A Columbia Engineering-designed robotic brace that supports the neck during its natural motion is reportedly the first device shown to dramatically assist ALS patients in holding their heads and actively supporting them during range of motion. (Photo courtesy of Haohan Zhang and Sunil K. Agrawal from Columbia Engineering)
Columbia University engineers share details about the neck brace they designed to help patients with Amyotrophic Lateral Sclerosis (ALS) hold their heads up and actively support them during range of motion.
This advance could result in improved quality of life for patients, not only in improving eye contact during conversation, but also in facilitating the use of eyes as a joystick to control movements on a computer, such as what scientist Stephen Hawking did, they suggest.
Designed by a team of engineers and neurologists, led by Sunil Agrawal, professor of mechanical engineering and of rehabilitation and regenerative medicine at Columbia, the brace incorporate both sensors and actuators to adjust the head posture, restoring roughly 70% of the active range of motion of the human head.
Using simultaneous measurement of the motion with sensors on the neck brace and surface electromyography (EMG) of the neck muscles, it also becomes a new diagnostic tool for impaired motion of the head-neck, a media release from Columbia University School of Engineering and Applied Science continues.
Their pilot study was published recently in the Annals of Clinical and Translational Neurology.
The brace also shows promise for clinical use beyond ALS, according to Agrawal, who directs the Robotics and Rehabilitation (ROAR) Laboratory.
“The brace would also be useful to modulate rehabilitation for those who have suffered whiplash neck injuries from car accidents or have from poor neck control because of neurological diseases such as cerebral palsy,” he states, in the release.
“Their neck brace is such an important step in helping patients with ALS, a devastating and rapidly progressive terminal disease,” states Hiroshi Mitsumoto, Wesley J. Howe Professor of neurology at the Eleanor and Lou Gehrig ALS Center at Columbia University Irving Medical Center who, along with Jinsy Andrews, assistant professor of neurology, co-led the study with Agrawal.
“We have two medications that have been approved, but they only modestly slow down disease progression. Although we cannot cure the disease at this time, we can improve the patient’s quality of life by easing the difficult symptoms with the robotic neck brace.”
Dropped head, due to declining neck muscle strength, is a defining feature of ALS, commonly known as Lou Gehrig’s disease. Over the course of their illness, which can range from several months to more than 10 years, patients completely lose mobility of the head, settling in to a chin-on-chest posture that impairs speech, breathing, and swallowing. Current static neck braces become increasingly uncomfortable and ineffective as the disease progresses.
To test this new robotic device, the team recruited 11 ALS patients along with 10 healthy, age-matched subjects. The participants in the study were asked to perform single-plane motions of the head-neck that included flexion-extension, lateral bending, and axial rotation.
The experiments suggest that patients with ALS, even in the very early stages of the disease, use a different strategy of head-neck coordination compared to age-matched healthy subjects. These features are well correlated with clinical ALS scores routinely used by clinicians. The measurements collected by the device can be used clinically to better assess head drop and the ALS disease progression, the release explains.
“In the next phase of our research, we will characterize how active assistance from the neck brace will impact ALS subjects with severe head drop to perform activities of daily life,” adds Agrawal, who is also a member of Columbia University’s Data Science Institute.
“For example, they can use their eyes as a joystick to move the head-neck to look at loved ones or objects around them.”
[Source(s): Columbia University School of Engineering and Applied Science, EurekAlert]
