Novel rehabilitation training using the newly developed upper limb wearable robot for patients with brachial plexus injury

• Project/Area Number: 17K13084
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: University of Tsukuba (2018-2019); Ibaraki Prefectural University of Health Science (2017)
• Principal Investigator: KUBOTA SHIGEKI 筑波大学, 医学医療系, 助教 (90763798)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2019: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2018: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000); Fiscal Year 2017: ¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000)
• Keywords: ロボットリハ / 腕神経叢損傷 / バイオフィードバック / 肋間神経移行術 / 上肢HAL / ロボットリハビリテーション / Hybrid Assistive Limb / リハビリテーション

Outline of Final Research Achievements

The cases of five patients in whom elbow flexor reconstruction (intercostal nerve transfer) for brachial plexus injury (BPI) was started the upper limb single-joint Hybrid Assistive Limb (upper limb HAL-SJ) training postoperatively. All patients could implement elbow training using the upper limb HAL-SJ even in MMT grade 1 of their elbow flexion power. Training with the upper limb HAL-SJ was performed safely and effectively in five patients with elbow flexor reconstruction after BPI. Postoperative training using the upper limb HAL-SJ was implemented elbow flexion power to MMT grade 3 once every 2 weeks as outpatients (18.2 ± 11.2 session, 10-34 sessions). The improvements of their biceps were observed MMT grade [4], [4], [3], [4], and [3], respectively (mean 11.8 ± 2.5 months).

Academic Significance and Societal Importance of the Research Achievements

肘屈曲再建術が行われた腕神経叢損傷者に対して、上肢HALを用いたバイオフィードバック訓練は、安全に訓練実施可能であり、かつ肘屈曲力を改善し、同患者に対してロボットを用いた新たな訓練ツールとなる可能性が示唆された。今後本研究は、筋電図学的にその回復メカニズムに関する解析研究を予定し、一部すでに開始している。従来のバイオフィードバック療法よりも、上肢HALを用いた訓練が筋電図学的に優れる訓練手法であることを証明したい。本研究の肘屈曲改善効果に関する部分的成果を国内・外学会・国際ジャーナルに対して発表・投稿を完了しているが、さらに今後の筋電図学的成果を公表し、その社会的意義を果たす予定である。

Research Products

• [Journal Article] Shoulder training using shoulder assistive robot in a patient with shoulder elevation dysfunction: A case report (2020)
  • Author(s): Kubota Shigeki、Kadone Hideki、Shimizu Yukiyo、Abe Tetsuya、Makihara Takeshi、Kubo Tadashi、Watanabe Hiroki、Marushima Aiki、Koda Masao、Hada Yasushi、Yamazaki Masashi
  • Journal Title: Journal of Orthopaedic Science Volume: 30 Issue: 5 Pages: 1154-1158
  • DOI: 10.1016/j.jos.2019.12.011
  • Peer Reviewed / Open Access
• [Journal Article] Robotic rehabilitation training with a newly developed upper limb single-joint Hybrid Assistive Limb (HAL-SJ) for elbow flexor reconstruction after brachial plexus injury: A report of two cases (2018)
  • Author(s): Kubota S, Kadone H, Shimizu Y, Hara Y, Kubo T, Watanabe H, Hada Y, Ochiai N, Sankai Y, Yamazaki M
  • Journal Title: J Orthop Surg (Hong Kong) Volume: 26(2) Issue: 2
  • DOI: 10.1177/2309499018777887
  • NAID: 120007134048
  • Peer Reviewed
• [Journal Article] Importance of the wrist extensor muscle training : Two cases of elbow flexor plasty following traumatic brachial plexus injuries (2018)
  • Author(s): Kubota S, Kubo T, Kameda H, Itoh Y
  • Journal Title: Case Rep Orthop Volume: 印刷中
  • Peer Reviewed
• [Journal Article] A newly developed upper limb single-joint HAL in a patient with elbow flexion reconstruction after traumatic brachial plexus injury: a case report (2017)
  • Author(s): Kubota S，Hara Y，Shimizu Y，Kadone H，Kubo T，Marushima A，Ueno T，Kawamoto H，Koda M，Matsumura A，Hada Y，Sankai Y，Yamazaki M
  • Journal Title: Interdiscip Neurosurg Volume: 10 Pages: 66-68
  • DOI: 10.1016/j.inat.2017.07.005
  • NAID: 120007134629
  • Peer Reviewed / Open Access
• [Presentation] 慢性期脊髄障害患者に対する両脚型HALを用いた機能回復治療 (2019)
  • Author(s): 久保田茂希、門根秀樹, 清水如代, 安部哲哉, 国府田正雄, 羽田康司, 山海嘉之, 山崎正志
  • Organizer: 第92回日本整形外科学会学術総会
• [Presentation] Robotic elbow flexion training with a newly developed upper limb single-joint Hybrid Assistive Limb (upper limb HAL-SJ) for elbow flexor reconstruction after brachial plexus injury (2019)
  • Author(s): Kubota S, Kadone H, Shimizu Y, Hara Y, Yamazaki M
  • Organizer: 14th International Federation of Societies for Surgery the Hand (IFSSH) and 11th International Federation of Societies for Hand Therapy (IFSHT)
  • Int'l Joint Research
• [Presentation] 重度歩行障害を呈する頸・胸椎後縦靱帯骨化症術後急性期におけるロボットスーツHALを用いた治療 (2018)
  • Author(s): 久保田 茂希, 安部 哲哉, 清水 如代, 門根 秀樹, 船山 徹, 國府田 正雄, 羽田 康司, 菅谷 久, 吉岡 友和, 山海 嘉之, 山崎 正志
  • Organizer: 第91回日本整形外科学会学術総会
• [Presentation] Robotic rehabilitation training with a newly developed upper limb single-joint Hybrid Assistive Limb (HAL-SJ) for elbow flexor reconstruction after brachial plexus injury (2018)
  • Author(s): Kubota S, Shimizu Y, Kadone H, Hara Y, Kubo T, Ochiai N, Hada Y, Yamazaki M
  • Organizer: 12th International society of physical and rehabilitation medicine (ISPRM) world congress
  • Int'l Joint Research
• [Presentation] 胸椎OPLLに伴う重度脊髄障害に対する後方除圧固定術＋ロボット歩行訓練による新たな治療 (2017)
  • Author(s): 久保田茂希，安部哲哉，藤井賢吾，船山徹，野口裕史，三浦紘世，門根秀樹，清水如代，羽田康司，山崎正志
  • Organizer: 第46回日本脊椎脊髄病学会学術集会
• [Presentation] Effectiveness of electromyography (EMG) of biofeedback therapy using upper limb HAL-SJ in patients with elbow flexion reconstruction after traumatic brachial plexus injury (2017)
  • Author(s): Kubota S，Hara Y，Kadone H，Shimizu Y，Kubo T，Hada Y，Yamazaki M
  • Organizer: The XXVI Congress of the International Society of Biomechanics (ISB)
  • Int'l Joint Research