Robotic neck brace helps analyze impact of cancer treatment


New robotic neck brace designed by Columbia Engineering researchers and colleagues at Columbia’s Department of Otolaryngology could help doctors analyze the impact of cancer treatments on patients’ neck mobility and guide their recovery .

Head and neck cancer was the seventh most common cancer in the world in 2018, with 890,000 new cases and 450,000 deaths, accounting for 3% of all cancers and over 1.5% of all deaths from cancer in the United States. Such cancer can spread to lymph nodes in the neck, as well as to other organs in the body. Surgical removal of the lymph nodes in the neck can help doctors study the risk of spreading, but can lead to pain and stiffness in the shoulders and neck for years.

Identifying which patients may have problems with neck movement “can be difficult, as the results are often subtle and difficult to quantify,” said Scott Troob, assistant professor of otolaryngology – head and neck surgery and division chief of facial plastic and reconstructive surgery at Columbia. Irving University Medical Center. However, successfully targeting any difficulties they might have with mobility can help patients benefit from targeted physiotherapy interventions, he explained.

The current techniques and tools available to doctors to assess the range of motion that a patient may have lost in the neck and shoulders are somewhat crude, explained Sunil K. Agrawal, professor of mechanical engineering and medicine. of Rehabilitation and Regeneration and director of ROAR (Laboratory of Robotics and Rehabilitation) at Columbia Engineering. They generally provide unreliable measurements or require too much time and space to set up for use in routine clinical visits.

To develop a more reliable and portable tool for analyzing neck mobility, Agrawal and his colleagues drew on a robotic neck brace they had previously developed to analyze head and neck movements in patients with lateral sclerosis. amyotrophic (ALS). In partnership with the Troob group, they have now designed a new portable robotic neck brace. Their study appears on July 12 in the journal Wearable technologies.

The new corset was made using inexpensive 3D printed materials and sensors. The easy-to-wear device was based on the head and neck movements of 10 healthy people.

“This is the first such study where a portable robotic neck brace has been designed to characterize the full range of motion of the head and neck,” said Agrawal.

In the new study, the researchers used the prototype splint, along with electrical measurements of muscle activity, to compare the mobility of the necks of five cancer patients before and one month after surgical removal of the neck lymph nodes. They found that their device could accurately detect changes in the movements of patients’ necks during routine clinical visits.

“The use of the detection neck brace allows a surgeon to screen patients postoperatively for movement difficulties, quantify their degree of impairment and select patients for physical therapy and rehabilitation,” Troob said.

“Patients consistently identify the need for rehabilitation and guided exercise after surgery as an unmet need for their medical care,” Troob said. “This work will lay the groundwork for the appropriate identification of patients for intervention. We further hope that by using the neck brace we will be able to objectively quantify their improvement and develop evidence-based rehabilitation programs.”

In the future, researchers hope to investigate larger groups of patients and use the neck brace to track patients through physical therapy to develop evidence-based rehabilitation protocols, Troob said. They would also like to develop similar braces for other surgical sites, such as the forearm, ankle or knee, he added.

Reference: Chang BC, Zhang H, Long S, Obayemi A, Troob SH, Agrawal SK. A new neck brace to characterize neck mobility disorders after neck dissection in patients with head and neck cancer. Wearable technologies. 2021. doi: 10.1017 / wtc.2021.8

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