Dataset Information

Voluntary Elbow Extension-Flexion Using Single Joint Hybrid Assistive Limb (HAL) for Patients of Spastic Cerebral Palsy: Two Cases Report.

ABSTRACT: Cerebral palsy (CP) patients with spastic diplegia struggle to perform activities of daily life (ADL) using their upper arms. The single-joint-type Hybrid Assistive limb (HAL) for upper limbs is a new portable robot that can provide elbow motion support in accordance with bioelectric activation of patient's biceps and triceps brachii muscles. The purpose of this study is to assess the feasibility and efficacy of the use of HAL for CP patients. Two patients were enrolled in this study. (Case 1: a 19-years-old male, at the Gross Motor Function Classification System (GMFCS) level IV, Case 2: a 17-years-old male at GMFCS level III). Both these patients experienced difficulty in voluntary elbow extension in ADLs. The HAL intervention (eight sessions; voluntary extension-flexion training of the elbow with HAL and clinical evaluation) was conducted for both sides in Case 1 and for the right side in Case 2. Clinical assessments were conducted as follows: Surface electromyography was used to evaluate the muscle activities of the biceps, triceps brachii, trapezius, and pectoralis major during elbow extension-flexion. The voluntary extension-flexion angles of the elbow, the coactivation index of the biceps and triceps brachii muscles, synergy analysis, and the Action Research Arm Test (ARAT) scores were assessed before and after the HAL sessions; the FIM score was evaluated before and after the entire intervention. In Case 1, the voluntary extension angle tended to increase after the HAL sessions. In both cases, the ARAT scores improved after the sessions. The FIM scores improved after HAL intervention. The voluntary extension-flexion of the elbow using the HAL may be a feasible option for rehabilitation of CP patients.

SUBMITTER: Shimizu Y

PROVIDER: S-EPMC6349701 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Voluntary Elbow Extension-Flexion Using Single Joint Hybrid Assistive Limb (HAL) for Patients of Spastic Cerebral Palsy: Two Cases Report.

Shimizu Yukiyo Y Kadone Hideki H Kubota Shigeki S Ueno Tomoyuki T Sankai Yoshiyuki Y Hada Yasushi Y Yamazaki Masashi M

Frontiers in neurology 20190122

Cerebral palsy (CP) patients with spastic diplegia struggle to perform activities of daily life (ADL) using their upper arms. The single-joint-type Hybrid Assistive limb (HAL) for upper limbs is a new portable robot that can provide elbow motion support in accordance with bioelectric activation of patient's biceps and triceps brachii muscles. The purpose of this study is to assess the feasibility and efficacy of the use of HAL for CP patients. Two patients were enrolled in this study. (Case 1: a ...[more]

PMID: 30723447

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Project description:The etiology of elbow flexion contracture in children with brachial plexus birth palsy remains unclear. We hypothesized that the long head of the biceps brachii muscle assists with shoulder stabilization in children with brachial plexus birth palsy and that overactivity of the long head during elbow and shoulder activity is associated with an elbow flexion contracture.Twenty-one patients with brachial plexus birth palsy-associated elbow flexion contracture underwent testing with surface electromyography. Twelve patients underwent repeat testing with fine-wire electromyography. Surface electrodes were placed on the muscle belly, and fine-wire electrodes were inserted bilaterally into the long and short heads of the biceps brachii. Patients were asked to perform four upper extremity tasks: elbow flexion-extension, hand to head, high reach, and overhead ball throw. The mean duration of muscle activity in the affected limb was compared with that in the contralateral, unaffected limb, which was used as a control. Three-dimensional motion analysis, surface dynamometry, and validated function measures were used to evaluate upper extremity kinematics, elbow flexor-extensor muscle imbalance, and function.The mean activity duration of the long head of the biceps brachii muscle was significantly higher in the affected limb as compared with the contralateral, unaffected limb during hand-to-head tasks (p = 0.02) and high-reach tasks (p = 0.03). No significant differences in mean activity duration were observed for the short head of the biceps brachii muscle between the affected and unaffected limbs. Isometric strength of elbow flexion was not significantly higher than that of elbow extension in the affected limb (p = 0.11).Overactivity of the long head of the biceps brachii muscle is associated with and may contribute to the development of elbow flexion contracture in children with brachial plexus birth palsy. Elbow flexion contracture may not be associated with an elbow flexor-extensor muscle imbalance, as previously hypothesized. The negative impact of elbow flexion contracture on upper extremity function warrants future research in the development of preventive and therapeutic techniques to address elbow flexion contractures in children with brachial plexus birth palsy.

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Dataset Information

Voluntary Elbow Extension-Flexion Using Single Joint Hybrid Assistive Limb (HAL) for Patients of Spastic Cerebral Palsy: Two Cases Report.

Publications

Voluntary Elbow Extension-Flexion Using Single Joint Hybrid Assistive Limb (HAL) for Patients of Spastic Cerebral Palsy: Two Cases Report.

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