Usability and Acceptance of a New Robotic Exoskeleton for Shoulder Rehabilitation

This study aims to:

• Test the safety and reliability of the FLOAT device for delivering post-acute motor and functional rehabilitation of patients with orthopaedic shoulder dysfunction.
• Assess the three different modalities of utilization of the exoskeleton (Passive Mode, Learn&Repeat Mode, Transparency Mode).
• Evaluate the usability of the device in terms of comfort, adaptability to different patients' anthropometrics, general functioning and overall satisfaction.

Six injured workers with shoulder post-traumatic and post-operative dysfunction will be enrolled in a single testing session at the INAIL Rehabilitation Center in Volterra. Pilot testing of FLOAT device will focus mainly on the feasibility of implementing the multiple operating modes of the new device, recording patients and therapist's feedback. The session will last about 3 hours and all exercises will be administered by a trained physical therapist supported by a member of the engineering team.

For Aim 1, Safety and Reliability of the device will be evaluated in terms of the number of adverse events and malfunctions occurring during the study session.

For Aim 2, each modality will be assessed by means of the Numeric Pain Rating Scale (NPRS), The Borg CR10 Scale Perceived Exertion (only for the Transparent mode) and ad-hoc clinician-generated questionnaires for both patients and therapists.

For aim 3, patient and therapist's general evaluation about usability will be detected through a final ad-hoc questionnaire.

Inclusion criteria

• Height between 160 and 185 cm;
• Distance between the shoulder joint center and the sagittal plane between 156 and 197 mm;
• Shoulder joint center to wall distance between 82 and 142 mm
• Maximum shoulter radius: 120 mm
• Distance between the shoulder joint center and the elbow joint center between 250 and 303 mm
• Time from acute event ≥ 60 days
• Right shoulder joint disfunction after orthopaedic injury or surgery as a result of work accidents
• Post-immobilization phase
• At least 80° shoulder passive flexion and 45° shoulder passive abduction
• Pain intensity on movement < 6 NRS;

Exclusion criteria

• Glenohumeral joint instability
• Shoulder Prosthetic implants
• Upper arm sensorimotor deficits
• Chronic inflammatory disorder involving upper arm joints
• Pseudoarthrosis of the proximal humerus fractures
• Spinal fractures within the last 3 months
• Open skin at the level of the patient-device interface
• Current or prior history of malignancy
• Pregnancy or breast feeding