A newly developed upper limb single-joint HAL in a patient with elbow flexion reconstruction after traumatic brachial plexus injury: A case report

We report a case in which elbow flexion exercises using the upper limb single-joint Hybrid Assistive Limb (upper limb HAL-SJ) were implemented in a patient 13months postoperatively following elbow flexion reconstruction with intercostal nerve transfer after a traumatic brachial plexus injury. Treatment using the upper limb HAL-SJ was administered once a week for 10 sessions from 13 to 16months after surgery. Exercises using the upper limb HAL-SJ supported elbow motion by detecting bioelectric signals through surface electrodes on the biceps and triceps brachii. No adverse events were observed during treatment with the upper limb HAL-SJ. Improvements in elbow flexion strength were observed during treatment. Treatment with the upper limb HAL-SJ can be performed safely and effectively following elbow flexion reconstruction by intercostal nerve transfer after a traumatic brachial plexus injury. •We demonstrated that upper-limb HAL treatment could be implemented safely and effectively.•This was a case of a patient with improvement in elbow flexion power after upper-limb HAL treatment.•Our findings suggests that upper limb HAL-SJ has the potential to be an effective rehabilitation tool for postoperative brachial plexus injury