NDLI: Pilot testing of the spring operated wearable enhancer for arm rehabilitation (SpringWear)

Content Provider	Springer Nature : BioMed Central
Author	Chen, Ji Lum, Peter S.
Abstract	Background Robotic devices for neurorehabilitation of movement impairments in persons with stroke have been studied extensively. However, the vast majority of these devices only allow practice of stereotyped components of simulated functional tasks in the clinic. Previously we developed SpringWear, a wearable, spring operated, upper extremity exoskeleton capable of assisting movements during real-life functional activities, potentially in the home. SpringWear assists shoulder flexion, elbow extension and forearm supination/pronation. The assistance profiles were designed to approximate the torque required to move the joint passively through its range. These three assisted DOF are combined with two passive shoulder DOF, allowing complex multi-joint movement patterns. Methods We performed a cross-sectional study to assess changes in movement patterns when assisted by SpringWear. Thirteen persons with chronic stroke performed range of motion (ROM) and functional tasks, including pick and place tasks with various objects. Sensors on the device measured rotation at all 5 DOF and a kinematic model calculated position of the wrist relative to the shoulder. Within subject t-tests were used to determine changes with assistance from SpringWear. Results Maximum shoulder flexion, elbow extension and forearm pronation/supination angles increased significantly during both ROM and functional tasks (p < 0.002). Elbow flexion/extension ROM also increased significantly (p < 0.001). When the subjects volitionally held up the arm against gravity, extension at the index finger proximal interphalangeal joint increased significantly (p = 0.033) when assisted by SpringWear. The forward reach workspace increased 19% (p = 0.002). Nine subjects could not complete the functional tasks unassisted and only one showed improvement on task completion with SpringWear. Conclusions SpringWear increased the usable workspace during reaching movements, but there was no consistent improvement in the ability to complete functional tasks. Assistance levels at the shoulder were increased only until the shoulder could be voluntarily held at 90 degrees of flexion. A higher level of assistance may have yielded better results. Also combining SpringWear with HandSOME, an exoskeleton for assisting hand opening, may yield the most dramatic improvements in functional task performance. These low-cost devices can potentially reduce effort and improve performance during task practice, increasing adherence to home training programs for rehabilitation.
Related Links	https://jneuroengrehab.biomedcentral.com/counter/pdf/10.1186/s12984-018-0352-4.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	17430003
DOI	10.1186/s12984-018-0352-4
Journal	Journal of NeuroEngineering and Rehabilitation
Issue Number	1
Volume Number	15
Language	English
Publisher	BioMed Central
Publisher Date	2018-03-02
Access Restriction	Open
Subject Keyword	Neurosciences Neurology Rehabilitation Medicine Biomedical Engineering and Bioengineering Upper extremity Stroke Therapy Exoskeleton Neurorehabilitation
Content Type	Text
Resource Type	Article
Subject	Health Informatics Rehabilitation
Journal Impact Factor	5.2/2023
5-Year Journal Impact Factor	5.6/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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