Ayaka Yokoi, OTR, Hiroyuki Miyasaka, OTR, PhD, Hiroki Ogawa, RPT, Shota Itoh, RPT, MS, Hideto Okazaki, MD, PhD, Shigeru Sonoda, MD, PhD
Jpn J Compr Rehabil Sci 15: 42-48, 2024
Objective: This study examined the effect of an upper
limb rehabilitation support robot and task-oriented
training on treating a patient with severe upper limb
paralysis after spinal cord infarction who required
total assistance with self-care.
Case: A 60-year-old man was diagnosed with
watershed infarction in the C5-7 spinal cord region.
He was admitted to our hospital 18 days after onset of
the disease. The patient had severe paralysis of both
upper limbs, and the total score for the Functional
Independence Measure (FIM) motor items was 25
points. Regarding the Canadian Occupational
Performance Measure (COPM), three goals were
listed: "eating," "going to the toilet," and "raising
one's hand in a meeting." The performance of "going
to the toilet" was rated three points, and the
performance and satisfaction of other items were one
point. The intervention was practiced for 1 h/day,
mainly items selected from COPM. The training using
an upper limb rehabilitation support robot was added
for 1 h/day. The upper limb rehabilitation support
robot adjusted the range of motion and dosage
according to the patient's motor function level and
recovery status. About three months after admission,
he improved until his upper limbs could be held in
space on activities of daily living (ADL), and the total
score for the FIM motor items improved to 81 points.
The satisfaction and performance of all items listed as
goals in COPM at the time of admission improved to
ten points, and the patient was discharged 108 days
after admission.
Conclusions: The upper limb rehabilitation support
robot training that matched the level of motor function
improved the motor function and active range of
motion (ROM). ADL generalization through taskoriented
training helped improve self-care. The use of
COPM for the training to enable the patient to acquire
the ability to perform meaningful activities led to
improved COPM performance and satisfaction.
Key words: upper limb function, spinal cord infarction, upper limb rehabilitation support robot