Robotic Rehabilitation Using the Hybrid Assistive Limb for Drop Fingers in a Patient with Cervical Spondylotic...

Background: Drop finger may occur in patients with C7 and/or C8 cervical radiculopathy caused by cervical spondylosis. Although surgical decompression of the affected nerve roots is performed in patients with drop finger refractory to conservative treatment, postoperative recovery of drop finger is often unsatisfactory. Furthermore, no effective rehabilitation strategy for improving drop finger has yet been established. Methods: Here, we report a patient with drop finger who underwent a novel postoperative rehabilitation program. A 64-year-old man presented with drop finger of the left hand caused by left C7 and C8 radiculopathy and underwent cervical foraminotomy. For postoperative rehabilitation, we applied the single-joint Hybrid Assistive Limb (HAL), a wearable robotic suit. The patient underwent a total of 21 sessions of metacarpophalangeal HAL training, which assisted voluntary flexion and extension movements of the metacarpophalangeal joints, and 6 sessions of wrist abduction HAL training, which assisted ulnar-direction wrist abduction movements. Results: As a result, improvement in the left-sided drop finger was achieved. In this case, the use of HAL enabled voluntary motor training within the normal range of motion of the fingers and wrist even during the early postoperative phase, when sufficient neurological recovery had not yet been achieved. Conclusions: This successful motor experience may have facilitated the reacquisition of normal movement patterns, thereby contributing to improvement in drop finger.