Efficacy of Robotic Upper Limb Rehabilitation Training in Patients With Tetraplegia

The goal of this clinical trial is to evaluate the efficacy of upper-limb robotic rehabilitation training (PABLO®) for recovering muscle strength in the scapulohumeral region and the proximal upper limb-compared to standard rehabilitation treatment alone-in male and female patients aged 18 to 80 years with tetraplegia/tetraparesis due to spinal cord injury of various etiologies (traumatic, ischemic, infectious, etc.) in the subacute phase.

Inclusion Criteria: 1. PRIMARY * The investigator obtains the patient's informed consent to participate in the clinical trial and to the processing of personal data. * Tetraplegic/tetraparetic patients with spinal cord injury of various etiologies (traumatic, ischemic, infectious, etc.) as defined by the ASIA Impairment Scale, who are capable of movements at least against gravity-even with a partial range of motion (MRC ≥2/5)-in the muscles of the scapulohumeral region and the elbow on at least one side of the body. * Age ≥ 18 years and ≤ 80 years. * Time interval between the acute event and study enrollment not exceeding 120 days. 2. SECONDARY * Ability to maintain a seated position in a non-reclined wheelchair (trunk-pelvis angle of 90°) for one hour. * Improvement in strength of ≥ 1 point (out of 5) on the MRC scale in less than half of the upper limb regions assessed at Visit V1. Exclusion Criteria: * ASIA with a neurological level of C2 or higher. * Previous cerebrovascular events, neurodegenerative disorders, or spinal cord injuries that have resulted in motor and/or cognitive impairment. * History of major psychiatric disorders. * Concurrent traumatic brain injury during the acute phase. * Previous orthopedic conditions of the shoulder resulting in severe functional impairment. * Active rheumatological conditions. * Severe uncorrected visual impairment (such that it prevents the patient from viewing the computer-based exercises proposed by the robot).