Compensation for the consequences of motor deficit in the upper limbs: an Italian study compares two commercialized articulated arms

Several neuromuscular diseases lead to motor deficit in the upper limbs at one point or another in their development. It is particularly true in Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA). The phenomenon is becoming even more significant due to these two patient populations aging linked to the improvement in care. The involvement of the upper limbs can predominate at the proximal level (root of the limb, shoulder, arm) or distal (hands, wrists, fingers) depending on the case. The technical solutions to alleviate the functional consequences of these deficits are poorly known and rarely prescribed. 

In an article published in January 2021, Italian researchers tested two types of articulated arms in 36 patients with muscular dystrophy (mostly DMD). The first, the  Wrex® model from Jaeco, is described as a passive device while the second, the Ayura® model from Armon, requires the partial participation of the person (semi-active process). The patients were able to test the two devices in turn, for three days in a row,  according to a well-established protocol (USEFUL study). The benefit was judged on the evolution of functional scores (the PUL in particular) and how the person felt. The experience has been overwhelmingly positive, the authors having identified, based on the degree of pre-existing disability, the best possible indications for these two types of technical aids. 


User-centred assistive SystEm for arm Functions in neUromuscuLar subjects (USEFUL): a randomized controlled study. V Longatelli, Al Antonietti, E Biffi et al.  J Neuroeng Rehabil. 2021 (Jan).