The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairment.

Publisher: BioMed Central Country of Publication: England NLM ID: 101232233 Publication Model: Electronic Cited Medium: Internet ISSN: 1743-0003 (Electronic) Linking ISSN: 17430003 NLM ISO Abbreviation: J Neuroeng Rehabil Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2004-

Activities of Daily Living* ; Stroke Rehabilitation*/methods; Humans ; Canada ; Orthotic Devices ; Printing, Three-Dimensional ; Prospective Studies ; Upper Extremity ; Feasibility Studies

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.
(© 2023. BioMed Central Ltd., part of Springer Nature.)

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Keywords: Assistive; Exoskeleton; Hand therapy; Rehabilitation; Stroke; Three dimensional (3D) printed active orthoses; Upper extremity impairment; Wearable robotics

ClinicalTrials.gov NCT04798378

Date Created: 20230804 Date Completed: 20230815 Latest Revision: 20231122

20231215

PMC10403889

10.1186/s12984-023-01228-2

37542335