PMC9475054_01
PMC9475054_02
PMC9475054_03
A, B: Patient 2 performs upper limb training of repetitive elbow flexion
(A)/extension (B) exercise at shoulder 90  flexion with the Hybrid Assistive Limb 
(HAL; Cyberdyne, Tsukuba, Japan). C, D: Patient 3 performs upper limb training of
repetitive elbow flexion (C)/extension (D) exercise at shoulder adduction with HAL and
Integrated Volitional Control Electrical Stimulator (IVES, OG Giken, Okayama,
Japan).
prm-7-20220050-g001.jpg
PMC9475054_03_prm-7-20220050-g001.jpg
fig_001
First, training of repetitive elbow flexion/extension exercises during shoulder adduction and 90  shoulder abduction were performed 50-100 times each (Fig. 1).
A: Patient 3 performs adjusted IVES output during finger movement. Arrowhead shows
an electrode with extensor carpi radialis and extensor digitorum communis; arrows show
the IVES body. B: Patient 3 practices scooping adzuki beans with a spoon from a bowl
while wearing HAL and IVES. C: Patient 1 wears HAL and practices hitting a ping-pong
ball with a table tennis bat to knock down a toy figure. D: Patient 2 wears HAL and
practices grasping and moving small beanbags from a box.
prm-7-20220050-g002.jpg
PMC9475054_03_prm-7-20220050-g002.jpg
fig_002
In addition, as ADL practice, activities such as eating (spooning beans) and washing (hanging and folding a towel) were performed according to the abilities of the patients (Fig. 2).