Single limb cable driven wearable robotic device for upper extremity movement support after traumatic brain injury

INTRODUCTION: Recently, soft exosuits have been proposed for upper limb movement assistance, most supporting single joint movements. We describe the design of a portable wearable robotic device (WRD), “Armstrong,” able to support three degrees-of-freedom of arm movements, and report on its feasibility for movement support of individuals with hemiparesis after traumatic brain injury (TBI). METHODS: We introduce Armstrong and report on a pilot evaluation with two male individuals post-TBI (T1 and T2) and two healthy individuals. Testing involved elbow flexion/extension with and without robotic-assisted shoulder stabilization; shoulder abduction with and without robotic-assisted elbow stabilization; and assisted shoulder abduction and flexion. Outcome measures included range of motion and root mean square trajectory and velocity errors. RESULTS: TBI subjects performed active, passive, hybrid and active assistive movements with Armstrong. Subjects showed improvements in movement trajectory and velocity. T1 benefited from hybrid, active, and assistive modes due to upper extremity weakness and muscle tone. T2 benefited from hybrid and assistive modes due to impaired coordination. Healthy subjects performed isolated movements of shoulder and elbow with minimal trajectory and velocity errors. CONCLUSIONS: This study demonstrates the safety and feasibility of Armstrong for upper extremity movement assistance for individuals with TBI, with therapist supervision.