Combining Wearable Robotic Orthosis with Visual and Haptic Feedback to Enhance the Recovery of Upper Extremity Motor Function and ADL in Persons with Acute SCI
Abstract
Spinal cord injury (SCI) is a medically complex and life-disrupting condition. An estimated prevalence of 17,700 new traumatic SCI cases are reported each year in the United States, including many active Service men and women, and Veterans. About half of those, the injury involve some part of the arm and hand, representing significant disability and dependence for those patients and their families. The Department of Veterans Affairs (VA) provides care for approximately 26% of individuals with SCI in the United States, making it the single largest network of care for persons with SCI. When arms/hands are impaired, a patient’s quality of life and level of independence are reduced. Restoration of UE motor function in people with SCI remains a high priority in rehabilitation and in the field of assistive technology; however, while there are many established rehabilitation technologies to provide strengthening and static splints to help assist with the contracture and function, few effective wearable powered devices are developed specifically for increasing the UE functional capability, especially wrist and hand functions. Further, it has been found that neuronal feedback from sites below the injury plays a crucial role during early recovery and for maintaining regained motor functions. These new basic research findings implicate the importance of continued use of affected body parts for rehabilitative success in persons with SCI. Video gaming for rehabilitation is an emerging field of research showing promising results in many contexts. Video games have been utilized as motivational tools that aim to activate a person’s intrinsic motivation and as a therapeutic tool has largely been studied within the stroke and brain injury populations with some benefits reported in upper limb motor performance, balance, coordination, and cardiovascular status. Virtual reality (VR) games can effect significant gains on body structure, function and activity level outcomes. The evidence supports the use of VR as an adjunct for stroke rehabilitation and potentially other populations (e.g., SCI), with effectiveness evident for a variety of platforms, training parameters, and stages of recovery. The HapticMaster (HM) robot (Moog, Inc.) presents a high-performance haptic device that provides haptic performance indicators force, force depth, stiffness, position resolution, and haptic resolution, which are key advantages to facilitate VR application and haptics research and rehabilitation. The HM utilizes the admittance control paradigm, which facilitates high stiffness, large forces, and a high force sensitivity. Therefore, the overall goal of this randomized clinical trial is to evaluate the usefulness of combining MyoPro robotic orthosis with visual feedback (as provided by VR-video games) and haptic feedback (as provided by HapticMaster Robot/vibration motors) in ameliorating wrist/hand/UE movement capability, and increasing activities of daily living and quality of life in people with acute SCI, with support from the manufacturing company (Myomo, Inc.). Results from this research will establish the first guidelines of a wearable powered orthosis (MyoPro) combined with visual and haptic feedback for rehabilitating persons with SCI, for specifically improving function, activity of daily living, and quality of life. The impact of the data generated from this clinical trial investigation should advance application of new and unique orthotic and prosthetic technologies to treating disabilities as a results of injuries or diseases such as SCI. The knowledge product and outcomes resulting from the proposed investigation will justify the utilization importance of such combined technologies, and will have a significant impact on improving the health and welfare of the general public living with SCI, including a large population of Service members, Veterans in the VA system (26% of the SCI individuals in the US). Beyond the common therap
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010920
Entities
People
- Ghaith Androwis
Organizations
- Kessler Foundation
- United States Army