Symptoms due to pathology of the neck are among the most common complaints that patients bring to the attention of neurologists and physiatrists. In this Pilot study we propose to develop two variants of a motion capable neck brace to serve these clinical situations. First, we will build and improve a neck brace for ALS patients with severe neck weakness. The inability to hold up the head not only decreases the quality of life, it can also decrease airway protection leading to the most common cause of death in ALS patients. The novel device will allow the patient to control the position of the head that is optimal for each activity. Secondly, we will develop a highly adjustable neck brace for the management of neck pain and cervical radiculopathy, two of the most common presenting symptoms in the neurology clinic. This neck brace can also be used for patients at risk for cervical cord compression but who are not surgical candidates. The novel device will provide increased stability, potential for traction, and the ability to easily adjust neck position. This Pilot study seeks to determine safety and tolerability and to identify potential benefits. Demonstration of safety, tolerability, and potentil benefits will allow full clinical trials for each of the devices. If successful these studies will provide a much need prostheses for a relatively neglected but important area of neural rehabilitation.
Military personnel who were deployed to the Gulf Region during the Gulf War period experience a greater risk of developing amyotrophic lateral sclerosis (ALS) (Haley, 2003; Horner et al., 2003; Weisskopf et al., 2005). The VA has designated ALS as a priority for research and treatment. Neck weakness resulting in a persistent head drop becomes common at the late stages of ALS. Head drop greatly decrease the quality of life and can lead to increased risk for compromised airway. This is an imminently treatable condition. The neck is almost always injured during blast injuries sufficient to cause TBI. Thus, rehabilitation of neck injury should b priority for the VA. In addition, neck pain is one of the most common conditions that bring veterans to the outpatient neurology clinic. Both of these conditions can potentially be treated effectively with the relative simple and inexpensive technology being developed in this proposal.
