Alberts Lonneke, Voet Nicole, Janssen Mariska
Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
Klimmendaal, Rehabilitation Center, Arnhem, The Netherlands.
Disabil Rehabil Assist Technol. 2025 Apr;20(3):552-561. doi: 10.1080/17483107.2024.2388284. Epub 2024 Sep 12.
Due to progressive muscle wasting and weakness in patients with Duchenne Muscular Dystrophy (DMD), physical fatigability increases, upper extremity function reduces, which negatively impacts quality of life. Assistive technology such as dynamic arm supports (DAS) may help reduce this fatigability. This study aims to assess whether the novel Yumen 'EXone' DAS can reduce upper extremity fatigue and fatigability in DMD patients and healthy controls (HC), both with and without the DAS. Additionally, longitudinal changes in DMD patients were evaluated.
Five DMD patients from the Yumen Bionics pioneer program and five HCs participated. Two submaximal tests simulating drinking and reaching were performed for two minutes, each with and without DAS. DMD participants completed these tests twice, at baseline (T0) and after 6-9 months (T1), while HCs completed them once. Physical fatigability was measured by the number of repetitions and changes in surface electromyography (sEMG) amplitude. Subjective fatigue was assessed using the Borg Scale (6-20) Rate of Perceived Exertion (RPE).
DMD participants generally performed more repetitions with the DAS than without. HCs showed similar or increased repetitions with the DAS. Assessing fatigability with sEMG was difficult due to the compensatory mechanisms used for the tests. Subjective fatigue scores on the Borg Scale were lower with the DAS for both DMD patients and HCs.
The Yumen 'EXone' DAS effectively reduces both fatigue and fatigability in DMD patients and healthy controls. Despite the methodological shortcomings, this research is one of the first studies investigating the impact of DAS on fatigue and fatigability.
由于杜氏肌营养不良症（DMD）患者存在进行性肌肉萎缩和无力，身体易疲劳性增加，上肢功能下降，这对生活质量产生了负面影响。诸如动态手臂支撑（DAS）等辅助技术可能有助于减轻这种易疲劳性。本研究旨在评估新型玉门“EXone”DAS能否减轻DMD患者和健康对照者（HC）在使用和不使用DAS情况下的上肢疲劳和易疲劳性。此外，还评估了DMD患者的纵向变化。
来自玉门仿生先锋项目的5名DMD患者和5名HC参与了研究。进行了两项模拟饮水和伸手动作的次最大测试，每次测试持续两分钟，分别在使用和不使用DAS的情况下进行。DMD参与者在基线期（T0）和6 - 9个月后（T1）完成这两项测试各两次，而HC仅完成一次。通过重复次数和表面肌电图（sEMG）振幅变化来测量身体易疲劳性。使用Borg量表（6 - 20）主观用力感觉评分（RPE）来评估主观疲劳。
DMD参与者在使用DAS时通常比不使用时能完成更多的重复次数。HC在使用DAS时重复次数相似或增加。由于测试中使用了代偿机制，用sEMG评估易疲劳性存在困难。对于DMD患者和HC，使用DAS时Borg量表上的主观疲劳评分均较低。
玉门“EXone”DAS能有效减轻DMD患者和健康对照者的疲劳和易疲劳性。尽管存在方法学上的不足，但本研究是首批调查DAS对疲劳和易疲劳性影响的研究之一。
