Evaluation of a passive wearable arm ExoNET.

Wearable ExoNETs offer a novel, wearable solution to support and facilitate upper extremity gravity compensation in healthy, unimpaired individuals. In this study, we investigated the safety and feasibility of gravity compensating ExoNETs on 10 healthy, unimpaired individuals across a series of tasks, including activities of daily living and resistance exercises. The direct muscle activity and kinematic effects of gravity compensation were compared to a sham control and no device control. Mixed effects analysis revealed significant reductions in muscle activity at the biceps, triceps and medial deltoids with effect sizes of -3.6%, -4.5%, and -7.2% rmsMVC, respectively, during gravity support. There were no significant changes in movement kinematics as evidenced by minimal change in coverage metrics at the wrist. These findings reveal the potential for the ExoNET to serve as an alternative to existing bulky and encumbering devices in post-stroke rehabilitation settings and pave the way for future clinical trials.

Uncovering clinical rehabilitation technology trends: field observations, mixed methods analysis, and data visualization.

Objective: To analyze real-world rehabilitation technology (RT) use, with a view toward enhancing RT development and adoption. Design: A convergent, mixed-methods study using direct field observations, semi-structured templates, and summative content analysis. Setting: Ten neurorehabilitation units in a single health system. Participants: 3 research clinicians (1OT, 2PTs) observed ∼60 OTs and 70 PTs in inpatient; ∼18 OTs and 30 PTs in outpatient. Interventions: Not applicable. Main Outcome Measures: Characteristics of RT, time spent setting up and using RT, and clinician behaviors. Results: 90 distinct devices across 15 different focus areas were inventoried. 329 RT-uses were documented over 44 hours with 42% of inventoried devices used. RT was used more during interventions (72%) than measurement (28%). Intervention devices used frequently were balance/gait (39%), strength/endurance (30%), and transfer/mobility training (16%). Measurement devices were frequently used to measure vitals (83%), followed by grip strength (7%), and upper extremity function (5%). Device characteristics were predominately AC-powered (56%), actuated (57%), monitor-less (53%), multi-use (68%), and required little familiarization (57%). Set-up times were brief (mean ± SD = 3.8±4.21 and 0.8±1.3 for intervention and measurement, respectively); more time was spent with intervention RT (25.6±15) than measurement RT (7.3±11.2). RT nearly always involved verbal instructions (72%) with clinicians providing more feedback on performance (59.7%) than on results (30%). Therapists' attention was split evenly between direct attention towards the patient during clinician treatment (49.7%) and completing other tasks such as documentation (50%). Conclusions: Even in a tech-friendly hospital, majority of available RT were observed un-used, but identifying these usage patterns is crucial to predict eventual adoption of new designs from earlier stages of RT development. An interactive data visualization page supplement is provided to facilitate this study.