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Using a robotic exoskeleton at home: An activity tolerance case study of a child with spinal muscular atrophy
Elena Garces1, Gonzalo Puyuelo2, Iván Sánchez-Iglesias3
1Marsi Bionics S.L., Calle Marie Curie 19, 28521 Rivas Vaciamadrid, Madrid, Spain; University of Alcalá, Pza. San Diego, s/n, 28801 Alcalá de Henares, Madrid, Spain.
Insights
A pediatric gait exoskeleton improved activity tolerance and functional outcomes in a child with Spinal Muscular Atrophy (SMA) Type II. This case study highlights the potential of exoskeleton technology for children with neuromuscular diseases.
Area of Science:
- Neurology
- Rehabilitation Engineering
- Pediatric Nursing
Background:
- Spinal Muscular Atrophy (SMA) Type II is a progressive neurodegenerative disease causing muscle weakness, impacting mobility and respiratory function in children.
- Current management focuses on supportive care, with limited options to enhance functional independence and activity tolerance.
Observation:
- A 6-year-old boy with SMA Type II and respiratory failure participated in a 2-month home-based trial using a pediatric gait exoskeleton.
- Nursing assessments, including interviews, performance observation, vital signs monitoring, fatigue assessment, and functional scales, were conducted before and during exoskeleton use.
Findings:
- The child demonstrated good activity tolerance and improved performance with the exoskeleton over time.
- Vital signs remained stable during exoskeleton use, and perceived fatigue decreased.
- The child achieved higher scores on select functional outcome measures.
Implications:
- This study provides initial nursing insights into the efficacy of exoskeleton technology for children with SMA Type II.
- Exoskeleton use shows potential for improving care and functional outcomes in pediatric neuromuscular diseases.
- Further research is warranted to explore the broader impact and application of gait exoskeletons in this population.
Purpose:
Spinal Muscular Atrophy (SMA) Type II is a neurodegenerative disease that leads to progressive muscle weakness. It prevents children from walking and affects their respiratory function and their activity tolerance, among other health problems. We aimed to assess the activity tolerance showed by a child with SMA using a pediatric gait exoskeleton at home when walking and performing activities.
Design And Methods:
This study presents the case of a 6-year-old boy with SMA Type II and respiratory failure who used a pediatric gait exoskeleton at home for a period of two months. A nursing assessment was done before and during the use of the device to evaluate the child's activity tolerance during the sessions. Nursing interviews, performance, vital signs, fatigue, field notes, and functional scales were analyzed.
Results:
The nursing assessment showed a good activity tolerance of the child. Performance using the device improved over time; vital signs did not vary significantly during the sessions; fatigue perception decreased over time; and the child reached a higher score on some functional outcomes.
Conclusions:
A first step has been taken to evaluate the impact of exoskeleton technology in children with SMA Type II from the nursing point of view, exposing the potential of this technology for the care of children with neuromuscular diseases, and the need for more research on the topic.
Practice Implications:
The information in this study will be useful to nurses to know the effects of gait exoskeletons in pediatric care of children with neuromuscular diseases like SMA.
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