User Evaluation of a Dynamic Arm Orthosis for People With Neuromuscular Disorders

Abstract

This paper presents the results of an online survey conducted with users of a functional upper extremity orthosis called the Wilmington Robotic EXoskeleton (WREX). The WREX is a passive anti-gravity arm orthosis that allows people with neuromuscular disabilities to move their arms in three dimensions. The paper also describes the design of a novel lightweight 3-D printed WREX used for ambulatory children. Three different versions of the WREX are now offered to patients. Two can be mounted on a wheelchair and one to a body jacket for ambulatory patients. An online user survey with 55 patients was conducted to determine the benefits of the various WREXs. The survey asked ten questions related to upper extremity function with and without the WREX as well as subjective impressions of the device. Results show a statistically significant improvement in arm function for everyday tasks with the WREX.

Outcome Measures with COPM of Children using a Wilmington Robotic Exoskeleton

“…In this study, the children and their A concurrent study using an online questionnaire to rate the performance of 10 common activities of daily living while wearing the WREX and while not wearing the WREX was conducted (Gunn, Shank, Eppes, Hossain, & Rahman, 2015). Fifty-five participants completed the online survey.…”

Control interfaces to actively support the arm function of men with Duchenn Muscular Dystrophy

“…The WREX (JAECO Orthopedic, USA) [34] and the TOP (Focal Meditech, the Netherlands) are passive arm supports that have been in the market for more than 20 years. The WREX (JAECO Orthopedics, USA) is now available in two versions: a metal version that attaches to the wheelchair or to a table, and a wearable version, known as Baby WREX, that combines 3D printed plastic parts and metal parts for ambulatory children [35]. More recent commercially available passive arm supports include the Sling, the Dowing and the Balancer (Focal Meditech, the Netherlands), the VERTICAL M.A.G.…”

“…Users also reported more improvement of arm function with the wheelchair-mounted WREX than with the body-mounted version. Aesthetics, fitting, and reimbursement were identified as areas for improvement [35]. Finally, a user evaluation study with the Neater arm support concluded that the use of the Neater arm support by adults and teenagers with neuromuscular disorders could greatly improve their independence, confidence, and ability to engage in social situations [38].…”

“…People with DMD can benefit from commercially available passive arm supports that compensate for the weight of their arms [6,35]. By the time they reach their twenties, the decrease of muscle force combined with the increase of passive joint-stiffness [255,4] generally makes gravity compensation insufficient to support their arm function [105].…”

“…As a result, currently, there is a considerable group of adults with DMD living with severe physical impairments and a strong dependency on care up to their 30's [1,4]. Several arm supports that compensate the weight of the arms are commercially available [5] and have shown to increase the independence and quality of life for people with muscular weakness [6,35]. However, in adults with DMD, the decrease of muscle force combined with an increase of passive joint-stiffness [104,255], due to the disuse of the arms, reduces the effectiveness of passive arm supports [105,262].…”