Use of Robot-Assisted Ankle Training in a Patient with an Incomplete Spinal Cord Injury: A Case Report

Abstract

Rehabilitation interventions are crucial in promoting neuroplasticity after spinal cord injury (SCI). We provided rehabilitation with a single-joint hybrid assistive limb (HAL-SJ) ankle joint unit (HAL-T) in a patient with incomplete SCI. The patient had incomplete paraplegia and SCI (neurological injury height: L1, ASIA Impairment Scale: C, ASIA motor score (R/L) L4:0/0, S1:1/0) following a rupture fracture of the first lumbar vertebra. The HAL-T consisted of a combination of ankle plantar dorsiflexion exercises in the sitting position, knee flexion, and extension exercises in the standing position, and stepping exercises in the standing position with HAL assistance. The plantar dorsiflexion angles of the left and right ankle joints and electromyograms of the tibialis anterior and gastrocnemius muscles were measured and compared using a three-dimensional motion analyzer and surface electromyography before and after HAL-T intervention. Phasic electromyographic activity was developed in the left tibialis anterior muscle during plantar dorsiflexion of the ankle joint after the intervention. No changes were observed in the left and right ankle joint angles. We experienced a case in which intervention using HAL-SJ induced muscle potentials in a patient with a spinal cord injury who was unable to perform voluntary ankle movements due to severe motor–sensory dysfunction.

Efficiency in Kinesiology: Innovative Approaches in Enhancing Motor Skills for Athletic Performance

“…The Special Issue closes with an insight into the innovative use of robotics for neuromotor rehabilitation in clinical settings. Koseki et al [ 17 ] provide an ankle rehabilitation training program with robot-assisted device in a patient with incomplete spinal cord injury. Using a three-dimensional motion analyzer and surface EMG, the Authors evaluate the treatment effectiveness using ankle plantar dorsiflexion exercises in the sitting position, knee flexion—extension exercises in the standing position, and stepping exercises in the standing position with hybrid-assistive limb assistance.…”