Adjusting Assistance Commensurates with Patient Effort During Robot-Assisted Upper Limb Training for a Patient with Spasticity After Cervical Spinal Cord Injury: A Case Report

This case report explores how much assistance a robot should give during arm exercises for someone with a spinal cord injury and spasticity. The study looks at different levels of robot help and how they affect muscle activity and spasticity. The patient used a special robot called HAL-SJ, which adjusts its assistance based on the patient's muscle signals. The researchers changed the robot's settings to make the exercises feel comfortable, somewhat hard, or require no effort from the patient. The results suggest that some effort from the patient during robot-assisted training may help reduce spasticity. However, too much assistance from the robot may not be beneficial and could potentially increase muscle co-contraction.

• 1
  Spasticity improved, and the level of effort was reduced immediately after training in sessions other than the no-effort setting.
• 2
  Spasticity did not decrease in the training session using HAL-SJ with the no-effort setting, but co-contraction further increased during extension after training.
• 3
  When performing upper-limb training with HAL-SJ in this SCI patient, the level of assistance with some effort may reduce spasticity and too strong assistance may increase co-contraction.