Clinical utility of a pediatric hand exoskeleton: identifying users, practicability, and acceptance, and recommendations for design improvement.

Only 10 participants were analysed for main outcomes, so results are preliminary and cannot establish effectiveness. A participant was excluded because PEXO electronics malfunctioned, and another had missing data after a transmission cable tore. The study was a single two-hour assessment, not a therapy programme, so it cannot show training or home-use effects. The therapist was not blinded, and participants knew whether PEXO was on. The kids-AHA was used beyond its validated age range and diagnosis. All participants had low spasticity and relatively strong proximal muscles, so the findings do not apply to children with high spasticity or weak shoulder or elbow movement. The device is a research prototype with technical failures, and cost and accessibility were not assessed.

Funding came from J&K Wonderland Foundation, Gemeinnützige Stiftung Accentus, Swiss National Science Foundation through the National Centre of Competence in Research on Robotics, and ETH foundation in collaboration with Hocoma AG. The paper does not say whether these funders designed, wrote, or analysed the study.

Do not conclude PEXO is an effective therapy for children's hand function. It improved the AHA measure in a 10-participant single-session prototype test, did not improve the Box and Block Test, reduced grip strength, and had technical failures. It is a design evaluation, not a tested clinical intervention.