Pilot testing of the spring operated wearable enhancer for arm rehabilitation (SpringWear).

This was a single-session pilot in 13 chronic stroke patients, with no control group and no rehabilitation training period, so it cannot show lasting improvement. The main outcomes were joint angles and reach workspace, not standardized clinical functional scores or daily-life use. The device assisted shoulder, elbow and forearm together, so the contribution of each joint's springs cannot be separated. Assistance shifted starting positions, so total range of motion did not increase at shoulder and forearm even when maximum angles increased. Functional task success was poor: nine subjects could not complete the tasks, and assistance did not consistently turn failures into successes. The device was not tested with HandSOME, so combined effect on hand function and ADL was not evaluated. Only the index finger was measured, using manual video analysis, so thumb and other finger movement were not assessed. Manual adjustment of spring stiffness may be impractical when spasticity changes quickly. The device is bulky, may interfere with activities, and requires a caregiver to help put it on. Early design problems were fixed for later subjects, so all 13 did not use exactly the same setup.

Funding was provided by the National Institutes of Health and the Catholic University of America. No commercial sponsor or author conflict statement appears in the supplied text.

Do not conclude that SpringWear improves functional ADL performance. It increased proximal joint angles and forward reach workspace, but nine subjects could not complete the functional tasks and only one changed from failure to success with assistance.