Exploring the Application of Upper Limb Exoskeletons in Pediatric Rehabilitation: A Literature Review

Abstract

Children with neuromotor impairments experience difficulties with upper limb movement. Upper limb exoskeletons offer the potential for a better therapy experience for this population through personalized treatment and facilitating movement throughout the arm, including the shoulder, elbow, forearm, wrist, and hand. However, limited exploration of the interaction and usability between these devices and children has been done. Therefore, this study explores the interaction between children and upper limb exoskeletons. To achieve this goal, this paper reviews 10 articles (out of 181 papers) concerning the application and effectiveness of upper limb exoskeletons in children’s rehabilitation. Upper limb exoskeletons were evaluated in these studies based on pediatric participants’ task performance (e.g., inserting an object into a hole) as well as subjective perspectives (e.g., comfortability and usability). Results showed that upper limb exoskeletons were proved to be effective in facilitating children’s upper limb movement in bimanual coordination and unilateral movements. Through tasks designed to require specific movements or the manipulation of objects, researchers noted improvements across coordination, precision, smoothness, quality of movement, and others. The improvements were related to the functioning of upper limb muscles (e.g., biceps and triceps). Limitations for these studies include (1) the lack of control groups when collecting data, (2) possible test-retest reliability concerns when studying the feasibility of exoskeleton use, and (3) implications for long-term efficacy and adaptability for individual physical differences in children. Additionally, some studies exclusively studied healthy children rather than testing devices with children who suffer from motor impairments, which affects the generalizability of results.