Investigative and Usability findings of the Move-D Orthotic Brace Prototype for Upper Extremity Tremors in Pediatric Patients: An unblinded, experimental study.

by Sharief Taraman

Coauthors: Coauthors: Amy Moss, Hieu Le, Lois Sayrs, and Tianyi Li Authors Li, Moss, and Taraman are inventors and hold intellectual property related to the Move-D brace.

Medical Devices & Digital Health

Tremors affect pediatric and adult populations, with roughly 3% worldwide experiencing essential tremor. Treatments include medication, deep brain stimulation, occupational/physical therapy, or adaptive equipment. This unblinded experimental pretest posttest study was performed at Children’s Health Orange County from April through September 2021. This study evaluated the effectiveness of Move-D, a novel orthotic brace, on pediatric tremors. Twelve eligible participants 14-19 years old with mild to moderate tremors in their dominant upper extremity met eligibility criteria with 10 enrolling and 2 opting out. All 10 participants (5 essential, 2 dystonic, 1 unspecified, 1 postural, and 1 course) as diagnosed by a neurologist, completed the study without adverse effects. Participants completed a usability survey and performance was measured utilizing the Bruininks Oseretsky Test of Motor Proficiency, second edition with and without the brace. Participant’s age equivalent scores in three subtests (fine motor precision, manual dexterity, and upper limb coordination) and manual coordination percentile scores were compared from baseline/control data (results of testing without assistance) to experimental data (results of testing when wearing the brace) using one-sided t-tests of mean differences. Statistically significant improvement in age equivalent scores in fine motor precision 20.5 (-3.8,44.8) months and upper limb coordination 15.1(2.4,27.8) months and manual coordination percentile rankings 2.9%(-1.3%,7.1%) were seen with the Move-D brace. Manual dexterity performance was unaffected. The usability survey revealed that 7/10 participants agreed or strongly agreed that they could move their arm freely while wearing brace, brace reduced their tremors, and they felt comfortable wearing brace at home. Through standardized testing and findings from the usability survey, Move-D showed improvement of functional abilities in a pediatric population with tremors. This study is limited by the small sample size, wide variability in effects, and the cohort imbalance between male and females, which may limit generalizability.