Experience of exoskeletal rehabilitation of a patient with superior flaccid monoparesis caused by a gunshot wound after neurosurgical reconstruction of the branches of the brachial plexus

Vorobyov A.A.

Volgograd State Medical University;
Federal Center for Support of the Development and Production of Exoprostheses;
Volgograd Scientific Medical Center

ORCID: 0000-0001-8378-0505

Barinov A.S.

Volgograd State Medical University

ORCID: 0000-0001-6391-7236

Gaivoronsky A.I.

Kirov Military Medical Academy

ORCID: 0000-0003-1886-5486

Barinova E.A.

Volgograd State Medical University

ORCID: 0000-0003-3073-0672

Andryushchenko F.A.

Volgograd Scientific Medical Center

ORCID: 0000-0002-6497-1848

Experience of exoskeletal rehabilitation of a patient with superior flaccid monoparesis caused by a gunshot wound after neurosurgical reconstruction of the branches of the brachial plexus

Authors:

Vorobyov A.A., Barinov A.S., Gaivoronsky A.I., Barinova E.A., Andryushchenko F.A.

More about the authors

Journal: Russian Journal of Operative Surgery and Clinical Anatomy. 2024;8(1): 35‑41

DOI: 10.17116/operhirurg2024801135

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To cite this article:

Vorobyov AA, Barinov AS, Gaivoronsky AI, Barinova EA, Andryushchenko FA. Experience of exoskeletal rehabilitation of a patient with superior flaccid monoparesis caused by a gunshot wound after neurosurgical reconstruction of the branches of the brachial plexus. Russian Journal of Operative Surgery and Clinical Anatomy. 2024;8(1):35‑41. (In Russ.)
https://doi.org/10.17116/operhirurg2024801135

Подписка 2025 (Russian Journal of Operative Surgery and Clinical Anatomy)

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BACKGROUND

Effective treatment and rehabilitation of patients after gunshot fractures significantly reduce the risk of complications and problems with limb functionality.

OBJECTIVE

To assess the initial experience of using the passive upper limb exoskeleton «Exar34» in rehabilitating a patient with paralytic changes in the upper limb resulting from extensive ballistic injuries to the chest and neck, in the context of comprehensive treatment involving the reconstruction of brachial plexus branches.

MATERIAL AND METHODS

The study involved gathering medical history, analyzing medical documentation, clinical examinations, and goniometry of the patient before, during, and after the use of the individual exoskeleton «Exar34»

RESULTS

The initial use of the exoskeleton led to a significant increase in the range of motion in the shoulder joint: abduction increased by more than 80°, flexion increased from 20° to 120°, and external rotation became possible, reaching 75°. The patient subjectively noted improvement during and after the first use of the exoskeleton. Objective data also confirmed an increase in the range of motion in the shoulder joint after the first session, with abduction increasing by 5°.

CONCLUSION

We believe that the initial experience of using the upper limb exoskeleton « Exar34» in the rehabilitation of patients with paralytic changes in the upper limb due to extensive ballistic injuries to the chest and neck, within the framework of comprehensive treatment including brachial plexus reconstruction, represents a promising direction in rehabilitation after ballistic injuries.

Keywords:

exoskeleton

rehabilitation

ballistic injuries

upper limbs

brachial plexus reconstruction

Authors:

Vorobyov A.A.

Volgograd State Medical University;
Federal Center for Support of the Development and Production of Exoprostheses;
Volgograd Scientific Medical Center

ORCID: 0000-0001-8378-0505

Barinov A.S.

Volgograd State Medical University

ORCID: 0000-0001-6391-7236

Gaivoronsky A.I.

Kirov Military Medical Academy

ORCID: 0000-0003-1886-5486

Barinova E.A.

Volgograd State Medical University

ORCID: 0000-0003-3073-0672

Andryushchenko F.A.

Volgograd Scientific Medical Center

ORCID: 0000-0002-6497-1848

Received:

04.12.2023

Accepted:

21.12.2023

List of references:

Trishkin DV, Kryukov EV, Chuprina AP, et al. Methodological recommendations for the treatment of combat surgical trauma. SPb.: Military Medical Academy named after S.M. Kirova; 2022. (In Russ.).
Khominetz VV, Shapovalov VM, Mikhailov SV, Brizhan LK. Treatment of wounded limbs in wars and armed conflicts: monograph. SPb.: Historical illustration; 2021.
Military field surgery: textbook. 2nd ed., amendments, and add. Ed. Gumanenko E.K. M.: GEOTAR-Media; 2008. (In Russ.).
Vorobyev AA, Barinov AS, Barinova EA, Andryushchenko FA. On the issue of exoskeletal rehabilitation of shoulder periarthritis after a gunshot wound of the scapular area. Issues of reconstructive and plastic surgery. 2023;26(3):47-53. (In Russ.). https://doi.org/10.52581/1814-1471/86/06
Nechaev EA, Gritsanov AI, Minnullin IP, Rukhlyada NV, Fomin NF, Shapovalov VM. Blast lesions: a guide for clinicians and students. Ed. Corresponding member RAMS prof. Nechaeva E.A. SPb.: Folio; 2002. (In Russ.).
Vorobyev AA, Petrukhin AV, Zasypkina OA, Krivonozhkina PS, Pozdnyakov AM. Exoskeleton as a New Means in Habilitation and Rehabilitation of Invalids (Review). Sovremennye tehnologii v medicine. 2015;7(2):185-197. (In Russ.). https://doi.org/10.17691/stm2015.7.2.22.
Shcherbina KK, Golovin MA, Zolotukhina MV. Research of the direction of developmentof musculoskeletal system exoskeletons. Physical and rehabilitation medicine. 2019;1(4):5-14. (In Russ.). https://doi.org/10.26211/2658-4522-2019-1-4-5-14
Vorobyev AA, Fomichev EV, Mikhalchenko DV, Sargsyan KA, Dyachenko DYu. Preclinical testing of the mandibular exoskeleton. Operative surgery and clinical anatomy. 2018;2(1):9-13. (In Russ.). https://doi.org/10.17116/operhirurg2018219-13
Vorobev AA, Andruschenko FA, Zasypkina OA, Krivonozhkina PC. Methods of determining anatomically dependent parameters of the exar upper extremity exoskeleton. Volgograd scientific and medical journal. 2015;1(45):58-61. (In Russ.).
He C, Xiong CH, Chen ZJ, Fan W, Huang XL, Fu C. Preliminary Assessment of a Postural Synergy-Based Exoskeleton for Post-Stroke Upper Limb Rehabilitation. IEEE Trans Neural Syst Rehabil Eng. 2021;29:1795-1805. https://doi.org/10.1109/TNSRE.2021.3107376
Sanchez C, Blanco L, Del Río C, Urendes E, Costa V, Raya R. A 3D-printed passive exoskeleton for upper limb assistance in children with motor disorders: proof of concept through an electromyography-based assessment. Peer J. 2023;11:e15095. https://doi.org/10.7717/peerj.15095
Gull MA, Bai S, Bak T. A Review on Design of Upper Limb Exoskeletons. Robotics. 2020;9(1):16. https://doi.org/10.3390/robotics9010016
Vorobiev A.A., Donika A.D., Gorelik I.M., Andryushchenko F.A. Rehabilitation of combatants: ehical and medical approaches. Bioethics journal. 2023;16(1):39-43. (In Russ.). https://doi.org/10.19163/2070-1586-2023-16-1-39-43

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