Use of the Wilmington Robotic Exoskeleton to Improve Upper Extremity Function in Patients With Duchenne Muscular Dystrophy

Timothy Estilow; Allan M Glanzman; Kacy Powers; Ashley Moll; Jean Flickinger; Līvija Medne; Gihan Tennekoon; Sabrina W Yum

doi:10.5014/ajot.2018.022939

Use of the Wilmington Robotic Exoskeleton to Improve Upper Extremity Function in Patients With Duchenne Muscular Dystrophy

Am J Occup Ther. 2018 Mar/Apr;72(2):7202345010p1-7202345010p5. doi: 10.5014/ajot.2018.022939.

Authors

Timothy Estilow¹, Allan M Glanzman², Kacy Powers³, Ashley Moll⁴, Jean Flickinger⁵, Līvija Medne⁶, Gihan Tennekoon⁷, Sabrina W Yum⁸

Affiliations

¹ Timothy Estilow, OTR/L, is Occupational Therapist, Occupational Therapy Department, Children's Hospital of Philadelphia, Philadelphia, PA; estilow@e-mail.chop.edu.
² Allan M. Glanzman, DPT, PCS, is Physical Therapy Clinical Specialist, Physical Therapy Department, Children's Hospital of Philadelphia, Philadelphia, PA.
³ Kacy Powers, MS, CPO, is Orthotist, Pediatric Orthotic Team, Orthologix, Trevose, PA.
⁴ Ashley Moll, MS, OTR/L, is Occupational Therapist, Occupational Therapy Department, Children's Hospital of Philadelphia, Philadelphia, PA.
⁵ Jean Flickinger, DPT, PCS, is Physical Therapist, Physical Therapy Department, Children's Hospital of Philadelphia, Philadelphia, PA.
⁶ Līvija Medne, MS, CGC, is Senior Genetic Counselor and Codirector, Roberts Individualized Medical Genetics Center, Children's Hospital of Philadelphia, Philadelphia, PA.
⁷ Gihan Tennekoon, MD, is Attending Neurologist, Neurology Department, Children's Hospital of Philadelphia, PA, and Professor of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
⁸ Sabrina W. Yum, MD, is Pediatric Neurologist, Neurology Department, Children's Hospital of Philadelphia, PA, and Assistant Professor of Clinical Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

PMID: 29426391
DOI: 10.5014/ajot.2018.022939

Abstract

Patients with Duchenne muscular dystrophy in their second decade of life present with decreased upper extremity strength and active range of motion (AROM) that limit activities of daily living (ADLs). We evaluated the ability of the Wilmington Robotic Exoskeleton (WREX) to improve AROM and independence with ADLs. A retrospective chart review of 9 patients who trialed the WREX was performed. Patients were classified on the basis of the Brooke Upper Extremity Scale. AROM, strength, and independence with ADLs were assessed before and after a WREX trial. Patients demonstrated increased shoulder flexion and abduction (25°-100°, median = 55°) and elbow flexion (10°-110°, median = 60°). Increased independence with self-feeding, item retrieval, use of phones and tablets, and facial grooming were noted. The WREX allowed for gravity-reduced movement via elastic bands to unweight the upper extremity, enabling increased upper extremity active movement that supported increased independence with ADLs.