Robotic collars help analyze the effects of cancer treatment
A new robotic neck brace from researchers at Columbia Engineering and their colleagues in the Columbia Department of Otorhinolaryngology could help doctors analyze the effects of cancer treatments on patients’ neck mobility and guide their recovery.
Head and neck cancer was the seventh most common cancer worldwide in 2018, with 890,000 new cases and 450,000 deaths, accounting for 3% of all cancers and more than 1.5% of all cancer deaths in the United States. Such cancer can spread to lymph nodes in the neck as well as other organs in the body. Surgical removal of lymph nodes in the neck can help doctors evaluate the risk of spread, but it can cause pain and stiffness in the shoulders and neck years later.
Identifying which patients may have neck movement problems “can be difficult because the results are often subtle and difficult to quantify,” said Scott Troob, assistant professor of ENT surgery – head and neck surgery and head of facial plastic and reconstructive surgery at the Columbia Medical Center, Irving University. However, if successfully addressed the difficulties they might have with mobility, it can help patients benefit from targeted physiotherapy interventions, he explained.
The current techniques and tools doctors have for assessing a patient’s range of motion in the neck and shoulders are somewhat crude, explained Sunil K. Agrawal, professor of mechanical engineering and rehabilitative and regenerative medicine and director of the ROAR (robotics and rehabilitation) laboratory at Columbia Engineering. They usually either provide unreliable measurements or require too much time and space to set up for use in routine clinical visits.
In order to develop a more reliable and portable instrument for analyzing neck mobility, Agrawal and his colleagues took inspiration from a robotic collar they had previously developed to analyze head and neck movements in patients with amyotrophic lateral sclerosis (ALS). In collaboration with Troobs Gruppe, they have now developed a new portable robotic collar. Her study appears in the journal on July 12th Wearable Technologies.
The new orthosis was made with 3D printed materials and inexpensive sensors. The easy-to-carry device was based on the head and neck movements of 10 healthy people.
“This is the first study of its kind to develop a wearable robotic neck brace to characterize the full range of motion of the head and neck,” said Agrawal.
In the new study, researchers used the prototype corset along with electrical measurements of muscle activity to compare neck mobility in five cancer patients before and one month after surgical removal of the cervical lymph nodes. They found that their device could accurately detect changes in the patient’s neck movements during routine clinical visits.
“Using the neck brace with sensor allows a surgeon to screen patients postoperatively for difficulty moving, quantify their degree of impairment, and select patients for physical therapy and rehabilitation,” said Troob.
“Patients consistently identify post-operative rehabilitation and guided exercise needs as unmet needs in their medical care,” Troob said. “This work will lay the foundation for an appropriate identification of patients for intervention. We also hope that through the use of the cervical collar we can objectively quantify their improvement and develop evidence-based rehabilitation programs.”
In the future, researchers hope to study larger populations and use the neck brace to guide patients through physical therapy in order to develop evidence-based protocols for rehabilitation, Troob said. They would also like to develop similar braces for other surgical sites like the forearm, ankle, or knee, he added.
Reference: Chang BC, Zhang H, Long S, Obayemi A, Troob SH, Agrawal SK. A novel neck support for the characterization of impaired neck mobility after neck dissection in patients with head and neck cancer. Wearable Technologies. 2021. doi: 10.1017 / wtc.2021.8
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