Enhanced Functionality Using a Powered Upper Extremity Exoskeleton in Patients With Brachial Plexus Injuries

Traumatic brachial plexus injury (BPI) results in significant disability, often hindering functionality in the patient’s daily life. Post- surgery, muscle strength recovery can take up to two years, with 40% of patients requiring even longer. A powered elbow orthosis can enhance functionality during activities of daily living (ADLs). This study tested a novel powered myoelectric elbow orthosis (PMEO) during ADLs. Subjects with BPI were fitted with the PMEO and divided into two groups: more impaired (Manual Muscle Test (MMT) < 3, N = 5) and less impaired (MMT≤ 3, N = 4). They performed four ADLs involving full elbow motion, including an activity requiring the subjects to lift a basket with weights. Upper extremity kinematics, electromyographic activity, weight lifted, and subject feedback on the device’s form and fit were collected and analyzed. Results showed that the PMEO significantly improved elbow range of motion in the more impaired group (14 ± 23 degrees, p = 0.019) without any additional compensatory motions in the shoulder or trunk. More impaired subjects lifted an average of 1.1 ± 0.6 kg with the PMEO, whereas they could not do so without it (p = 0.011). Subjects appreciated the PMEO’s weight, fit, and form. All could don and doff the device with minimal assistance. These findings demonstrate that the PMEO is a viable option to enhance ADL function for patients with BPI.