NSF Award
1706428
Children with certain developmental disabilities often do not possess the muscle tone (or underlying muscle tension) in the neck necessary to hold their heads erect. Without external support, the head falls to the chest, to the side, or behind them. This brings about other complications, such as drooling and inability to maintain normal gaze, and inhibits the child's ability to explore the world, causing developmental delays. The current therapeutic practice is to suspend the child's head from a rigid support using a cable and head strap. This rigid suspension can only provide one passive level of support; how much it helps to hold up the head cannot be easily modified in response to the wearer's needs. While this does help eliminate some of the symptoms and complications of poor head posture, it does nothing to help the child learn to control their head by their own muscle power. It also prohibits the child from moving their head in certain directions when desired. This research brings together trained therapists and engineers who will investigate whether assisting the child to raise their head from positions where it is difficult to do so (e.g. with the head tilted far forward, back, or resting on the shoulder), and providing less assistance where it is easier for the child to support the head on their own will promote developing independent control of the head, with less need for support over time. Researchers will measure the amount of assistance being provided by the suspension device, construct a computer model that identifies head poses requiring the most support and how the neck muscles work to support the head, and build a suspension device that can be programmed with different levels of support provided based on therapist input and the predictions of the computer model. Children at the Little Light House, a development center for children with special needs in Tulsa, OK who have low muscle tone base, will use the device on a regular basis. They will be assessed to determine how well varying the support provided to the head promotes the child's ability to develop the muscular control needed to hold up their head independently. Outreach activities will be conducted to University of Tulsa undergraduate students involved in Make A Difference Engineering (MADE at TU), a student group dedicated to using engineering skills to meet the needs of disabled persons. Students from this group will be involved in non-safety-critical aspects of the project. This will educate them about rehabilitation engineering research and prepare them for graduate study and careers in this important area.<br/><br/>This project includes three objectives to support the overall goal of developing a system to provide dynamic head/neck support for individuals with hypotonia. First, a biomechanical model of the neck will be developed that will integrate the muscles that provide appropriate head support in normal individuals. This model will then be further developed to account for changes due to hypotonia and the effect of a head support. Second, the model will be validated for hypotonic conditions in the presence of a head support. Finally, an active, dynamic head support device will be developed that can respond to the pose of the head, an individual's intent, and therapist input to promote strengthening of the neck muscles and an improved quality of life for the individual. The model will be developed to be functionally accurate, including appropriate muscles to fully model the function of the neck in maintaining head posture and account for differences in the response of hypotonic individuals. It will be developed in OpenSim using a combination of cadaveric, radiographic, and in vivo studies and validated against measurements made in collaboration with physical therapists. The device that is developed will be evaluated in a clinical setting to determine if it supports the rehabilitative goals of strengthening the neck and allowing more independent head support over time.
