{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:08:11Z","timestamp":1777982891995,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Upper extremity dysfunction after stroke affects quality of life. Focusing on the shoulder joint, we investigated the safety and effectiveness of rehabilitation using a shoulder joint hybrid assistive limb (HAL). Eight patients with chronic stroke and upper extremity functional disability were enrolled and used a shoulder joint HAL, which assisted shoulder movement based on the user\u2019s intention, through myoelectric activation of the shoulder flexor. Ten training sessions of 30\u201340 min each were performed to assist voluntary movement of upper limb elevation on the affected side through triggering the deltoid muscle. All patients completed the interventions without shoulder pain. Surface electromyography evaluation indicated post-intervention improvement in coordinated movement of the affected upper extremity. Significant improvements in voluntary and passive shoulder joint range of motion were obtained after the intervention, suggesting improvement in shoulder muscle strength. A significant decrease in the modified Ashworth scale and improvements in functional scores in the upper limb were also observed. Along with safe use for our study patients, the shoulder HAL provided appropriate motor learning benefits. Improvements in shoulder joint function and whole upper limb function were observed, suggesting that HAL could be an optimal treatment method.<\/jats:p>","DOI":"10.3390\/jcm12031215","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T02:35:10Z","timestamp":1675391710000},"page":"1215","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Shoulder Joint Hybrid Assistive Limb Treatment for Chronic Stroke Patients with Upper Limb Dysfunction"],"prefix":"10.3390","volume":"12","author":[{"given":"Masakazu","family":"Taketomi","sequence":"first","affiliation":[{"name":"Doctoral Program in Clinical Science, Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8575, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7491-4516","authenticated-orcid":false,"given":"Yukiyo","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2953-6434","authenticated-orcid":false,"given":"Hideki","family":"Kadone","sequence":"additional","affiliation":[{"name":"Center for Innovative Medicine and Engineering, University of Tsukuba Hospital, Tsukuba 305-8575, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4455-4585","authenticated-orcid":false,"given":"Shigeki","family":"Kubota","sequence":"additional","affiliation":[{"name":"Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Kagai","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba 305-8576, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshitaka","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba 305-8576, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0292-3493","authenticated-orcid":false,"given":"Yasushi","family":"Hada","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9293-3531","authenticated-orcid":false,"given":"Masashi","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1161\/CIRCULATIONAHA.109.192666","article-title":"Executive summary: Heart disease and stroke statistics\u20142010 update: A report from the American Heart Association","volume":"121","author":"Adams","year":"2010","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1080\/096382899297459","article-title":"The long-term outcome of arm function after stroke: Results of a follow-up study","volume":"21","author":"Broeks","year":"1999","journal-title":"Disabil. 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