Researchers at the Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, Massachusetts, and Boston Children’s Hospital, Massachusetts, have collaborated in the development of a pediatric exoskeletal thumb orthosis that treats hand weakness caused by cerebral palsy (CP) and stroke. Use of the device as part of an occupational therapy treatment plan may avoid thumb-in-palm deformity and limited hand function that can result without effective treatment, they said.
The device, called the Isolated Orthosis for Thumb Actuation (IOTA), is a two degrees of freedom (2-DOF) thumb exoskeleton that provides assistive support to the carpometacarpal (CMC) and metacarpophalangeal (MCP) joints. The IOTA is actuated through flexible cables that connect to a portable control box and has modes to assist the child with opposition grasp and fine motor control. The device can also allow clinicians to remotely monitor its usage and performance.
A team of engineers and occupational and physical therapists designed the IOTA to focus its assistive properties on the thumb joints as a key component of grasping, and to be small enough to leave the palm open, allowing children to grasp and interact with objects. Existing devices are often made to assist the hand as a whole and could cover large parts of the hand and palm, interfering with the child’s ability to manipulate objects. This iteration of the device fits children six to 16 years old.
“Even when devices are made for the pediatric population, they are often made for older teenagers and are created by simply making an adult device smaller,” Annette Correia, OT, told Vector, the Boston Children’s Hospital science and clinical innovation blog. “What’s exciting is that we had the opportunity to make a device specifically for children that is consistent with their developmental needs.
Fifteen patients at Boston Children’s Hospital are currently participating in a pilot clinical study of the IOTA. Five of those patients will be observed for six weeks as they use the device at home and in the hospital, according to Vector.
The IOTA was first introduced in a paper delivered in June 2013 at the Institute of Electrical and Electronics Engineers (IEEE) International Conference on Rehabilitation Robotics (ICORR).