Shoulder motion assistance using a single-joint Hybrid Assistive Limb<sup>®</sup> robot: Evaluation of its safety and validity in healthy adults

Makihara, Takeshi; Kadone, Hideki; Onishi, Shinzo; Kuzuhara, Shigeki; Hada, Yasushi; Shimizu, Yoshiki; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi

doi:10.1177/2309499017727951

Cited by 8 publications

(10 citation statements)

References 16 publications

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“…Before shoulder HAL training, grade 3-4/10 numbness was observed in both hands (C7 and 8 areas). The training method was similar to that reported by Makihara et al (15). First, the therapists set up the shoulder HAL foundation on the floor, and the shoulder HAL was attached and fixed to the foundation.…”

Section: Development Of Postoperative C5 Palsymentioning

confidence: 99%

“…We previously employed a single-joint HAL in a patient with motor loss associated with the biceps muscle after surgery of the cervical spine; using the HAL, the patient could perform elbow flexion exercises ( 14 ). The single-joint HAL was subsequently modified to develop a shoulder rehabilitation system ( 15 ). The new system contains sensors that allow the HAL to detect muscle action potentials from the deltoid of the user and assists voluntary shoulder abduction exercises.…”

Section: Introductionmentioning

confidence: 99%

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Robotic Shoulder Rehabilitation With the Hybrid Assistive Limb in a Patient With Delayed Recovery After Postoperative C5 Palsy: A Case Report

et al. 2021

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C5 palsy is a serious complication that may occur after cervical spine surgery; however, standard procedures for shoulder rehabilitation for patients with postoperative C5 palsy have not yet been established. We used a wearable robot suit Hybrid Assistive Limb (HAL) in a patient with delayed recovery after postoperative C5 palsy and conducted shoulder abduction training with the HAL. A 62-year-old man presented with weakness in his left deltoid muscle 2 days after cervical spine surgery. He experienced great difficulty in elevating his left arm and was diagnosed with postoperative C5 palsy. Seven months after surgery, shoulder abduction training with a HAL was initiated. In total, 23 sessions of shoulder HAL rehabilitation were conducted until 26 months after surgery. His shoulder abduction angle and power improved at every HAL session, and he was able to fully elevate his arm without any compensatory movement after the 23rd session, suggesting that the HAL is a useful tool for shoulder rehabilitation in patients with postoperative C5 palsy. We employed shoulder HAL training for a patient with delayed recovery from postoperative C5 palsy and achieved complete restoration of shoulder function. We believe that the HAL-based training corrected the erroneous motion pattern of his paralyzed shoulder and promoted errorless motor learning for recovery. Our collective experience suggests that shoulder HAL training could be an effective therapeutic tool for patients with postoperative C5 palsy.

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Section: Development Of Postoperative C5 Palsymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robotic Shoulder Rehabilitation With the Hybrid Assistive Limb in a Patient With Delayed Recovery After Postoperative C5 Palsy: A Case Report

et al. 2021

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“…Shoulder HAL was developed using single-joint type HAL. It was originally developed for the knee and elbow joints, supporting uniaxial movements at a single joint, such as flexion and extension of the joint [ 14 ]. In order to support shoulder flexion and extension movements, the proximal arm of the robot was affixed to the platform and the distal arm of the robot to the upper arm.…”

Section: Case Presentationmentioning

confidence: 99%

“…Focusing on the shoulder dysfunction after stroke, we considered the clinical application of shoulder type HAL, which was developed in our facility [ 14 , 15 ] for patients after stroke. This is the first case report of active repetitive upper limb-raising training using a shoulder joint HAL for a hemiplegic patient with moderate upper limb dysfunction due to a chronic stroke.…”

Section: Introductionmentioning

confidence: 99%

Hybrid Assistive Limb Intervention for Hemiplegic Shoulder Dysfunction Due to Stroke

Taketomi¹,

Shimizu²,

Kadone³

et al. 2021

Cureus

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Upper limb dysfunction after stroke is one of the most serious functional disorders, and adequate functional recovery is often not expected. Although various studies have been conducted on effective rehabilitation for upper limb dysfunction, active rehabilitation such as repetitive training of upper limb elevation has not been sufficiently conducted yet because the shoulder joint is highly unstable and the appearance of pain is easily observed. In this study, we performed right shoulder joint elevation training in a seated position using a single-joint hybrid assistive limb (HAL) in a 54-year-old female with right hemiplegia after a stroke. Her right upper limb function improved as follows: passive and active range of motion (ROM) of shoulder flexion, from 105° to 115° and from 65° to 105°, respectively; manual muscle test (MMT), from 2 to 4; box and block test of the right hand, from 1 to 8; right grip strength, from less than 5 to 7.4 kg; and action research arm test (ARAT) total scores, from 10 to 20. No adverse events including shoulder pain were seen. According to the result of the pilot study, HAL may be an effective rehabilitation tool for upper limb dysfunction after stroke.

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“…However, if upper limb robot-assisted 10.3389/fnins.2022.817659 rehabilitation has gained interest these past few years, still remarkably few projects study shoulder training and shoulder robotic assisted rehabilitation. Makihara et al (2017) recently demonstrated the feasibility, validity, and safety of shoulder motion assistance using the single-joint HAL in healthy participants. Kubota et al (2021Kubota et al ( , 2022 later reported its efficiency for a spinal cord injury case and a C5 palsy case, revealing a potential diminution of compensatory motion.…”

Section: Introductionmentioning

confidence: 99%

Alteration of muscle activity during voluntary rehabilitation training with single-joint Hybrid Assistive Limb (HAL) in patients with shoulder elevation dysfunction from cervical origin

et al. 2022

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Shoulder elevation, defined here as arm raising, being essential for activities of daily living, dysfunctions represent a substantial burden in patients’ lives. Owing to the complexity of the shoulder joint, the tightly coordinated muscular activity is a fundamental component, and neuromuscular impairments have devastating effects. A single-joint shoulder type version of the Hybrid Assistive Limb (HAL) allowing motion assistance based on the intention of the user via myoelectric activation has recently been developed, and its safety was demonstrated for shoulder rehabilitation. Yet, little is known about the physiological effects of the device. This study aims to monitor the changes in muscle activity and motion during shoulder HAL rehabilitation in several patients suffering from shoulder elevation dysfunction from cervical radicular origin. 8 patients (6 males, 2 females, mean age 62.4 ± 9.3 years old) with weakness of the deltoid muscle resulting from a damage to the C5 nerve root underwent HAL-assisted rehabilitation. We combined surface electromyography and three-dimensional motion capture to record muscular activity and kinematics. All participants showed functional recovery, with improvements in their Manual Muscle Testing (MMT) scores and range of motion (ROM). During training, HAL decreased the activity of deltoid and trapezius, significantly more for the latter, as well as the coactivation of both muscles. We also report a reduction of the characteristic shrugging compensatory motion which is an obstacle to functional recovery. This reduction was notably demonstrated by a stronger reliance on the deltoid rather than the trapezius, indicating a muscle coordination tending toward a pattern similar to healthy individuals. Altogether, the results of the evaluation of motion and muscular changes hint toward a functional recovery in acute, and chronic shoulder impairments from cervical radicular origin following shoulder HAL rehabilitation training and provide information on the physiological effect of the device.

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Shoulder motion assistance using a single-joint Hybrid Assistive Limb^® robot: Evaluation of its safety and validity in healthy adults

Abstract: The single-joint HAL provided safe and effective assistance to scapular plane shoulder flexion-extension among healthy adults.

Cited by 8 publications

References 16 publications

Robotic Shoulder Rehabilitation With the Hybrid Assistive Limb in a Patient With Delayed Recovery After Postoperative C5 Palsy: A Case Report

Robotic Shoulder Rehabilitation With the Hybrid Assistive Limb in a Patient With Delayed Recovery After Postoperative C5 Palsy: A Case Report

Hybrid Assistive Limb Intervention for Hemiplegic Shoulder Dysfunction Due to Stroke

Alteration of muscle activity during voluntary rehabilitation training with single-joint Hybrid Assistive Limb (HAL) in patients with shoulder elevation dysfunction from cervical origin

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Shoulder motion assistance using a single-joint Hybrid Assistive Limb® robot: Evaluation of its safety and validity in healthy adults

Abstract: The single-joint HAL provided safe and effective assistance to scapular plane shoulder flexion-extension among healthy adults.

Cited by 8 publications

References 16 publications

Robotic Shoulder Rehabilitation With the Hybrid Assistive Limb in a Patient With Delayed Recovery After Postoperative C5 Palsy: A Case Report

Robotic Shoulder Rehabilitation With the Hybrid Assistive Limb in a Patient With Delayed Recovery After Postoperative C5 Palsy: A Case Report

Hybrid Assistive Limb Intervention for Hemiplegic Shoulder Dysfunction Due to Stroke

Alteration of muscle activity during voluntary rehabilitation training with single-joint Hybrid Assistive Limb (HAL) in patients with shoulder elevation dysfunction from cervical origin

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Shoulder motion assistance using a single-joint Hybrid Assistive Limb^® robot: Evaluation of its safety and validity in healthy adults