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VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: 
https://doi.org/10.33137/cpoj.v1i2.32022         

1 

 
OPEN  ACCESS 

 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (ORAL PRESENTATION) 

MYOELECTRIC ELBOW-WRIST-HAND ORTHOSIS WITH ACTIVE GRASP FOR 

PATIENTS WITH STROKE: A CASE SERIES 

Eric Shoemaker, 

Ability Prosthetics and Orthotics, Inc. 2005 Technology Parkway, Mechanicsburg, Pennsylvania, USA. 

Email: eric.shoemaker@abilitypo.com 

DOI: https://doi.org/10.33137/cpoj.v1i2.32022  

 

INTRODUCTION 

This case series presents prescription, evaluation, fitting 

and initial functional benefits of a myoelectric elbow- 

wrist-hand orthosis with active grasp. Custom fit, 

myoelectric orthoses are now also being provided to 

patients with upper extremity paresis due conditions such 

as stroke, brachial plexus injury, spinal cord injury, 

multiple sclerosis and amyotrophic lateral sclerosis to 

enable them to self-initiate and control movement of a 

partially paretic limb using their own volitional 

myoelectric signals. A recent study of 18 chronic stroke 

participants demonstrated functional improvements on 

the Fugl-Meyer Impairment Scale (FM) and a battery of 

functional tasks with this device.1 

METHODS 

Patients are currently being evaluated by an 

interdisciplinary team at the Lebanon, PA outpatient VA 

clinic for the MyoPro 2 Motion G device (Myomo Inc., 

Cambridge, MA). Two recent candidates who received 

the device were followed to evaluate the functional 

benefits they experienced. Patient 1: 67 year old male s/p 

CVA in 2013 affecting his right side. Patient 2: 61 year 

old male s/p CVA in 2014 affecting his right side. Both 

men were previously right hand dominant, both present 

with high motivation, and both have a strong family and 

care-giver support structure in place. During initial 

consultation, passive and active ROM were assessed as 

well as MMT. EMG signals were tested with the wrist 

flexors and extensors as well as biceps and triceps. Both 

men were able to generate and sustain an EMG signal for 

all 4 sites. Both men completed initial surveys with the 

Disabilities of the Arm Shoulder and Hand (DASH). 

Patient 1 scored 85 and patient 2 scored 67.5. A battery 

of functional tasks was also used to evaluate current 

deficits. The tasks included: lifting a laundry basket, 

bringing a spoon to the mouth, drink from a cup, turning 

on a light switch. Both patients were casted by a certified 

orthotist using fiberglass wrap from the level of the axilla 

and to include the hand in a neutral position. The cast was 

taken in one segments with assistance to capture the 

desired position at each joint. The custom MyoPro 2 

Motion G was fabricated by a  central fabricator, and the 

device was fit  

within 3 weeks of casting. No adjustments were needed 

at the time of fitting. Programming was performed by the 

certified orthotist to optimize control of the device. Both 

patients began using Biceps Mode for elbow control and 

Voluntary Opening for grasp control. The software made 

it possible to change the control strategy of the device for 

better control of the assistive device for ADLs, because 

initially both patients struggled to control the elbow and 

grasp with independent and separate EMG signals from 

antagonist muscle groups. Both patients were referred to 

occupational therapy by a clinician trained in using the 

MyoPro. 

RESULTS 

Upon fitting of the MyoPro motion G, both patients were 

able to control flexion and extension of the elbow and 

open and close of the fingers. The patients still struggled 

to drink from a cup and bring a spoon to their mouths 

with the device but patient 2 was able to pick up a laundry 

basket and turn on a light switch with the device and was 

unable without. Active ROM was measured and showed 

an increase in both patients when wearing their MyoPro 

motion G devices. Patient 1 experienced an improvement 

in active ROM in elbow flexion of 10 degrees and elbow 

extension of 50 degrees with the MyoPro. Patient 2 

showed a 35 deg improvement in elbow with the 

MyoPro. Active ROM with and without the MyoPro is 

depicted in Table 1. 

 

CONCLUSION 

This case series highlights the unique orthotic 

intervention to restore active motion and independence 

with the upper extremity now available to patients with 

stroke. Initial fitting of the MyoPro 2 Motion G 

mailto:eric.shoemaker@abilitypo.com
https://doi.org/10.33137/cpoj.v1i2.32022


 

 

Shoemaker E. MYOELECTRIC ELBOW-WRIST-HAND ORTHOSIS WITH ACTIVE GRASP FOR PATIENTS WITH STROKE: A CASE SERIES. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, 
VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: 
https://doi.org/10.33137/cpoj.v1i2.32022         

2 

 
OPEN  ACCESS 

 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (ORAL PRESENTATION) 

demonstrated increased active ROM of the both the 

elbow and the fingers for 3 jaw chuck grasp. Both 

patients showed an increase in active ROM with the 

MyoPro. These patients are expected to continue to 

follow up, and their progress with the MyoPro 2 Motion 

G will be documented throughout their recovery. 

 SIGNIFICANCE  

Patients who’ve suffered a CVA have the potential to 

increase independence when performing certain 

activities of daily living. The ability to position the hand 

in space via elbow control and then grasp an object with 

the MyoPro can allow patients to perform bimanual 

activities such as lifting and carrying and laundry basket 

as was demonstrated here. 

REFERENCES 

1. Peters, HT. "Giving Them a Hand: Wearing a Myoelectric 

Elbow-Wrist-Hand Orthosis Reduces Upper Extremity 

Impairment in Chronic Stroke." Arch. of PM&. pp 1821- 827, 

2017. DOI:10.1016/j.apmr.2016.12.016 

2. Takahashi KZ & Stanhope SJ. ASB Annual Meeting, Boston, 

MA, USA, 2015.  

DISCLOSURE 

 The authors are employed by Ability Prosthetics and 

Orthotics, Inc. and have no conflict of interest to report related 

to this case series. 
 

 

https://doi.org/10.1016/j.apmr.2016.12.016

