Northwestern University Feinberg School of Medicine

Northwestern University Prosthetics-Orthotics Center

Functional Assistance Provided by Myoelectric Elbow-wrist-hand Orthoses (FAME)

Co-Principal Investigators: Stefania Fatone, PhD, BPO(Hons), and Elliot Roth, MD

Study Coordinator: Jessica Yohay

Occupational Therapist: Caitlin Doman, OTR

Funded by: Myomo Inc.

Status: In Progress This project is part of a multi-site study led by Stephen J. Page, PhD, The Ohio State University. 

Introduction

Of the 5.7 million stroke survivors living in the U.S., the majority exhibits significant weakness in one upper extremity. This devastating impairment undermines performance of valued activities and diminishes quality of life. While many promising upper extremity rehabilitative strategies have been developed, most are only efficacious in mildly impaired individuals. In contrast, survivors exhibiting moderate upper extremity impairment constitute a larger proportion of the stroke population, yet exhibit little to no active movement in their paretic wrists and fingers; and limited active proximal movements. These diminished movement capabilities hamper participation in therapies that emphasize repetitive task practice. Hence, device-oriented approaches have been explored to facilitate increased movement capability in moderately to severely impaired stroke survivors. For example, sophisticated robotic systems have been developed to evaluate and treat patients who have sustained strokes; but the cost and complexity of these systems, as well as their size, limit their applicability in the clinical and home environments. A device that is compact, relatively easy to use, capable of capturing the interest of the user, and easily integrated into valued activities could potentially meet this need.

MyoPro 2 Motion G Device

MyoPro 2 Motion-G (Myomo Inc., Cambridge, MA)The MyoPro 2 Motion-G (Myomo Inc., Cambridge, MA, USA) is a custom-fabricated myoelectric upper limb orthosis. It uses surface electromyography (EMG) signals from affected muscle groups to provide powered proportional assistance for elbow flexion and extension and gross grasp motions via motors attached to the exterior of the orthosis. It functions by continuously monitoring the surface EMG signals of the user’s biceps and triceps muscles for elbow motion; and the forearm flexor and extensor muscle groups for grasp motion. These signals are filtered and processed to provide a desired joint torque proportional to the effort that is exerted by the user.

Objective

The primary study objective is to compare upper extremity movement while wearing 1) the MyoPro 2 Motion-G; 2) a resting hand splint; and 3) no device among stroke survivors with moderate upper extremity dysfunction. During the study, subjects will undergo a short period of general training in the operation of the two orthotic devices and be guided through a series of standard clinical outcome measures. The entire study will enroll 75 stroke subjects (16 at Northwestern University).

Specific Aims

Specific Aim 1: Determine the impact of the MyoPro 2 Motion-G myoelectric brace on affected upper extremity movement using the upper extremity section of the Fugl-Meyer Scale. 
Specific Aim 2: Determine the impact of the MyoPro 2 Motion-G myoelectric brace on affected upper extremity outcomes using a battery of functional tasks and the Box and Block Test (B&B).