Expanding Access to Assistive Walking Devices: Managing Symptoms for Child and Adolescent CMT Patients with Exoskeletal Boots.

This project develops exoskeleton technology to support treatment for youth with Charcot-Marie-Tooth Disease (CMT), a peripheral neuropathy that results in progressive muscle weakness and atrophy of arms and legs, among other conditions. The goal is to decelerate the progression of CMT by creating a new alternative to ankle/foot bracing which can be started years earlier than is possible with today�s ankle foot orthoses (AFOs) which have multiple issues of discomfort, bulkiness, high costs, and stigma. Current clinical care guidelines acknowledge the difficulty of wearing AFOs and do not prescribe them until after significant disease progression, leaving 10+ years of missed opportunity for earlier treatment. Project objectives are to design a new exoskeleton bracing device hidden within a boot with greater drop-foot resistance; to conduct benchtop testing and compare boot performance to today�s best AFOs; and to design a Phase II clinical study that overcomes barriers to participation of all populations. This technology may allow youth to start bracing years early and reduce non-adherence, leading to sustained activity at school and in the community, reduced likelihood of developing compensatory gait and the accelerated loss of ankle/foot strength, support for normal musculoskeletal development to better prepare adolescents for adulthood, and reduced stigma of bracing to improve psycho-social development.