Authors: (including presenting author): :
Wong SY (1), Chan KL (1), Ma WL (1)
Affiliation: :
(1) Community Rehabilitation Service Support Centre, Queen Elizabeth Hospital
Keyword 1: :
Transverse Myelitis
Keyword 3: :
Occupational Therapy
Keyword 4: :
Community Reintegration
Introduction: :
Transverse Myelitis (TM) is an immune-mediated inflammatory disorder of the spinal cord that results in motor weakness, sensory alterations, and significant neurological fatigue. For the 46-year-old female patient in this case study, chronic hip flexor weakness and pelvic instability created substantial barriers to navigating her home and community. In Occupational Therapy, bridging the gap between clinical recovery and home-based independence is a primary goal. While traditional orthotics offer static support, wearable robotic hip exoskeletons designed for home use provide active assistance during the swing phase of gait. This technology aims to reduce the physical burden of movement, allowing patients to maintain the energy levels required for meaningful engagement in daily life activities and long-term participation in home-based occupations.
Objectives: :
To evaluate the clinical efficacy of a wearable robotic hip exoskeleton for home use on functional mobility, gait endurance, and the overall quality of daily life for a middle-aged female with chronic Transverse Myelitis.
Methodology: :
A single-case study design compared functional performance across two conditions: without the device and with the wearable hip exoskeleton configured for daily home application. Quantitative assessments included the Timed Up and Go (TUG) for dynamic balance during household transitions, the 10-Meter Walk Test (10MWT) for gait speed, and the 6-Minute Walk Test (6MWT) for community-level endurance. User satisfaction and the impact on daily life were measured via the Quebec User Evaluation of Satisfaction with Assistive Technology (C-QUEST) and the Psychosocial Impact of Assistive Devices Scale (PIADS).
Result & Outcome: :
The integration of the hip exoskeleton for home use resulted in immediate improvements in all mobility metrics. The TUG time decreased from 55 to 44 seconds (20% improvement), and the 10MWT was reduced from 63 to 55 seconds (12.7% improvement). Functional endurance, measured by the 6MWT, increased from 57 to 61 meters (7% improvement). The patient reported a C-QUEST score of 4.5/5, indicating high satisfaction with the device's utility in a home environment. The PIADS data revealed that the exoskeleton significantly improved her daily life by increasing her willingness to take chances and her ability to take advantage of activities of daily living and life opportunities. The patient reported a greater ability to participate in meaningful roles, alongside enhanced independence, self-esteem, and a sense of control. These findings suggest that home-use exoskeletons are vital tools for occupational participation, allowing patients to overcome physical fatigue and re-engage in daily life with increased autonomy.
