A Neuromuscular Disease (NMD) is a disorder that affects the motor nerve cells in the central nervous system (brain, spinal cord, cranial nerves) and peripheral nervous system (autonomic nervous system, neuromuscular junction and muscles). There are 4 million children affected by NMDs worldwide, around 800,000 in Europe. Within NMD, the most common dystrophy is Duchenne Muscular Dystrophy (DMD), which affects 1 in every 3,500 to 5,000 children and is characterised by progressive weakness of the pelvic waist in children from 2 to 3 years. One can also quote Spinal Muscular Atrophy (SMA), a disease of the motor neurons of the spinal cord, that although has less incidence than DMD (between 1/6,000-1/10,000) is more life-threatening.
When the absence of mobility becomes chronic (permanent sitting) the child suffers from a number of physical and psychological complications (scoliosis, respiratory and circulatory difficulties, depression, social isolation), which is added to the patient’s disease symptoms and significantly accelerates the loss of health. The key is maintaining the walking ability for improving their quality of life and slowing down the deterioration caused by permanent sitting. Marsi Bionics offers Wearable Gait Exoskeletons as an effective 24/7 in-house therapy solution for allowing NMD children to walk.
Marsi Bionics R&D activities, as well as its innovative paediatric exoskeletons, are focused on NMD children with SMA (the most life-threatening NMD) and DMD (the most common NMD disease).
Our first paediatric prototype ATLAS 2020 is assisted by a supporting frame that provides postural balance during walking, standing up and sitting down manoeuvres. We are currently making technical progress and incorporating to our new model - ATLAS 2030 - dynamic balance control. Taking into account the loss of mobility due to progressive muscles weakness, ATLAS 2030 will assist the patient as needed, thus adapting to the variable symptoms and walking patterns of each NMD and children.
The overall objectives of the project were:
• To develop a balance biometric control system for innovative gait assistive robotic technologies.
• To develop an effective and robust ergonomics to be implemented in the exoskeleton structure.
through the opportunity of recruiting a biomechanical engineer.
The main conclusions of the action have been that the recruitment and the incorporation to our team of an individual highly qualified in ergonomics and biomechanics of locomotion to analyse the motor dysfunctions in SMA and DMD, analyzing patterns such as stability, mobility and synergies in joints and muscles has been a great opportunity to improve our gait exoskeletons as an alternative therapy, allowing to delay the complications arising from losing walking ability. Modular and flexible designs that are key in ATLAS 2030, taking into account the variety of patients that we intend to assist have been tackled. ATLAS 2030 design must allow not only adaptability in size to adapt the exoskeleton to the body, but also must comply with the different pathological patterns and other side effects affecting children with NMDs. For this purpose, the skills and contribution of the expert in gait biomechanics have been essential for this project.
