G.P.99 : The Wilmington Robotic Exoskeleton (WREX) improves upper extremity function in patients with Duchenne muscular dystrophy

Abstract

Non-ambulatory patients with Duchenne muscular dystrophy (DMD) have arm weakness limiting anti-gravity movement resulting in severe functional impairments. The Wilmington Robotic Exoskeleton (WREX), by employing a unique 4bar link technology married with a variable linear elastic band power source, allows for 3 dimensional gravity reduced movement of the arms to enhance function for the completion of Activities of Daily Living (ADL). To establish the utility of WREX in patients with DMD, we report our experience from 2011 to 2014. Nine boys with DMD, aged 11–17y/o (median age 16y/o), were evaluated. Active range of motion (AROM) and functional task completion (self-feeding, drinking from a glass, access to face for grooming, manage eyeglasses, and access their environment, computer, cell phone, and other technology) were completed both with and without the WREX. AROM (without WREX/with WREX) was the following: shoulder flexion 0–30 degrees/45–100 degrees, shoulder abduction 0–30 degrees/45–100 degrees, and elbow flexion was 0–100 degrees/80–120 degrees. With the WREX, all patients demonstrated increased functional skills, especially the ability to self-feed, access joystick, access face for grooming, and reach away from the body to use technology. We conclude WREX provides a decreased gravity environment that allows for significant increased AROM at the shoulder and elbow joints. In addition, WREX allows for the patients to reach away from the body and across midline, improved independence with ADL completion, as well as increased safety in the home and community. WREX may also improve psychosocial wellbeing as all patients demonstrated a positive emotional response to WREX use.