Abstract
C5 palsy is a serious complication that may occur after cervical spine surgery; however, standard procedures for shoulder rehabilitation for patients with postoperative C5 palsy have not yet been established. We used a wearable robot suit Hybrid Assistive Limb (HAL) in a patient with delayed recovery after postoperative C5 palsy and conducted shoulder abduction training with the HAL. A 62-year-old man presented with weakness in his left deltoid muscle 2 days after cervical spine surgery. He experienced great difficulty in elevating his left arm and was diagnosed with postoperative C5 palsy. Seven months after surgery, shoulder abduction training with a HAL was initiated. In total, 23 sessions of shoulder HAL rehabilitation were conducted until 26 months after surgery. His shoulder abduction angle and power improved at every HAL session, and he was able to fully elevate his arm without any compensatory movement after the 23rd session, suggesting that the HAL is a useful tool for shoulder rehabilitation in patients with postoperative C5 palsy. We employed shoulder HAL training for a patient with delayed recovery from postoperative C5 palsy and achieved complete restoration of shoulder function. We believe that the HAL-based training corrected the erroneous motion pattern of his paralyzed shoulder and promoted errorless motor learning for recovery. Our collective experience suggests that shoulder HAL training could be an effective therapeutic tool for patients with postoperative C5 palsy.
Highlights
C5 palsy is a severe complication that may occur after cervical spine surgery, with a sudden occurrence of motor loss in the C5 region, resulting in difficulty in elevating the arm [1,2,3,4,5,6]
We reported the use of shoulder Hybrid Assistive Limb (HAL) training in a patient in a critical condition with delayed recovery from postoperative C5 palsy, in whom shoulder dysfunction continued for 7 months after surgery
We believe that HAL training corrected the erroneous motion pattern of his paralyzed shoulder and enabled errorless motor learning for recovery
Summary
C5 palsy is a severe complication that may occur after cervical spine surgery, with a sudden occurrence of motor loss in the C5 region, resulting in difficulty in elevating the arm [1,2,3,4,5,6]. More than 60% of patients with postoperative C5 palsy achieve complete recovery from motor loss [2, 7]; in some patients, recovery from C5 palsy is incomplete, and the shoulder. Physical and occupational therapies are common approaches to shoulder rehabilitation post-C5 palsy after cervical spine surgery. Standard procedures for shoulder rehabilitation in patients with postoperative C5 palsy have not yet been established. There is an urgent need to develop a novel rehabilitation technique for C5 palsy to promote early recovery of shoulder dysfunction
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