The development of a new robotic device may provide the necessary hand functionality for children with hemiplegic CP. The device helps children with their muscle movements through the use of small motors placed over the joints of the hands. These motors (or actuators) provide children with sensory and visual feedback. This particular device is called the Isolated Orthosis for Thumb Actuation (IOTA for short).
The idea for IOTA was the product of conversations between the developers and two orthopedic surgeons about the rarity of robotic systems for the hand, especially those designed specifically for children. As they began the project, the team realized it was extremely challenging to build robotic systems for the human hand.
While it is certainly no secret that intervention works best when presented in early childhood, the majority of robotic devices for the hand are designed for adults. This makes it difficult for children who need to learn motor skills after they have suffered neurological trauma. These devices are usually too heavy and large for the average child and can actually impede the child’s ability to manipulate items.
Shortcomings of Current Devices
One of the problems with current/previous devices is even the pediatric ones are often designed to accommodate older teenagers. In fact, these particular devices are nothing more than a scaled down version of an adult device. However, this new development provided the opportunity for developers to design something specifically for children, a device that keeps their developmental needs in mind.
Another thing to keep in mind is current devices are designed to help the child with movement in all five fingers; this is called whole hand shaping. However, the developers of IOTA wanted to focus on helping the child use the thumb for grasping things. Occupational therapists use a variety of treatment options that includes the implementation of rigid or semi-rigid orthotics, functional electrical simulation, and Constraint Induced Movement Therapy. The problem with these methods is they fail to provide much in the way of thumb stimulation.
The most current device is designed to fit over a child’s hand and includes actuators that fit over the joints of the thumb. There are sensors on the device that have the ability to detect any attempts the child makes in movements of the thumb and wrist. It will then relay this information to a computer that is located inside a portable control box whose function is to allow the box to assist the child to complete the motion he or she is attempting.
The IOTA is small enough for the child to leave the palm open which helps him more effectively grasp and interact with items within reach. Unfortunately, the age range of this device 6-16 years of age, but the developers hope to create small versions of IOTA for even younger patients.