It has been estimated that in the United States spastic hemiplegia cerebral palsy occurs in 1 out every 1000 births. Affected children typically have one hand with compromised positioning and limited function. While they frequently have the ability to initiate grasping and open the fingers, the affected hand is often maintained with a thumb-in-palm pose, compromising their ability to grasp successfully. The longer this situation persists the less the hand is used due to the lack of a learning loop incorporating feedback from successful attempts at grasping. The pattern of disuse contributes to a lack of development of strength and agility for the hand. The inability to successfully use one hand cascades into other issues, including difficulty using mobility devices and performing activities of daily living. The product proposed for development funding is an intelligent active glove orthosis designed to provide wrist, finger and thumb positioning to increase the success of grasping and a prompting function to increase the frequency with which grasping is initiated. The hypothesis is that more frequent attempts at using the hand accompanied by increased success with grasping may result in cortical reorganization which may over time result in an increase in functionality of the affected hand. This in turn may allow increased success in performing activities of daily living and using other assistive technology. The target population i children from 2-10 years old with spastic hemiplegia. The glove will be sized and manufactured using 3-D scanning and 3-D printing, allowing it to be customized to hands of varied shapes and sizes. Current solutions available for children are passive positioning gloves and splints designed to prevent muscle shortening and joint contracture. Such immobilization can impair the development of strength and agility of the hand and contribute to the pattern of disuse. Dynofit, Inc. proposes to build an intelligent active orthotic that fits over the hand and wrist and include a microprocessor, motors, an exoskeletal frame with cables, pressure sensors, and a battery. It uses a cable system to position the wrist, fingers and thumb, as well as to sequence finger and thumb movement to enhance the success of grasping. Periodic movement of the fingers initiated by the glove provides a prompting function to increase awareness of the hand through external mechanical stimulus. The Dynofit development team consists of a biomedical engineer, an electrical engineer, two pediatric orthotists and a rehab medicine doctor with pediatric experience. Phase I will include development of a prototype glove and several focus groups of parents of the target population. A human subject study is planned for Phase II.
Cerebral palsy is the most common motor disability among children1 with spastic hemiplegia cerebral palsy occurring in approximately 1 out every 1000 births the United States.2,3,4,5,6 This is a neuromuscular condition of spasticity that results in the muscles on one side of the body being in a constant state of contraction and is often accompanied by other developmental disabilities. The limited function of the affected hand hinders independent activities of daily living and use of other assistive devices. Currently available orthotics for young children with spastic hemiplegia are passive positioning devices that address muscle contraction and joint contracture but do not assist in successful grasping. Dynofit Inc. proposes to design and build an active intelligent pediatric glove for children 2-10 years old to induce successful grasping of the affected hand and improve the ability to independently conduct activities of daily living and use other mobility devices. This device will b applicable to other target populations with compromised grasping function.