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Implementation, testing and pilot clinical evaluation of superelastic splints that decrease joint stiffness.

Simone Pittaccio¹, L Garavaglia, S Viscuso

¹Institute for Energetics and Interphases, National Research Council of Italy (CNR), Corso Promessi Sposi 29, 23900, Lecco, Italy. s.pittaccio@ieni.cnr.it

Annals of Biomedical Engineering

|June 25, 2013

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Customized shape memory alloy (SMA) splints effectively treat pediatric spastic paresis by reducing joint stiffness. These innovative pseudoelastic devices offer postural control without limiting limb mobility, improving rehabilitation outcomes.

Area of Science:

Biomedical Engineering
Materials Science
Rehabilitation Medicine

Background:

Spastic paresis in pediatric patients often requires long-term management with bracing.
Traditional splints can be rigid, potentially hindering residual limb mobility and causing discomfort.
Shape memory alloys (SMAs) offer unique properties for dynamic assistive devices.

Purpose of the Study:

To demonstrate the efficacy of customized shape memory alloy (SMA) splints for treating pediatric spastic paresis.
To investigate the potential of SMA pseudoelasticity in corrective postural action without impeding voluntary movement.
To evaluate the mechanical stability and clinical effectiveness of SMA-based rehabilitation devices.

Main Methods:

Designing and constructing SMA hinges using NiTi or NiTiNb elements for elbow and ankle splints.

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Conducting mechanical testing to assess device stability and durability over repeated cycles and deflections.

Prescribing patient-specific pseudoelastic splints to 25 pediatric patients with spastic tetraparesis for crossover trials.

Main Results:

SMA splints exhibited complete mechanical stability after 20-100 cycles and unchanged characteristics after 1000 deflections.
Compared to fixed-angle braces, pseudoelastic devices significantly decreased passive joint stiffness.
The SMA splints provided equivalent control of limb posture while allowing for residual mobility.

Conclusions:

Customized SMA composition, thermo-mechanical treatment, and shaping enable effective rehabilitation devices for pediatric spastic paresis.
Pseudoelastic SMA hinges offer a novel approach to reduce joint stiffness and improve outcomes in spasticity management.
Dynamic pseudoelastic braces represent an innovative treatment for spastic paresis, enhancing patient mobility and comfort.