Artikel
Robotic elbow flexion training with a newly developed upper limb single-joint Hybrid Assistive Limb (upper limb HAL-SJ) for elbow flexor reconstruction after brachial plexus injury
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Autoren
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Shigeki Kubota
- University of Tsukuba, Tsukuba, Japan
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Hideki Kadone
- University of Tsukuba, Tsukuba, Japan
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Yukiyo Shimizu
- University of Tsukuba, Tsukuba, Japan
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Yuki Hara
- University of Tsukuba, Tsukuba, Japan
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Masashi Yamazaki
- University of Tsukuba, Tsukuba, Japan
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objective: This study aimed to evaluate the effectiveness and safety of using a newly developed upper limb single-joint Hybrid Assistive Limb (upper limb HAL-SJ) during elbow flexion training following elbow flexion reconstruction for brachial plexus injury (BPI). The upper limb HAL-SJ is a wearable robot that can support elbow flexion even in MMT [1] of elbow flexion power. We present cases of three patients in whom the upper limb HAL-SJ elbow training was implemented 5, 7 and 6 months postoperatively following elbow flexion reconstruction for BPI.
Materials and Methods: Three patients (mean age 37.3 ± 17.2) underwent elbow flexion reconstruction with intercostal nerve-to-musculocutaneous nerve transfer (ICN-MCN transfer) after BPI (one of the three patients underwent finger flexion reconstruction with latissimus dorsi muscle to flexor digitorum profundus transfer). Postoperative training using the upper limb HAL-SJ was started from the manual muscle testing (MMT) [1] elbow flexion power once every week or every 2 weeks. Clinical evaluation included the MMT and active flexion ROM of the elbow joint at the start of every session. All patients also received conventional rehabilitation such as range of motion (ROM) exercises, muscle training, and visual-audio EMG biofeedback therapy during the upper limb HAL-SJ training.
Results: No serious adverse events were observed during the upper limb HAL-SJ training in three patients. All patients could implement elbow training using the upper limb HAL-SJ even in MMT [1] of their elbow flexion power. Improvement in elbow flexion power of MMT [3] in all patients was observed after upper limb HAL-SJ training. Mean postoperative months (POM) of improvement in elbow flexion power of MMT [3] were 12.0 ± 3.5 POM. Mean number of sessions using the upper limb HAL-SJ were 18.7 ± 13.9 sessions.
Conclusions: Training with the upper limb HAL-SJ was performed safely and effectively in three patients with elbow flexion reconstruction with intercostal nerve transfer after BPI.
