. 31 Issue 5 Pg. e44-9 ISSN: 1539-2570 [Electronic] United States
• PMID: 21654447 (Publication Type: Case Reports, Journal Article)

Topics

• Adolescent
• Arthrogryposis (physiopathology, rehabilitation)
• Child
• Equipment Design
• Exercise Therapy (instrumentation)
• Female
• Follow-Up Studies
• Gravitation
• Humans
• Male
• Orthotic Devices
• Prospective Studies
• Quality of Life
• Recovery of Function (physiology)
• Robotics (instrumentation)
• Spinal Muscular Atrophies of Childhood (physiopathology, rehabilitation)
• Therapy, Computer-Assisted (instrumentation)