The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairment
Abstract Background Active upper extremity (UE) assistive devices have the potential to restore independent functional movement in individuals with UE impairment due to neuromuscular diseases or injury-induced chronic weakness. Academically fabricated UE assistive devices are not usually optimized f...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-023-01228-2 |
| _version_ | 1797453667788390400 |
|---|---|
| author | Mehdi Khantan Mikael Avery Phyo Thuta Aung Rachel M. Zarin Emma Hammelef Nabila Shawki Mijail Demian Serruya Alessandro Napoli |
| author_facet | Mehdi Khantan Mikael Avery Phyo Thuta Aung Rachel M. Zarin Emma Hammelef Nabila Shawki Mijail Demian Serruya Alessandro Napoli |
| author_sort | Mehdi Khantan |
| collection | DOAJ |
| description | Abstract Background Active upper extremity (UE) assistive devices have the potential to restore independent functional movement in individuals with UE impairment due to neuromuscular diseases or injury-induced chronic weakness. Academically fabricated UE assistive devices are not usually optimized for activities of daily living (ADLs), whereas commercially available alternatives tend to lack flexibility in control and activation methods. Both options are typically difficult to don and doff and may be uncomfortable for extensive daily use due to their lack of personalization. To overcome these limitations, we have designed, developed, and clinically evaluated the NuroSleeve, an innovative user-centered UE hybrid orthosis. Methods This study introduces the design, implementation, and clinical evaluation of the NuroSleeve, a user-centered hybrid device that incorporates a lightweight, easy to don and doff 3D-printed motorized UE orthosis and a functional electrical stimulation (FES) component. Our primary goals are to develop a customized hybrid device that individuals with UE neuromuscular impairment can use to perform ADLs and to evaluate the benefits of incorporating the device into occupational therapy sessions. The trial is designed as a prospective, open-label, single-cohort feasibility study of eight-week sessions combined with at-home use of the device and implements an iterative device design process where feedback from participants and therapists informs design improvement cycles. Results All participants learned how to independently don, doff, and use the NuroSleeve in ADLs, both in clinical therapy and in their home environments. All participants showed improvements in their Canadian Occupational Performance Measure (COPM), which was the primary clinical trial outcome measure. Furthermore, participants and therapists provided valuable feedback to guide further development. Conclusions Our results from non-clinical testing and clinical evaluation demonstrate that the NuroSleeve has met feasibility and safety goals and effectively improved independent voluntary function during ADLs. The study’s encouraging preliminary findings indicate that the NuroSleeve has met its technical and clinical objectives while improving upon the limitations of the existing UE orthoses owing to its personalized and flexible approach to hardware and firmware design. Trial Registration: ClinicalTrials.gov identifier: NCT04798378, https://clinicaltrials.gov/ct2/show/NCT04798378 , date of registration: March 15, 2021. |
| first_indexed | 2024-03-09T15:26:30Z |
| format | Article |
| id | doaj.art-9e862459b36148539569c07c3cfc09d5 |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-03-09T15:26:30Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-9e862459b36148539569c07c3cfc09d52023-11-26T12:32:19ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032023-08-0120111910.1186/s12984-023-01228-2The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairmentMehdi Khantan0Mikael Avery1Phyo Thuta Aung2Rachel M. Zarin3Emma Hammelef4Nabila Shawki5Mijail Demian Serruya6Alessandro Napoli7Raphael Center for Neurorestoration, Thomas Jefferson UniversityStudio KreaRaphael Center for Neurorestoration, Thomas Jefferson UniversityRaphael Center for Neurorestoration, Thomas Jefferson UniversityRaphael Center for Neurorestoration, Thomas Jefferson UniversityRaphael Center for Neurorestoration, Thomas Jefferson UniversityRaphael Center for Neurorestoration, Thomas Jefferson UniversityRaphael Center for Neurorestoration, Thomas Jefferson UniversityAbstract Background Active upper extremity (UE) assistive devices have the potential to restore independent functional movement in individuals with UE impairment due to neuromuscular diseases or injury-induced chronic weakness. Academically fabricated UE assistive devices are not usually optimized for activities of daily living (ADLs), whereas commercially available alternatives tend to lack flexibility in control and activation methods. Both options are typically difficult to don and doff and may be uncomfortable for extensive daily use due to their lack of personalization. To overcome these limitations, we have designed, developed, and clinically evaluated the NuroSleeve, an innovative user-centered UE hybrid orthosis. Methods This study introduces the design, implementation, and clinical evaluation of the NuroSleeve, a user-centered hybrid device that incorporates a lightweight, easy to don and doff 3D-printed motorized UE orthosis and a functional electrical stimulation (FES) component. Our primary goals are to develop a customized hybrid device that individuals with UE neuromuscular impairment can use to perform ADLs and to evaluate the benefits of incorporating the device into occupational therapy sessions. The trial is designed as a prospective, open-label, single-cohort feasibility study of eight-week sessions combined with at-home use of the device and implements an iterative device design process where feedback from participants and therapists informs design improvement cycles. Results All participants learned how to independently don, doff, and use the NuroSleeve in ADLs, both in clinical therapy and in their home environments. All participants showed improvements in their Canadian Occupational Performance Measure (COPM), which was the primary clinical trial outcome measure. Furthermore, participants and therapists provided valuable feedback to guide further development. Conclusions Our results from non-clinical testing and clinical evaluation demonstrate that the NuroSleeve has met feasibility and safety goals and effectively improved independent voluntary function during ADLs. The study’s encouraging preliminary findings indicate that the NuroSleeve has met its technical and clinical objectives while improving upon the limitations of the existing UE orthoses owing to its personalized and flexible approach to hardware and firmware design. Trial Registration: ClinicalTrials.gov identifier: NCT04798378, https://clinicaltrials.gov/ct2/show/NCT04798378 , date of registration: March 15, 2021.https://doi.org/10.1186/s12984-023-01228-2AssistiveExoskeletonHand therapyRehabilitationStrokeWearable robotics |
| spellingShingle | Mehdi Khantan Mikael Avery Phyo Thuta Aung Rachel M. Zarin Emma Hammelef Nabila Shawki Mijail Demian Serruya Alessandro Napoli The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairment Journal of NeuroEngineering and Rehabilitation Assistive Exoskeleton Hand therapy Rehabilitation Stroke Wearable robotics |
| title | The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairment |
| title_full | The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairment |
| title_fullStr | The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairment |
| title_full_unstemmed | The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairment |
| title_short | The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairment |
| title_sort | nurosleeve a user centered 3d printed hybrid orthosis for individuals with upper extremity impairment |
| topic | Assistive Exoskeleton Hand therapy Rehabilitation Stroke Wearable robotics |
| url | https://doi.org/10.1186/s12984-023-01228-2 |
| work_keys_str_mv | AT mehdikhantan thenurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT mikaelavery thenurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT phyothutaaung thenurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT rachelmzarin thenurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT emmahammelef thenurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT nabilashawki thenurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT mijaildemianserruya thenurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT alessandronapoli thenurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT mehdikhantan nurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT mikaelavery nurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT phyothutaaung nurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT rachelmzarin nurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT emmahammelef nurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT nabilashawki nurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT mijaildemianserruya nurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment AT alessandronapoli nurosleeveausercentered3dprintedhybridorthosisforindividualswithupperextremityimpairment |