Hammelef E, Zakaria SJ, Andersen SH, Kelly TJ, Grampurohit N, Avery M, Napoli A, Mulcahey MJ, Serruya MD. A Pilot Feasibility Trial of an Upper Extremity Assistive System.
Arch Rehabil Res Clin Transl 2023;
5:100308. [PMID:
38163018 PMCID:
PMC10757169 DOI:
10.1016/j.arrct.2023.100308]
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Abstract
Objective
To develop and clinically evaluate a customizable active upper extremity (UE) assistive system with integrated functional electrical stimulation (FES) that improves function and independence of individuals during activities of daily living (ADLs).
Design
Single-arm, prospective, open-label cohort feasibility trial.
Setting
An academic research institution.
Participants
Subjects were 5 adults with a medical history of stroke resulting in distal UE impairment (N=5). The subjects volunteered from recruitment materials that detailed information about the study.
Interventions
A novel, wearable, lightweight, low-profile, and patient-tailored UE assistive system. It comprises a splint component and FES unit that may each be controlled by electromyography (EMG) signals, inertial measurement units (IMUs), manual control source (joystick), and/or voice control.
Main Outcome Measures
Several occupational therapy outcome measures were used, including the Canadian Occupational Performance Measure (COPM), Action Research Arm Test (ARAT), The Box and Blocks Test (BBT), the ABILHAND-Manual Ability Measure, and Patient Reported Outcomes Measurement Information System (PROMIS) UE Short Form.
Results
All participants learned to use our UE assistive system to perform ADLs and were able to use it independently at home. Most participants experienced a clinically meaningful improvement in both performance and satisfaction for the majority of their COPM goals while using the system. All participants experienced improvement in hand grip and release as shown by their baseline and post assessment scores for hand function (BBT, ARAT) and patient-reported outcomes (ABILHAND, PROMIS).
Conclusions
The clinical outcomes suggest that our UE assistive system improves functional performance in patients with UE impairment, allowing them to engage more actively in ADLs. Further innovation including elbow and shoulder components will allow users to have more degrees of freedom during tasks.
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