Spatial and temporal movement characteristics after robotic training of arm and hand: A case study of a person with incomplete spinal cord injury

Background: Upper limb weakness is the primary concern of tetraplegic individuals who have sustained incomplete spinal cord injury (SCI), to an extent that it is considered more important than standing abilities. Recent evidence of the plasticity of the brain and the spinal cord that can be enhanced by repeated practice- such as that available with robotic devices- suggest that robotic training of upper limbs can be beneficial to persons with SCI. The goal of this pilot study was to evaluate an innovative rehabilitation technique using the RiceWrist, a newly developed robotic device, for a person with tetraplegia. A 24-year-old male with incomplete SCI at the C4 level, 6.5 months post-injury participated in 10 sessions of robotic training over 2 weeks. Variability of movement trajectory (spatial) and the time to complete (temporal) simple point-to-point wrist and forearm movements were collected before and after training completion to determine skill acquisition. The participant successfully completed 10 sessions of robotic training. While there were minimal changes in variability of movement trajectory, great improvements were observed for the average movement time for the majority of wrist and forearm movements. Overall, results suggest that the RiceWrist robotic device could be used for upper-limb rehabilitation and can potentially serve as an assessment tool for the SCI population.