Neuromuscular conditions such as spinal muscular atrophy, muscular dystrophy, and arthrogryposis can negatively affect children’s abilities to perform tasks. Long-term spinal health is a concern for this population because the trunk and neck are repeatedly flexed to compensate for the weakness in the upper limbs; complications can include scoliosis and joint contractures. In a study published in the Winter 2017 issue of The Open Journal of Occupational Therapy , researchers used the Canadian Occupational Performance Measure (COPM) to determine patient satisfaction and performance with the Wilmington Robotic Exoskeleton (WREX) among children with such conditions. The WREX is a customized, body-powered orthosis that provides four degrees of freedom and allows gravity-minimized movement of the arm at the shoulder and elbow. According to the study’s authors, the results indicate significant improvement in satisfaction with and performance of self-care, school-related, and leisure activities, as rated by the children’s parents.
Twenty-five families completed a phone interview based on the COPM. Inclusion criteria were arm weakness between 1 and 3 on the Manual Muscle Test, greater than 50 degrees of passive elbow range of motion, and greater than 90 degrees of passive shoulder flexion. Exclusion criteria were severe elbow and shoulder contractures. Each participating family had a child between two and 21 years old who had a neuromuscular disorder and who had used the WREX regularly for eight months to 120 months (with a mean of 25 months). Fifteen of the children were ambulatory and wore the device mounted to a TLSO. The mean age of the participants, 16 boys and nine girls, was 8.87 years. The children’s range of neuromuscular diagnoses included arthrogryposis (14), cerebral palsy (3), spinal muscular atrophy (2), muscular dystrophy (2), and other (4).
The parents rated their child’s performance of and satisfaction with completing self-chosen activities both with and without the WREX. The scores were assessed for change between the two conditions. Twenty-four of the parents reported that their children had greater levels of performance and satisfaction when they were wearing the WREX. The mean change in performance score was 3.61 points, and the mean change in satisfaction score was 4.44 points.