How could the service delivery process of dynamic arm supports be optimized?

BACKGROUND: The service delivery process of dynamic arm support (DAS) is complex. Obtaining an optimal match between user and DAS depends on a variety of interrelated factors, different professionals are involved, and the market of available solutions is evolving. OBJECTIVE: To determine how the service delivery process of DAS could be optimized. METHODS: Interviews with DAS users that retrospectively focused on the experienced service delivery process, which was compared to the general Dutch prescription guideline. Results were presented in a focus group session to seven DAS consultants, and subsequently verified by a member-check. RESULTS: Sixteen people who considered the Gowing (a DAS new on the market) as a solution and seven DAS consultants participated. Aspects that can be optimized in the current service delivery process included an improved cooperation between clients, professionals and consultants, increased knowledge of DAS in professionals, an embedded user evaluation, and timely delivery. CONCLUSIONS: It is recommended that the service delivery process is optimized by developing a DAS specific prescription framework. The issues identified in this study should be addressed in this framework. For this additional knowledge on how to optimally match persons and DAS is needed

Is it possible to assess the effects of dynamic arm supports on upper extremity range of motion during activities of daily living in the domestic setting using a portable motion capturing device? - A pilot study

BACKGROUND: Understanding how dynamic arm supports affect the ability to perform activities of daily living (ADL) in daily life situations is essential for improved prescription. OBJECTIVE: To determine whether the newly developed MMAAS is a useful tool to assess the RoM at home. Secondly, to investigate differences in RoM and ADL performance with and without dynamic arm support. METHODS: Five dynamic arm support users performed nine activities with and without dynamic arm support at home. A reference group of five participants was included. Shoulder and elbow RoM were assessed for the three most difficult tasks. RESULTS: The measurement of the elbow joint RoM appeared unreliable. In most participants shoulder RoM increased with dynamic arm support, but the magnitude of change differed. Variation was also found regarding whether people could perform ADL with and without support. CONCLUSIONS: In its current state the MMAAS is not regarded a useful tool for assessing the RoM in the domestic setting. The ability to perform ADL and RoM seem influenced by the environment, users' needs and abilities. Future studies investigating effects and benefits of dynamic arm supports should be conducted in a broader daily life context

Comparative study of actuation systems for portable upper limb exoskeletons.

During the last two decades, a large variety of upper limb exoskeletons have been developed. Out of these, majority are platform based systems which might be the reason for not being widely adopted for post-stroke rehabilitation. Despite the potential benefits of platform-based exoskeletons as being rugged and reliable, stroke patients prefer to have a portable and user-friendly device that they can take home. However, the types of actuator as well as the actuation mechanism used in the exoskeleton are the inhibiting factors why portable exoskeletons are mostly non-existent for patient use. This paper presents a quantitative analysis of the actuation systems available for developing portable upper arm exoskeletons with their specifications. Finally, it has been concluded from this research that there are not many stand-alone arm exoskeletons which can provide all forms of rehabilitation, therefore, a generic solution has been proposed as the rehabilitation strategy to get best out of the portable arm exoskeletons