Development and initial evaluation of the Playskin AirTM pneumatic exoskeletal garment
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of Delaware
Abstract
For children with upper extremity disabilities, performing antigravity arm movement can be a very difficult task. This can limit participation and performance of daily living activities. Most of the existing exoskeletons on the market are bulky, heavy, and unattractive, which can lead to low rates of utilization. Therefore, there is a critical need to design novel exoskeletons that address users’ broad needs. The purpose of this dissertation was to develop and evaluate a pediatric soft pneumatic exoskeleton to improve range of motion, function, and the performance of daily activities for children who have UE disabilities. ☐ Aim 1 consisted of a systematic review of the evidence on the effectiveness of UE exoskeletons and robot-assisted devices for pediatric rehabilitation. Sixty articles were included. Most evaluated body structure and function and activity effects with less emphasis on participation. Most effects were positive. Devices were primarily evaluated in clinical or laboratory, rather than natural, environments. Users had numerous negative perceptions about the devices. A need for increased rigor in research study design was detected. Across populations, devices, settings, interventions, and dosing schedules, UE exoskeletons and robot-assisted devices may improve function, activity, and perhaps participation for children with physical disabilities. ☐ Aim 2 involved the development and comparative evaluation of pneumatic actuators for the Playskin AirTM. Textile pneumatic actuators were developed and evaluated with the goal of providing full assistance to lift the arm of a model of an 11-year-old male beyond 120 degrees of shoulder abduction. Two fabrics and a variety of sealing techniques, methods of attachment, and actuator shapes were comparatively evaluated using textile and functional tests. The results identified that both fabrics and one of the three sealing techniques were effective for creating air-tight, functional actuators. Actuators were more effective when the bands attaching them were closer to the axilla. Rectangular and wing-shaped actuators, both lifting the model’s arm above 120 degrees of abduction, were more effective than Y-shaped actuators. The results showed that multiple designs and materials may be acceptable for building textile pneumatic actuators to lift the full weight of a child’s arm. ☐ Aim 3 consisted of the design and development of the first pediatric pneumatic exoskeletal garment aimed at enhancing arm mobility for children with UE movement impairments. The two parts for Aim 3 were an interview and the exoskeletal garment design. ☐ For the Aim 3 interview, A qualitative study design involving an in-depth, semi-structured interview was performed with families able to communicate in English and with at least one child 3-16 years of age who reportedly needs help lifting and holding up their arm(s). Responses were analyzed using NVivo qualitative data analysis software (QSR International Pty Led.). Twenty-two parents and 12 children with UE disability among 21 families were interviewed. Child participants were 3-15 years old (Mean=8.1, S.D.=4.1). Families identified key personal care, function and mobility, manual interaction, academic, recreation, and social activities they would like devices to support. Families rated a variety of functional, expressive, aesthetic, and accessibility needs for exoskeletons in terms of relative importance. Families pointed out that their current UE wearable assistive devices are better at meeting some functional needs than they are at meeting other needs. Finally, families discussed their suggestions for the design of future exoskeletons, including preferences for attachment mechanisms, fasteners, and control systems. ☐ In the Aim 3 exoskeletal garment design, the researcher successfully developed a design for the novel, soft, pneumatic exoskeletal garment, the Playskin AirTM, aimed at supporting shoulder abduction for children with UE disabilities. The exoskeleton was evaluated on the model of an 11-year old male, where it was shown to successfully lift the arm greater than 120 degrees into shoulder abduction. This design along with the prototype of a control system allowing for user control were preliminarily evaluated on a healthy 11-year-old male. ☐ Aim 4 involved initial evaluation of the feasibility, utility, and assistive effects of the novel soft exoskeleton, Playskin AirTM, in a child with UE weakness due to spinal muscular atrophy (SMA). Three participants were evaluated, but the device was not deemed useful by two of those participants, their families, and the research team; the device was not supportive enough for one child whose weakness was severe, and the device was not helpful for a child whose weakness was minimal. The participant who benefitted from the device was a 7-year-old male with SMA type 2. The child had limited UE Range of Motion (ROM) and weakness in both arms. Wearing the exoskeleton improved the child’s active ROM for shoulder abduction, helped the child complete a variety of manual tasks more quickly, but only after practice with the exoskeleton, and improved the child’s participation. Contrarily, no assistive effects were found in terms of quality of UE movement in the current case study. Importantly, the exoskeleton was feasible for the family to use several days each week in the home environment and the child and his parents had very positive perceptions about the exoskeleton across a variety of factors.
Description
Keywords
Exoskeleton, Interview, Pediatric, Wearable