Training With a Gravity-Balanced Exoskeleton Robot to Improve Upper Limb and Daily Function in Patients With Tetraplegia.

OBJECTIVE

Patients with tetraplegia experience significant limitations in upper extremity function, restricting the performance of activities of daily living. Herein, we evaluated the effects of upper extremity training using an exoskeleton robot device, in the form of mobile arm support, on functional recovery and activities of daily living performance.

DESIGN

This preliminary study employed a one-group pre-post test design and used a Wilmington robotic exoskeleton for training. The training comprised six sessions conducted three times per week over a 2-wk period. Assessments were conducted using the Manual Muscle Test, range of motion, Upper Extremity Functional Index, and Efficiency of Assistive Technology and Services. Twenty participants were enrolled.

RESULTS

The participants demonstrated significant improvements in muscle strength across shoulder and elbow flexion. Regarding range of motion, significant improvements were observed in all areas except for shoulder internal rotation and elbow flexion. The Upper Extremity Functional Index results indicated no significant differences in the difficulty of performing most tasks. The Efficiency of Assistive Technology and Services showed some improvement in task performance difficulty; however, they were not significant.

CONCLUSIONS

A gravity-balanced exoskeleton robot effectively improved the upper extremity muscle strength and range of motion in patients with tetraplegia. Mobile arm support devices can be utilized to assist in upper extremity function and training in patients with tetraplegia.