NDLI: Development and evaluation of a passive trunk support system for Duchenne muscular dystrophy patients

Content Provider	Springer Nature : BioMed Central
Author	Mahmood, Mohammad Nauzef Peeters, Laura H. C. Paalman, Micha Verkerke, Gijsbertus J. Kingma, Idsart van Dieën, Jaap H.
Abstract	Background Patients with Duchenne muscular dystrophy gradually lose the ability to use different muscles of their body. Consequently, they lose the ability to stabilize their trunk against gravity. This hinders them to effectively perform different daily activities. In this paper, we describe the design, realization and evaluation of a trunk orthosis for these patients that should allow them to move their trunk and maintain stability. Method This study aimed to primarily assess the effectiveness of the trunk support system in terms of unloading of trunk muscles, so only healthy participants were recruited for this phase of the study. Measurements were done on 10 healthy participants (23.4±2.07 [M±SD] years old, average body weight 68.42±24.22 [M±SD] kg). The experiment comprised maintaining a constant trunk posture in three different device conditions (control without orthosis and two conditions with different configurations of the orthosis), at four different flexion angles (10°, 20°, 30°, 40°) for each device condition and for two load conditions (with and without stretching the arms). Electromyography (EMG) signals from the trunk muscles were measured to estimate activation levels of the trunk muscles (iliocostalis, longissimus, external oblique and rectus abdominis) and a motion capture system was used to record the movement of the participants during the experiment. Results Wearing the orthosis caused reductions in longissimus and iliocostalis activity. The average muscle activity level was 5%–10% of maximum voluntary contraction in the unsupported conditions for those particular muscles. This level was reduced to 3%–9% of maximal voluntary contraction for the supported conditions. No effect on external oblique and rectus abdominis activity was observed. Moreover, no pain or discomfort was reported by any of the participants during the experiment. The results from the current experiment also suggests the necessity of lumber stabilizing systems while using trunk orthosis. Conclusion The developed orthosis reduces trunk muscle activation level and provides a solid step for further development of support systems for Duchenne muscular dystrophy patients. Trial registration The current study was approved by the medical ethics committee Arnhem-Nijmegen (study number: NL53143.091.15 ), The Netherlands.
Related Links	https://jneuroengrehab.biomedcentral.com/counter/pdf/10.1186/s12984-018-0353-3.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	17430003
DOI	10.1186/s12984-018-0353-3
Journal	Journal of NeuroEngineering and Rehabilitation
Issue Number	1
Volume Number	15
Language	English
Publisher	BioMed Central
Publisher Date	2018-03-14
Access Restriction	Open
Subject Keyword	Neurosciences Neurology Rehabilitation Medicine Biomedical Engineering and Bioengineering DMD Patients Muscle Activation Levels Orthosis Iliocostalis (IC) External Oblique (EO)
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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