• Simona Portaro, Vincenzo Cimino, Maria Accorinti, Alessandra Pidalà, Antonino Naro, and Rocco S Calabrò.
• Bonino Pulejo Neurotrauma Center and Institute for Research and Care, Messina, Italy.
• Eur J Phys Rehabil Med. 2019 Aug 1; 55 (4): 515-518.

BackgroundAmyotrophic lateral sclerosis flail arm (ALS-FA) is a motor neuron disease form confined to the upper limbs (cervical spinal cord region), often with asymmetric onset. To date, there is no defined neurorehabilitation strategy for ALS patients, although aerobic exercises may be of some help.Case ReportA 69-year-old woman affected by ALS-FA was admitted to our research institute because of upper limb muscle weakness. She was then submitted to two different conventional physiotherapy programs, the first stand-alone and the second combined to a robotic treatment. The patient gained an important motor improvement only after a 2-month treatment of physiotherapy plus Armeo-Power (AP), a robotic rehabilitation exoskeleton for upper limbs training, providing intelligent arm support in a 3D workspace.Clinical Rehabilitation ImpactEven though this is a single case, our combined neurorehabilitation approach (i.e. conventional physiotherapy plus robotics) could be considered a promising tool in improving upper limb function in patients affected by motoneurons disease, including ALS. Further studies involving a larger cohort of ALS-FA patients and long-term follow-up are needed, in order to evaluate the efficacy of robotics in prolonging patient's independence in active daily living.

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