Exoskeleton Assists Children with Cerebral Palsy Walk More Easily

A team of researchers from the National Institutes of Health (NIH) Clinical Center have revealed an exoskeleton prototype that assists children with cerebral palsy (CP) walk more easily. Cerebral palsy affects mobility and is the most common childhood movement disorder. Half of children with CP become unable to walk by the time they reach adulthood. There is currently no cure for CP, though patients have seen improved motor skills with supportive therapies, medication, and surgery. The team hopes that their less invasive and high-tech solution will empower children with mobility difficulties. The team published an article on their technology in Science Translational Medicine this past August. Thomas Bulea, staff scientist in the Center's Rehabilitation Medicine Department and lead author of the study, wrote, “Most of the children were pretty excited to feel the way that this device changed how they walked, more striking was the reaction we saw on a lot of the parents' faces. Several, if not most of them, expressed surprise at the visible effects of the exoskeleton during walking."

 

Their study included children with cerebral palsy ages five to nineteen who all experienced difficulties with excessive knee flexion due to their crouch gait. Six of the seven children displayed walking improvements with the exoskeleton similar to those seen with orthopedic surgery in a period of eight to twelve weeks. Diane Damiano, chief of the Functional and Applied Biomechanics section in the NIH Clinical Center's Rehabilitation Medicine Department and a co-author of the study wrote, “Our exoskeleton provides assistance to improve upright posture when worn while still requiring the person to control their own muscles and stability. Children with cerebral palsy have a physical disability that persists their entire life, so they need to be continuously monitoring and working to maintain their motor functioning as part of their everyday lives. Wearable devices could provide a novel mechanism to do this."

 

The team hopes to continue their research and test the exoskeleton on more children with mobility impairments. There also remain questions about the prolonged use of the device, such as the device accommodating the growth of the child.  About this future research, Bulea wrote, “The big question that we're looking to answer going forward is, how do these improvements in walking and muscle activity that we see with the exoskeleton affect their walking in the long term? How does it, or does it, change their walking pattern when they're not using the exoskeleton? And that's a question that is still very much open. We're still a long way off from this being a commercially available product. We're excited by the promise that this initial study showed, but we still have to do more studies to establish the effectiveness of this as a rehabilitation device.” 

 

Steven Collins, Associate Professor of Mechanical Engineering at Stanford University commented on this study, saying, "In the future, I expect we will see more and more exoskeletons like this used in children's medicine. Exoskeletons are versatile and controllable, so they can adapt alongside their users. In some cases, this may make them better than surgery." Technology that adapts to its user dynamically is growing as designers and researchers make their devices suited to the diverse needs of their clients. The NIH’s exoskeleton is one of the most recent examples of this trend. Source: Jacqueline Howard, CNN; Lerner and colleagues, Science Translational Medicine.