Wilmington robotic exoskeleton: a novel device to maintain arm improvement in muscular disease

J Pediatr Orthop. 2011 Jul-Aug;31(5):e44-9. doi: 10.1097/BPO.0b013e31821f50b5.


Background: Upper-extremity movement is limited in individuals with muscular weakness. This paper describes a novel, articulated upper-extremity orthosis, the Wilmington Robotic Exoskeleton (WREX), which helps people overcome this movement deficit.

Methods: This prospective, case-controlled study involved an ambulatory patient with arthrogryposis multiplex congenita and 2 nonambulatory patients with spinal muscular atrophy type II. The WREX uses elastic bands to negate the effects of gravity; it allows a person with neuromuscular weakness to move their arm in 3 dimensions. The WREX can be fixed on a brace for ambulatory patients and on the wheelchair for nonambulatory patients. Assessment was performed through motion analysis (with and without the WREX), clinical examination, and qualitative questionnaire.

Results: Motion analysis showed a marked improvement in upper-extremity function with the WREX. The questionnaire illustrated enhanced functionality with the WREX including self-feeding, fine motor control, and use of a television remote control. Enhanced functionality resulted in improved quality of life by increasing participation in school, raising self-esteem, and increasing social interaction. Two unexpected outcomes were increased security with trunk inclination and amelioration of the effects of contractures.

Conclusions: The WREX provided an increase in functionality and improved the quality of life of the patients. The device has become an integral part of the lives of the 3 patients.

Level of evidence: Level III in Therapeutic Studies-Investigating the Results of Treatment.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Arthrogryposis / physiopathology
  • Arthrogryposis / rehabilitation*
  • Child
  • Equipment Design
  • Exercise Therapy / instrumentation*
  • Female
  • Follow-Up Studies
  • Gravitation
  • Humans
  • Male
  • Orthotic Devices*
  • Prospective Studies
  • Quality of Life
  • Recovery of Function / physiology*
  • Robotics / instrumentation*
  • Spinal Muscular Atrophies of Childhood / physiopathology
  • Spinal Muscular Atrophies of Childhood / rehabilitation*
  • Therapy, Computer-Assisted / instrumentation