jaeco WREX Setup Instructions

Setup Instructions

for

WREX

JAECO WREX

Wilmington Robotic EXoskeleton

The JAECO WREX is a functional upper
limb orthosis designed to enhance
movement for individuals with
neuromuscular disabilities. Its state-of­the-art construction utilizes a light
weight exoskeleton that approximates
normal human anatomy. Linear elastic
bands are used both for balance and to
assist movement in three dimensions
against the effects of gravity. These
features provide for exceptional range of
motion to aid in a variety of therapeutic
and daily living activities.

This manual is designed to assist with
initial set-up and balance of the WREX
Mobile Arm Support

The WREX was developed with an NIH grant.
Special thanks to Tariq Rahman; PhD. Senior Research Engineer and Head [phone] and
Whitney Sample; Research Design Engineer [phone], Pediatric Engineering Research Lab
Department of Bio Medical Research A.I. duPont Hospital for Children, Wilmington, DE 19899
and in cooperation with Timothy Estilow; OTR/L and Deborah Humpl OTR/L,ATP Department of
Occupational Therapy of Children's Hospital of Philadelphia.

Table of Contents

Section 1: Parts Description

1-1: Mount Parts Description
1-2: Arm Part Description

Section 2: Mount Attachment

2-1: Mount Base Attachment
2-2: Mount Link Attachment
2-3: MR-10 Mount Base

2-3: Preparing Mount Base
2-4: Mount Base Attachment

2-6: MR-8 Mount Base Attachment

2-6: Preparing Mount Base
2-7: Mount Base Attachment

2-8: Optional Side Attachment

2-9: MR-7 Mount Base Attachment

2-10: Preparing Backrest and Mount Base
2-11: Mount Base Attachment
2-13: Rotating Mount Arms

Attachment

Section 3: WREX Arm Setup

3-1: Measuring and Presetting Arm Components
3-1: Select and Pre-fit Forearm Support
3-2: Attach Forearm Support to WREX Arm
3-3: Measure and Preset Humeral Elevating Links

Section 4: Fitting and Adjustments with Client

4-1: Attaching the WREX Arm to the Wheelchair Mount

4-1: WREX Arm Attachment

4-2: Position WREX Shoulder Joint

4-2: Pitch Pivot Adjustment
4-3: Roll Pivot Adjustment

4-4: Place the Clients Arm into the WREX
4-4: Check for Appropriate Alignment
4-5: Application of Elastic Bands
4-6: Basic Adjustment for Functionality
4-7: Desired Functional Outcomes of the WREX
4-7: Removing the Arm from the WREX
4-8: Finalizing Setup

Section

1

Part Description

JAECO WREX

Mount Parts Description

19

18

20

21

17

22

16

23

15

24

1

2

5

9

10

11

12

3

8

13

4

1 MR-10 Mount Adapter 13 Attachment Hole

2 Moveable Jaw 14 Locking Knob

3 Jaw Locking Set Screw 15 Arm Mount Shaft

4 Base Clamp screw 16 Alignment Pin

5 Mount Screw 17 Arm Clamp

6 Reinforcement Washer 18 3 inch Arm

7 MR-7 Mount Adapter 19 Joint Pin

8 T-Nut Screws 20 4 inch Mount Arm

9 MR-8 Mount Adapter 21 Shaft Screw

10 Mr-8 T-nut 22 Shaft Mount Base

11 Arm Mount Base 23 Clamp Locking Set Screw

12 Alignment Slot 24 Arm Clamp Screw

6

7

14

1-1

28

29

JAECO WREX

Arm Parts Description

30

46

48

35

31

27

32

26

34

26 Pitch Mount Shaft 38 Elevator J-Link

27 Pitch Pivot 39 Elbow Pivot

28 Pitch Pivot Cover 40 Elbow J-Link

33

35

36

37

38

39

44

47

35

45

42

43

40

41

29 Pitch Link 41 Band Cradle

30 Roll Pivot 42 Forearm Pivot

31 Lateral Stop 43 Forearm Link

32 Shoulder Link 44 Slide Saddle

33 WREX Level 45 Band Spool Pivot

34 Upper Humeral Pivot 46 L-Bar

35 Band Spool 47 Forearm Support Mount Plate

36 Humeral Links 48 Forearm Support

37 Lower Humeral Pivot

1-2

Section

2

Mount Attachment

Mount Base Attachment

The WREX can be attached to most common

wheelchairs and mobility seating systems utilizing
one of the three Mount Bases provided with the arm.
These are the same attachment systems that are the
basis of our JAECO Mount Relocator.

It is essential that you identify the best attachment

position. Then choose from one of the three mount
bases for either;

(1) a Tubular Mount: MR-10

(2) a Keyed Back Post: MR-8

(3) direct attachment to a Molded Backrest: MR-7

MR-10 MR-7MR-8

2-1

Mount Link Attachment

The Mount Link for the WREX is designed so that

each of the three articulation; at the Mount Base,
at the Link Joint and at the Pitch Mount Shaft can
pivot 360 degrees. This will allow for the ability to
locate the Pitch Mount Shaft in a large variety of
locations to optimize its position and/or avoid
other apparatus attached to the chair.

The Mount Links will be shipped with the Clamp

Screws and Clamp Locking Set Screws loosened for
ease of application.

2-2

MR-10

Mount Base Installation

Alignment Slot

MR-10 Mount Adapter

Arm Mount Base

Locking Knob

Preparing Mount Base

1. Orient the Arm Mount Base as in illustration above.
Insert the Mount Base Screw (supplied with
Arm Mount Base) thru the Attachment Hole to
the MR-10 Mount Adapter. Using large T-Wrench
secure these two parts.

Moveable Jaw

Jaw

Locking Set

Screws

Base Clamp

Screws

2. Loosen Clamp Screws using large T-Wrench

Do not remove screws

its widest position by pushing the Moveable
Jaw forward and pulling it outward as shown in
photo.

and open clamp to

2-3

Mount Base Attachment

1. In this open position, apply the mount to the
wheelchair upright (back post).

Note: Mount positioning (angle) will vary depending on

wheelchair style.

2. Position the mount so that the top of the mount is
not more than 6 inches below the top of the clients
shoulder.

3. Tighten Base Clamp Screws.

Do not tighten Jaw Locking Set Screws at this
time.

Note: Adjustments in position may be necessary for

optimal function.

4. Loosen but do not remove the Locking Knob

on the Arm Mount Base.

5. Position the Mount Link so that the Alignment
Pin in the Arm Mount Shaft is aligned with
the Alignment Slot of the Arm Mount Base.
Insert the shaft into the base and tighten the
Locking Knob.

6. Preposition the Mount Links so that the
Shaft Mount Base that receives the Pitch
Mount Shaft is located in the lateral 1/3 of
the clients torso on the side which you
intend to use the WREX Arm.

2-4

7. Snug but do not tighten the six Clamp Screws

using the large T-Wrench. Add enough

tension so that the joints do not move easily
but can be repositioned if required to optimize
the arm alignment.

Note: Do not tighten the Clamp Locking Set

Screws at this time.

8. Hold the Pitch Mount Shaft so that the black
Pitch Pivot is at the proximal end, the hole
through the Pitch Pivot is in the line of
progression of the chair and the plate of the
pivot is facing laterally. Insert the Pitch
Mount Shaft into the Shaft Mount Base. Snug
but do not tighten the Shaft Screws on the
Shaft Mount Base.

9. With client sitting in the chair align the
square hole in the Pitch Pivot approximately
1 ½ inches above their shoulder.

2-5

For use on some Invacare and Motion Concept Seating

MR-8

Mount Base

Adapter

T-Nut

Screws

Arm Mount Base

MR-8

Mount Base Installation

Systems

T-Nut

Alignment Slot

Locking Knob

Preparing Mount Base

1. Locate and mark an area 2 to 8 inches below the
clients shoulder on the Keyed Back Post of the
wheelchair.

2. Locate and remove ( if applicable) the plastic cap
from the top of the Keyed Back Post of the
wheelchair.

Note: Adjustments in position may be necessary for

optimal function.

Attachment Hole

Keyed

Back Post

2-6

Mount Base Attachment

1. Using the large T-Wrench loosen, Do not remove,

the two T-Nut Screws on the MR-8 Mount Adapter.

2. Insert the T-Nut into Keyed Back Post channel and
position the MR-8 Mount Adapter at the marked
location (see Preparing Mount Base #1). Tighten the
two T-Nut screws.

Note: It may be necessary to remove the Spreader Bar

(bar that links both Keyed Back Posts) to attach the
Mount Adapter below and sometimes above the
marked location. Loosen, Do not remove, all four
Spreader Bar bolts using 7/16 inch wrench and
slide bar out of Keyed Back Posts.

3. Orient the Arm Mount Base as shown in illustration.
Insert the Mount Base Screw (supplied with
Arm Mount Base) thru the Attachment Hole to
the MR-8 Mount Adapter. Using the large T-Wrench
secure these two parts.

Note: If Spreader Bar was removed, reattach Spreader

bar, secure in place, and insert the plastic cap that
was removed in step 4 of Preparation instructions
Page 2-4.

Note: Adjustments in position may be necessary for

optimal function.

4. Loosen but do not remove the Locking Knob
on the Arm Mount Base.

5. Position the Mount Link so that the Alignment Pin in
the Arm Mount Shaft is aligned with the Alignment
Slot of the Arm Mount Base. Insert the shaft into the
base and tighten the Locking Knob.

2-7

Optional Side Attachment

1. Using the large T-Wrench loosen, Do not remove, the two

T-Nut Screws on the Mount Adapter.

2. Insert the T-Nut into Keyed Back Post channel and position the
MR-8 Mount Adapter at the marked location (see Preparing
Mount Base #1). Tighten the two T-Nut screws.

3. Orient the Arm Mount Base as shown in illustration.

Insert the Mount Base Screw (supplied with
Arm Mount Base) thru the Attachment Hole to
the MR-8 Mount Adapter. Using the large T-Wrench
secure these two parts.

Note: Adjustments in position may be necessary for

optimal function.

4. Loosen but do not remove

the Locking Knob

on the Arm Mount Base.

5. Position the Mount Link so that the Alignment Pin in
the Arm Mount Shaft is aligned with the Alignment
Slot of the Arm Mount Base. Insert the shaft into the
base and tighten the Locking Knob.

2-8

6. Preposition the Mount Links so that the Mount
Shaft Base that receives the Pitch Mount Shaft is
located in the lateral 1/3 of the clients torso on
the side which you intend to use the WREX Arm.

7. Snug but do not tighten the six Clamp Screws
using the Large T-Wrench. Add enough

tension so that the joints do not move easily
but can be repositioned if required to optimize
the arm alignment.

Note: Do not tighten the Clamp Locking Set

Screws at this time.

8. Hold the Pitch Mount Shaft so that the black Pitch
Pivot is at the proximal end, the hole through the
Pitch Pivot is in the line of progression of the chair
and the plate of the pivot is facing laterally. Insert
the Pitch Mount Shaft into the Mount Shaft Base.
Snug but do not tighten the Shaft Screws on the
Mount Shaft Base.

9. With client sitting in the chair align the square
hole in the Pitch Pivot approximately 1 ½ inches
above their shoulder.

2-9

MR-7

Mount Base Installation

For use on some Permobil and Other Seating Systems

Mount Screw

Reinforcement

Washer

MR-7

Mount Base

Adapter

Locking Knob

Arm Mount Base

Preparing Backrest and Mount Base

1. Remove backrest cushion.

2. Tape the template on the back of the backrest 1 ½ to
2 inches down from upper edge and as close to the
midline as possible.

Note: Place Base Drill Template on flattest area of

backrest

Alignment Slot

Attachment Hole

4. Use drill bit supplied and drill the two marked holes.

5. Orient the Arm Mount Base as shown in illustration.
Insert the Mount Base Screw (supplied with
Arm Mount Base) thru the Attachment Hole to
the MR-7 Mount Adapter. Using large T-Wrench
secure these two parts.

2-10

Mount Base Attachment

6. Using the large T-Wrench remove the two Mount
Screws with Reinforcement Washers from the MR-7
Mount Base. Insert the screws with Reinforcement
Washers through the drilled holes and into the
MR-7 Mount Base. Tighten the two Mount Screws

7. Loosen but do not remove the Locking Knob
on the Mount Base.

8. Position the Mount Link so that the Alignment
Pin in the Arm Mount Shaft is aligned with
the Alignment Slot of the Arm Mount Base. Insert
the shaft into the block and tighten the
Locking Knob.

9. Preposition the Mount Links so that the Mount
Shaft Base that receives the Pitch Mount Shaft is
located in the lateral 1/3 of the clients torso on
the side which you intend to use the WREX Arm.

2-11

Note: Check to insure the Clamp Screws are accessible.

If they are not complete the steps on page 2-13.

10. Snug but do not tighten the six Clamp Screws

using the Large T-Wrench. Add enough

tension so that the joints do not move easily
but can be repositioned if required to optimize
the arm alignment.

Note: Do not tighten the Clamp Locking Set

Screws at this time.

11. Hold the Pitch Mount Shaft so that the black Pitch

Pivot is at the proximal end, the hole through the
Pitch Pivot is in the line of progression of the chair
and the plate of the pivot is facing laterally. Insert
the Pitch Mount Shaft into the Mount Shaft Base.
Snug but do not tighten the screws on the Mount
Shaft Base.

12. With client sitting in the chair align the square hole

in the Pitch Pivot approximately 1 ½ inches above
their shoulder.

2-12

Rotating Mount Arms

1. Lay the Mount Arm flat on work surface.

2. Using the large T-Wrench remove the two Clamp
Screws and the Arm Clamp from the 4 inch Mount
Arm.

3. Rotate the 3 inch Arm and position the 4 inch
Mount Arm onto the Joint Pin as shown. Replace
the Arm Clamp and the two Clamp Screws. Tighten
the Clamp Screws.

Note: The Clamp Screws on the 3 inch Arm and

the 4 inch Mount Arm should be facing opposite
directions as shown in photo.

2-13

Section

3

WREX Arm Setup

Measuring and Presetting Arm Components

The WREX is designed for optimum functionality when

all of its exoskeletal articulations can approximate
the patients anatomical joints. Although this can
not be exact, careful measurement and pre-fitting of
the arm components will maximize the outcome.

We recommend fittings and assemblies in this section

should not

be done while the arm is attached to the

wheelchair.

3-1

Select and Pre-fit Forearm Support

1. Measure the distance from the Olecranon to
the Ulna Styloid then subtract one inch.
Insure size and side is correct from the chart
attached page 4-8.

2. Place the clients arm into the forearm
support. When the clients arm is strapped
in, the fit should be snug but not tight. The
Forearm support circumference can be
adjusted by squeezing the edges of the trough
together. This does require a great deal of

force. Use of a vice or small rubber mallet may
be required. Alternately padding may be added

to insure a intimate fit.

3. Remove the clients arm from the Forearm
Support.

Attach Forearm Support to WREX Arm

1. While depressing the button on the side of
the Forearm Support Slide Saddle.

2. Slide the L-Bar into the Slide Saddle from the
top.

3. Release button on the Slide Saddle to lock the
Forearm Support in the first (highest) position
on the L-Bar.

3-2

Measure and Preset Humeral Elevating Links

1. On the side you plan to fit the orthosis take a
measurement from the head of the humerus
to the lateral epicondyle. Record this
measurement.

2. Lay the WREX arm flat on a work surface.

3. Using the medium T-Wrench remove the Four

screws that connect the sections of the upper

and lower Humeral Elevating Links

3. By sliding the link sections on each other
shorten or lengthen the Humeral Links until the
distance between the centers of the Upper and
Lower Humeral Pivots is equal to the
measurement from Step 1.

4. Reinsert and tighten the Four screws to
secure both links.

3-3

Section

4

Fitting and

Adjustments with

Client

Attaching the WREX Arm to the Wheelchair Mount

Transfer the patient into the Wheelchair

WREX Arm Attachment

1. Using the large T-Wrench loosen but do not
remove the top screw on the Pitch Plate
Cover.

2. Orient the WREX arm with the slot in the Roll
Pivot facing up.

3. Slide the Pitch Link into the square hole of
the Pitch Pivot.

Note: The WREX arm is designed to have as little friction as possible at all of its

articulations. For client safety please be sure to control the entire device as
you are attaching the arm and making adjustments.

4-1

Position WREX Shoulder Joint

Pitch Pivot Adjustment

1. Using the large T-Wrench, while supporting
the WREX arm, loosen the screw on the Pitch
Pivot adjustor.

2. With the aid of the Bubble Level position the
Pitch Link so that it is horizontal and parallel
to the floor.

3. Tighten the Pitch Plate Adjuster Screw

4. Slide the Pitch Link into a position where the
articulation of the Roll Pivot is in line with the
top of the shoulder joint with a minimum of
1½ inches of space between the skin and the
bottom of the pivot.

Note: Positioning of the Shoulder Link may

require loosening of the two screws on the
Shaft Mount Base or repositioning the

Mount Links

4-2

Roll Pivot Adjustment

1. Using the large T-Wrench loosen the screw
for the Roll Pivot Adjustment.

2. With the aid of the bubble level roll the
adjustment medially or laterally until the
bubble is centered.

3. Tighten the Roll Pivot Adjuster Screw.

4. Using the large T-Wrench tighten all six of
the Mount Link Clamp Screws and the two
Mount Shaft Base Screws.

5. Recheck that the bubble in the level is still
centered. Adjust the Pitch Pivot or Roll Pivot
as necessary.

Caution: Do not put the clients arm into the orthosis until all

previous steps in this section have been completed.

4-3

Place the Clients Arm into the WREX

Because the WREX operates with band tension it must carefully be handled

during arm placement to prevent injury

1. With one hand support the WREX arm under
the Forearm Support.

2. Using your other hand lift the clients arm with
his/her elbow flexed and place it in the Forearm
Support. Insure that the back of elbow is
touching the elbow pad

3. Secure Velcro straps

Check for Appropriate Alignment

1. Roll Pivot joint should be 1½ inch above the
top of the shoulder to allow full shoulder range
of movement.

1. Adjust with the height of the Mount Shaft

2. Upper Humeral Pivot should be aligned with
the head of the humerus and the Lower
Humeral Pivot should align with the lateral
epicondyle.

1. Adjust by shortening or lengthening the
Humeral Elevating Links

3. Elevator Links should align with the shaft of the
humerus

1. Adjust the height of the Roll Pivot above
the shoulder

4. Clients elbow should be above the center of the
Elbow Pivot

1. Adjust depressing the bottom button on
the forearm Slide Saddle and moving the
forearm support forward or back.

Note: Insure there is clearance between the elbow area

of the Forearm Support and the Elbow Pivot,
when the clients arm is flexed.

4-4

Application of Elastic Bands

The number of bands varies depending on the weight of the clients arm and their

strength

The optimal number of bands allows for the client to move through their

maximal range of movement. The client must be able to return to starting
location to avoid the arm floating in space without control.

JAECO supplies three sizes of elastic bands:

Blue: Large

Red: Medium

Beige: Light

Note: Start with the largest bands then use the smaller bands to “fine tune” the

clients movements.

1. Supporting the clients arm at the elbow with
one hand, loop elastic bands one at a time
over the Band Spools on the Humeral
Elevating Links until the arm begins to “float” in
space.

2. Supporting the clients forearm with on hand,
loop elastic bands one at a time over the Band
Spools on the Forearm Link until the client is
able to easily flex and extend their elbow.

4-5

Basic Adjustment for Functionality

Ask the client to move horizontally from side to side

then toward and away from the body across a
tabletop.

To improve reach from side to side:

1. Support the clients limb

2. Loosen the Roll Adjustment screw

3. Rolling the arm toward the midline to aid in

reaching medially. Rolling the arm away from
midline will aid in reaching laterally.

To improve forward and return reach:

1. Support the clients limb

2. Loosen Pitch Adjustment screw

3. Tilting the Pitch Link down will aid in reaching

away from the body. Tilting the Pitch Link up will
aid in reaching toward the body.

Ask the client to move vertically from tabletop to

mouth and from tabletop to face.

To improve humeral elevation or depression:

1. Support the clients limb

2. Add / remove elastic bands or decrease /

increase the size of the bands

To improve Humeral rotation:

1. Add small elastic bands across the Elbow Pivot

To improve elbow flexion or extension

1. Support the clients forearm

2. Add / Remove elastic bands or decrease /

increase the size of the bands

Note on adjustments:

- Mark or document the starting point before any adjustments are made so the system
can be moved back if the adjustment is not effective.

- Make adjustments in small increments

- Only make one adjustment at a time (example: if the client is having trouble reaching

across their body at and forward. Adjust one or the other to optimize that movement
before working on the next)

- Give the client the opportunity to use the WREX multiple times before making major

adjustments

4-6

Desired Functional Outcomes of the WREX

• Ability to access face for

– Oral hygiene

– Feeding

– Washing face

– Shaving

– Wiping nose

– Adjusting glasses

– Etc.

• Ability to access environment for

– Using computer

– Handwriting

– Retrieving items from

countertop, closet, etc.

Removing the Arm from the WREX

Because the WREX operates with band tension it must carefully be handled during

arm removal to prevent injury

• Secure Forearm support with one hand holding in place

• Remove velcro straps and clients arm with the other hand

• Allow the forearm and shoulder links to return to starting position in a slow and

controlled manner

4-7

Finalizing Setup

Check Overall Setup

• Again, observe clients shoulder and forearm to be sure they are at a comfortable,

level, resting position. (If the client is uncomfortable, WREX wear time and use
will be limited.)

• Make adjustments as necessary to achieve functional use.

Secure the Settings

 Evaluate the WREX with a variety of activities. When you and the client are

satisfied with the overall function, secure the settings.

 Insure all knobs are tight.

 Using the large T-Wrench insure all screws are tight.

• Using the small T-Wrench tighten the Jaw Locking Set Screws on the Mount Base

(if applicable) and the Clamp Locking Set Screws on the Mount
Arm. The pointed end of these locking set screws will pierce fabric and/or metal.

Warning: If Further adjustments are required to Mount Base or Mount Arm,

loosen these locking set screws first.

Locking the MR-10 Mount Base in Place

Jaw

Locking Set

Screws

Locking the Mount Arm in Place

Clamp

Locking Set

Screw

4-8

WREX Product Numbers

JWREX-1-L: WREX Arm left (Forearm Support sold Separately)

JWREX-1-R: WREX Arm right (Forearm Support sold Separately)

Forearm Support Size Chart

WFS-6: Ex.Small Elbow to wrist crease length: Minimum - 6" Maximum - 7-1/2"

WFS-8: Small Elbow to wrist crease length: Minimum - 8-1/2" Maximum - 9-1/2"

WFS-9: Medium Elbow to wrist crease length: Minimum - 9-1/2" Maximum - 10-1/2"

WFS-10: Large Elbow to wrist crease length: Minimum - 10-1/2" Maximum - 12"

WFS-11: Ex.Large Elbow to wrist crease length: Minimum - 11-1/2" Maximum - 13"

WFS-1C: Custom Supply: Elbow to Wrist Crease Length & Largest Circumference of

Forearm

4-9

JAECO WREX Order Form

BILL TO:

1

Customer Name

Address

City State Zip

Phone ( )

Fax ( )

Your Name

3

Method of Payment:

Check (Payable to JAECO Orthopedic) Bill our Account: Purchase order Number

Credit Card: Visa MasterCard

Printed Name:

Signature: Date:

CC Billing Address City State Zip

4

Shipping:

Ground 1-5 Days 3-Day 2ndDay Air Next Day Air

Credit Card Number: Expiration date:

SHIP TO:

2

Customer Name

Attention

Department

Address

City State Zip

5

Select WREX Arm:

Qty. Product # Product Description

JWREX-1L WREX Arm Left

JWREX-1R WREX Arm Right

6

Select WREX Forearm Support:

Qty. Product # Product Description

WFS-6 6 in. Pediatric

WFS-8 8 in. Small

WFS-9 9 in. Medium

WFS-10 10 in. Large

FSC-1 Custom: Supply measurements

Custom Forearm Support Measurements

Forearm Length

Wrist Circumference

Forearm Circumference

[phone] * Fax: [phone] * Email: [email protected] * Web: www.jaeco-orthopedic.com

4-10

214 Drexel

Hot Springs, AR 71901

Ph: 501-623-5944

Fax: [phone]

Email: [email protected]

www.jaeco-orthopedic.com

January 18, 2007