ABSTRACT
The effectiveness of a robotic training device was evaluated in a 24-year-old male, cervical level four, ASIA Impairment Scale D injury. Robotic training of both upper extremities was provided for three hr/day for ten consecutive sessions using the RiceWrist, an electrically-actuated forearm and wrist haptic exoskeleton device that has been designed for rehabilitation applications. Training involved wrist flexion/extension, radial/ulnar deviation and forearm supination/pronation. Therapy sessions were tailored, based on the patient's movement capabilities for the wrist and forearm, progressed gradually by increasing number of repetitions and resistance. Outcome measures included the ASIA upper-extremity motor score, grip and pinch strength, the Jebsen-Taylor Hand Function test and the Functional Independence Measure. After the training, improvements were observed in pinch strength, and functional tasks. The data from one subject provides valuable information on the feasibility and effectiveness of robotic-assisted training of forearm and hand functions after incomplete spinal cord injury.
Subject(s)
Forearm/physiology , Spinal Cord Injuries/rehabilitation , Wrist/physiology , Humans , Male , Young AdultABSTRACT
Regaining upper extremity function is the primary concern of persons with tetraplegia caused by spinal cord injury (SCI). Robotic rehabilitation has been inadequately tested and underutilized in rehabilitation of the upper extremity in the SCI population. Given the acceptance of robotic training in stroke rehabilitation and SCI gait training, coupled with recent evidence that the spinal cord, like the brain, demonstrates plasticity that can be catalyzed by repetitive movement training such as that available with robotic devices, it is probable that robotic upper-extremity training of persons with SCI could be clinically beneficial. The primary goal of this pilot study was to test the feasibility of using a novel robotic device for the upper extremity (RiceWrist) and to evaluate robotic rehabilitation using the RiceWrist in a tetraplegic person with incomplete SCI. A 24-year-old male with incomplete SCI participated in 10 sessions of robot-assisted therapy involving intensive upper limb training. The subject successfully completed all training sessions and showed improvements in movement smoothness, as well as in the hand function. Results from this study provide valuable information for further developments of robotic devices for upper limb rehabilitation in persons with SCI.