Safety and efficacy of robotic elbow training using the upper limb single-joint hybrid assistive limb combined with conventional rehabilitation for bilateral obstetric brachial plexus injury with co-contraction: a case report.

This is a case report, so it describes a patient's response rather than a comparison group. The patient also received conventional rehabilitation, so the contribution of HAL-SJ alone cannot be separated. Some outcomes did not improve: MRC grade and right handheld dynamometer testing were unchanged, and left STEF and left DASH scores were equal to or slightly worsened. Long-term effects were not assessed after HAL-SJ training. The authors did not measure deltoid muscle activity during HAL-SJ training, so the proposed inhibition of cocontraction was not shown. The patient had normal passive range of motion and no joint contractures, so it may not apply to patients with more restricted joints. The authors note fatigue and session frequency may have influenced results.

This work was supported by grants from Ibaraki Prefectural University of Health Sciences, the Japan Society for the Promotion of Science, and the Japan Orthopaedics and Traumatology Research Foundation. The authors declared no conflicts of interest.

Do not conclude that the robot alone caused the improvements. The patient also received conventional rehabilitation during the same 12 sessions, and the authors state it is difficult to determine the main effect of the therapy. This is a case report, so it cannot show that the intervention works.