TBI – Upper Limb Function

chest_presses (005)Longitudinal Observation of Myoelectric Upper Limb Orthosis Use among Veterans with Upper Limb Impairment


Traumatic Brain Injury (TBI) is a major challenge in the military and Veteran populations. Since 2000 to June 2015, 36,000 moderate and severe TBI incidents have occurred among US military and civilian casualties. Upper limb problems occur in about 17% of TBI patients and are likely to limit ability to perform Activities of Daily Living (ADL).

To increase upper limb function, Myomo Inc. recently combined powered elbow with powered grasp to create the MyoPro Motion-G myoelectric elbow-wrist-hand orthosis. This commercially-available device is a non-invasive, powered orthosis that is worn on a partially paralyzed arm to help initiate movement and enhance function. It is designed to be used by persons with various neurological problems, including TBI. When the user tries to bend their elbow or grasp objects, sensors in the device detect the weak myoelectric signal from the muscle. This signal activates the motor to move the arm/hand in the desired direction. The user is completely controlling their own arm and hand. The MyoPro Motion-G is a relatively new orthosis, and clinicians and researchers know very little about how well it works to help improve arm and hand function in people with arm impairments, particularly those caused by TBI. This limits patient access to this device. Furthermore, combining device training with motor therapy may result in greater improvements in arm function than training without the device.

Program Information

Objective/Specific Aims:  The main objective of this research study is to document functional outcomes over time in patients who use and train with an arm brace with powered elbow motion and hand grasp. Our study proposes to contribute the evidence needed to support clinical implementation of the MyoPro Motion-G brace. Documenting benefits is essential to the prescription, provision, and reimbursement of the device.

The specific aims of this project are to evaluate therapeutic effects of the myoelectric upper limb orthosis, and to evaluate functional effects of the myoelectric upper limb orthosis.

Protocol: This four-part study requires 29 visits over the course of 22 weeks. The four components of this study include enrollment, orthotic fitting, therapy/training, and home use. Evaluations of therapeutic and functional benefits will take place every 2-3 weeks over 18 weeks using simple, short clinical tests.


More details on this program available at:

Principal Investigator: Svetlana Pundik, MD, MSc
Clinical Coordinator: Jessica McCabe, PT
Contact Number: (216) 791-3800 x63830
Contact Email: jmccabe@fescenter.org