Adjustment effect during shoulder abduction training with the Hybrid Assistive Limb in a patient with postoperative...

Standard shoulder rehabilitation procedures for patients with postoperative C5 palsy have not yet been established. We applied a wearable robot suit hybrid assistive limb (HAL) for a patient with postoperative C5 palsy and conducted shoulder abduction training with HAL. A 65-year-old woman was diagnosed with postoperative C5 palsy after undergoing cervical spine surgery. Five days after surgery, shoulder abduction training with HAL was initiated. The shoulder abduction angle and power and trapezius and deltoid activities were evaluated. Ten rehabilitation sessions were conducted until 82 days after surgery. Shoulder abduction training was safely and effectively performed from the first session. Her shoulder abduction angle and power improved at every session, and she could fully elevate her arm without any compensatory motion after the 10th session. Shoulder HAL training suppressed the muscular activity of the trapezius and activated that of the deltoid, especially in the earlier stages of rehabilitation. Moreover, it had an adjustment effect for obtaining normal shoulder motion, which might have promoted smoother arm elevation using errorless motor learning. These findings suggest that HAL is a useful tool for shoulder rehabilitation in patients with postoperative C5 palsy.