VP.19 Rehab Robo: A high sensitivity patient outcome tracking and physical exercise tool for spinal muscular atrophy

Abstract

In the advent of novel disease altering therapies targeting Spinal Muscular Atrophy (SMA), there is a need for appropriate outcome measures that provide higher sensitivity in tracking patient strength and function while undergoing treatment alongside a need for conjunctive rehabilitation and exercise to promote drug efficacy. ATDev is developing Rehab Robo (RR) to address the gaps in patient outcome tracking and access to rehabilitation and exercise. RR is a telehealth enabled exoskeleton that can provide assistive and resistive forces to a single joint while collecting key biomechanical metrics. Embedded sensors in the device can objectively measure range of motion (ROM) and applied torque (strength) as patients complete various exercises and activities of daily living. Each RR device consists of a base unit, which can be reused by multiple patients, and patient specific interfaces, which are custom 3D printed to match a patient's unique anatomy. The patient specific design allows even the most severely contracted or weak individuals with SMA to use RR. The bespoke design also naturally improves the biomechanical alignment of the device, thereby increasing the accuracy of ROM and strength data and enabling reliable, remote patient monitoring. Benchtop data collection with RR shows an extremely low minimal detectable change and intra-rater reliability compared to industry standard devices for ROM and isometric strength, 0.0219° MDC, 0.99 ICC and 1.15Nmm, 0.98 ICC respectively. In preliminary human subject testing (n=1) the device measured an SMA Type 2 patient's ROM within 2.13° of a goniometer over 9 repeated measurements. The device also detected repeatable bicep flexion torques of 25Nmm. Future human subject testing will be completed in conjunction with Dr. Tina Duong, DPT throughout 2022. Product development of RR is conducted by Assistive Technology Development, Inc. (ATDev) and is supported by a NIDILRR SBIR Phase 1 grant.