Swiss Children's Rehab - Research Department, University Children's Hospital Zurich, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland.
Children's Research Center, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
J Neuroeng Rehabil. 2022 Feb 11;19(1):17. doi: 10.1186/s12984-022-00994-9.
Children and adolescents with upper limb impairments can experience limited bimanual performance reducing daily-life independence. We have developed a fully wearable pediatric hand exoskeleton (PEXO) to train or compensate for impaired hand function. In this study, we investigated its appropriateness, practicability, and acceptability.
Children and adolescents aged 6-18 years with functional limitations in at least one hand due to a neurological cause were selected for this cross-sectional evaluation. We characterized participants by various clinical tests and quantified bimanual performance with the Assisting Hand Assessment (AHA). We identified children whose AHA scaled score increased by ≥ 7 points when using the hand exoskeleton and determined clinical predictors to investigate appropriateness. The time needed to don each component and the number of technical issues were recorded to evaluate practicability. For acceptability, the experiences of the patients and the therapist with PEXO were evaluated. We further noted any adverse events.
Eleven children (median age 11.4 years) agreed to participate, but data was available for nine participants. The median AHA scaled score was higher with PEXO (68; IQR: 59.5-83) than without (55; IQR: 37.5-80.5; p = 0.035). The Box and Block test, the Selective Control of the Upper Extremity Scale, and finger extensor muscle strength could differentiate well between those participants who improved in AHA scaled scores by ≥ 7 points and those who did not (sensitivity and specificity varied between 0.75 and 1.00). The median times needed to don the back module, the glove, and the hand module were 62, 150, and 160 s, respectively, but all participants needed assistance. The most critical failures were the robustness of the transmission system, the electronics, and the attachment system. Acceptance was generally high, particularly in participants who improved bimanual performance with PEXO. Five participants experienced some pressure points. No adverse events occurred.
PEXO is a safe exoskeleton that can improve bimanual hand performance in young patients with minimal hand function. PEXO receives high acceptance. We formulated recommendations to improve technical issues and the donning before such exoskeletons can be used under daily-life conditions for therapy or as an assistive device. Trial registration Not appropriate.
上肢功能障碍的儿童和青少年可能会出现双手活动能力受限，从而降低日常生活独立性。我们研发了一款全可穿戴式儿科手部外骨骼（PEXO），用于训练或补偿受损的手部功能。本研究旨在评估其适宜性、实用性和可接受性。
本研究纳入了因神经原因导致至少一只手存在功能障碍的 6-18 岁儿童和青少年患者，进行了这项横断面评估。我们通过各种临床测试对参与者进行了特征描述，并使用辅助手评估（Assisting Hand Assessment，AHA）对双手活动能力进行了量化。我们确定了使用手部外骨骼后 AHA 评分增加≥7 分的儿童，并确定了临床预测指标，以探讨其适宜性。记录佩戴每个组件所需的时间和出现的技术问题数量，以评估其实用性。为了评估可接受性，我们评估了患者和治疗师对 PEXO 的体验。我们还记录了任何不良事件。
共有 11 名儿童（中位年龄 11.4 岁）同意参与，但其中 9 名参与者的数据可用于分析。使用 PEXO 时，AHA 评分中位数较高（68；IQR：59.5-83），而不使用 PEXO 时评分较低（55；IQR：37.5-80.5；p=0.035）。Box 和 Block 测试、上肢选择性控制量表和手指伸肌肌力可以很好地区分 AHA 评分增加≥7 分和未增加≥7 分的参与者（灵敏度和特异性在 0.75 到 1.00 之间变化）。佩戴背部模块、手套和手部模块所需的中位时间分别为 62、150 和 160 秒，但所有参与者均需要帮助。最关键的故障是传动系统、电子设备和连接系统的稳定性。总体而言，接受度较高，尤其是在使用 PEXO 提高双手活动能力的参与者中。5 名参与者出现了一些压痛点。无不良事件发生。
PEXO 是一种安全的外骨骼，可改善手部功能极小的年轻患者的双手活动能力。PEXO 受到高度认可。我们提出了一些建议，以改进技术问题和佩戴流程，为外骨骼在日常生活条件下用于治疗或辅助设备做好准备。
不适用。
