Bilateral Upper-Extremity Hybrid Assistive Limb Treatment for GNE Myopathy.

GNE myopathy is a progressive distal myopathy typically manifested in late teens to thirties. We described the effects of bilateral upper-extremity hybrid assistive limb (HAL) rehabilitation in patients with GNE myopathy. We described a case series of 6 patients with GNE myopathy. Among them, five patients underwent bilateral upper-extremity HAL rehabilitation during a two-week hospitalization. The rehabilitation program consisted of elbow flexion-extension exercises with gradually adjusted assistance levels. HAL rehabilitation resulted in significant improvements in upper extremity strength scores (p = 0.0311), and overall upper limb motor function assessed by Simple Test for Evaluating Hand Function (STEF) (p = 0.0014). No significant changes in creatine kinase (CK) levels were observed, indicating that the exercise intensity did not cause muscle damage. Patients reported functional improvements including increased ability to perform daily activities requiring elbow flexion. While further research is needed to assess long-term effects and underlying mechanisms, these findings suggest potential benefits of HAL rehabilitation for neuromuscular diseases with upper-limb weakness.