Research scientist Michele Lobo outfits a healthy baby at the Early Learning Center with the P-WREX+.

P-WREX+

Upper-extremity exoskeleton to be modified for infants

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10:02 a.m., Dec. 16, 2013--Watch a very young infant for a few minutes and you’ll see a lot of what looks like random arm flapping.

It turns out that these movements aren’t random at all — they’re a precursor to reaching, mouthing, batting, and banging, all of which teach babies valuable lessons about cause-and-effect relationships and the properties of objects.

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But what happens to children who are born with neurological or muscular deficiencies that prevent or limit this early movement and exploration?

“They’re at risk for future learning disabilities as well as difficulty with basic tasks like feeding and dressing themselves,” says Michele Lobo, research scientist and member of the GoBabyGo team at the University of Delaware.

Most of the baby mobility research in UD’s GoBabyGo project has focused on promoting whole-body movement by allowing children to “drive” robotic devices and modified ride-on racecars. Although Lobo’s work focuses on the upper body, her goal is the same — enabling babies to explore their environment and thereby drive their physical, cognitive, social, and emotional development.

She recently received a grant from the National Institutes of Health to test a novel device for intervention in infants with brain injury. The research team includes experts in rehabilitation engineering, neonatology, and pediatric rehabilitation from UD, Nemours/A.I. duPont Hospital for Children, Christiana Care Health System, and Jefferson Medical College.

“Bioengineered devices for the arms have made significant advances in the rehabilitation of adults with nervous system injury,” Lobo says, “but there’s a surprising lack of adaptation of these devices for use in pediatric populations. This is especially troubling given the importance of early intervention and rehabilitation for optimal neurological and behavioral development.”

The device the team will be testing is an enhanced pediatric version of the commercially available Wilmington Robotic Exoskeleton (WREX). The Pediatric WREX Plus (P-WREX+) can selectively assist or resist antigravity arm movements based on the needs of an individual child. 

In the planned study, 20 infants born with brain injuries and at high risk for significant movement impairments will be followed for two years, with periodic assessments of arm movement and function with and without the P-WREX+. 

“The research has two primary goals, one focused on the device as an assistive tool and the other evaluating its use for rehabilitation,” Lobo says. “First, we want to determine how infants take advantage of the antigravity assistance provided by the P-WREX+ in the short term to improve their arm movement and function. Second, we hope to determine how intervention using the P-WREX+ impacts infants’ arm movement and function over the long term even when they’re not wearing the device.”

About the Grant

The project, titled “An Innovative Device for Intervention in Infants With Nervous System Injury,” is supported by grant number 1R21HD076092-01A1 from the National Institutes of Health.

Article by Diane Kukich

Photos by Kathy F. Atkinson

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