[Case Study] Robotic rehabilitation of the paralyzed upper limb for a stroke patient using the single-joint hybrid assistive limb: a case study assessed by accelerometer on the wrist – Full Text PDF

Abstract

[Purpose] Recent studies have reported the effectiveness of robotic rehabilitation of paralyzed upper limbs in stroke patients. For example, the Single-Joint Hybrid Assistive Limb has been shown to improve upper limb impairments. However, limited data are available on the effectiveness of robotic rehabilitation of the upper limb with regards to daily living. In this case study, an accelerometer was adopted to examine whether rehabilitation using the Single-Joint Hybrid Assistive Limb improved upper limb activity during daily living in a stroke patient.

[Participant and Methods] The participant was a 69-year-old male diagnosed with stroke and left hemiparesis. The Single-Joint Hybrid Assistive Limb was applied to the participant’s elbow on the paralyzed side. The participant wore an accelerometer on each wrist to measure the activities of the upper limbs. Clinical tests of the paralyzed upper limb were also performed.

[Results] The activity of the paralytic limb was significantly higher after Single-Joint Hybrid Assistive Limb intervention than before the intervention. On the other hand, none of the results of the clinical tests changed beyond a clinically important difference.

[Conclusion] The Single-Joint Hybrid Assistive Limb could be useful for promoting active use of a paralyzed upper limb in daily living. In addition, an accelerometer could be especially useful for evaluating the effects of robotic rehabilitation.

INTRODUCTION

Hemiparesis is a sequela that can substantially influence the lives of patients with stroke. For these patients, exercise therapy can improve not only the impairment but also the patients’ daily activities and quality of life1, 2). Recent studies have reported the effectiveness of robotic rehabilitation of paralyzed upper limbs in patients with stroke37). For example, Saita et al. demonstrated that the Single-Joint Hybrid Assistive Limb (HAL-SJ; HAL-FS01, CYBERDYNE, Inc., Tsukuba, Japan) improved upper limb impairment in stroke patients7) . However, these studies evaluated the upper limb function in a testing situation, such as by using Fugl-Meyer assessment or the Action Research Arm Test. Few data are available about the effectiveness of robotic rehabilitation for the upper limb for activities of daily living.
Recently, some studies reported that an accelerometer provides an effective method for assessing arm activity in daily living for patients with stroke8) . Thus, accelerometer may be useful for evaluating the effectiveness of robotic rehabilitation for daily activities. In this case study, accelerometer was used to examine whether robotic rehabilitation using the HAL-SJ improved upper limb activity in daily living in a patient with stroke.

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