Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Augspurger Komm Engineering, Inc., Phoenix, AZ 85040, USA.
Mil Med. 2024 Aug 19;189(Suppl 3):585-591. doi: 10.1093/milmed/usae196.
Recovering from neuromuscular injuries or conditions can be a challenging journey that involves complex surgeries and extensive physical rehabilitation. During this process, individuals often rely on orthotic devices to support and enable movement of the affected limb. However, users have criticized current commercially available powered orthotic devices for their bulky and heavy design. To address these limitations, we developed a novel powered myoelectric elbow orthosis.
The orthosis incorporates 3 mechanisms: a solenoid brake, a Bowden cable-powered constant torque elbow mechanism, and an extension limiter. The device controller and battery are in a backpack to reduce the weight on the affected arm. We performed extensive calculations and testing to ensure that the orthosis could withstand at least 15 Nm of elbow torque. We developed a custom software effectively control the orthosis, enhancing its usability and functionality. A certified orthotist fitted a subject who had undergone a gracilis free functioning muscle transfer surgery with the device. We studied the subject under Mayo clinic IRB no. 20-006849 and obtained objective measurements to assess the orthosis's impact on upper extremity functionality during daily activities.
The results are promising since the orthosis significantly improved elbow flexion range of motion by 40° and reduced compensatory movements at the shoulder (humerothoracic joint) by 50°. Additionally, the subject was able to perform tasks which were not possible before, such as carrying a basket with weights, highlighting the enhanced functionality provided by the orthosis.
In brief, by addressing the limitations of existing devices, this novel powered myoelectric elbow orthosis offers individuals with neuromuscular injuries/conditions improved quality of life. Further research will expand the patient population and control mechanisms.
从神经肌肉损伤或疾病中恢复可能是一个充满挑战的过程，涉及复杂的手术和广泛的物理康复。在此过程中，患者通常依赖矫形器来支撑和实现受影响肢体的运动。然而，患者对当前市场上商用的动力矫形器笨重且沉重的设计提出了批评。为了解决这些限制，我们开发了一种新型的电动肌电肘矫形器。
该矫形器包含 3 个机构：螺线管制动器、鲍登电缆驱动的恒扭矩肘机构和延伸限位器。设备控制器和电池置于背包中，以减轻受影响手臂的重量。我们进行了广泛的计算和测试，以确保矫形器能够承受至少 15Nm 的肘扭矩。我们开发了定制软件，有效地控制矫形器，提高其可用性和功能性。一位经过认证的矫形师为一位接受过游离股薄肌功能性肌肉转移手术的患者安装了该设备。我们在梅奥诊所 IRB 号 20-006849 下对该患者进行了研究，并获得了客观测量值，以评估矫形器在日常活动中对上肢功能的影响。
结果令人鼓舞，因为矫形器显著改善了 40°的肘弯曲运动范围，并减少了肩部（胸锁关节）的代偿运动 50%。此外，患者能够完成以前不可能完成的任务，如携带装有重物的篮子，突出了矫形器提供的增强功能。
总之，通过解决现有设备的局限性，这种新型电动肌电肘矫形器为神经肌肉损伤/疾病患者提供了更好的生活质量。进一步的研究将扩大患者群体和控制机制。
