Efficacy of a hybrid assistive limb in post-stroke hemiplegic patients: a preliminary report

Abstract

BackgroundRobotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work. We evaluated the effects of a hybrid assistive limb robot suit on the gait of stroke patients undergoing rehabilitation.MethodsThe study group comprised 16 stroke patients with severe hemiplegia. All patients underwent gait training. Four patients required assistance, and 12 needed supervision while walking. The stride length, walking speed and physiological cost index on wearing the hybrid assistive limb suit and a knee-ankle-foot orthosis were compared.ResultsThe hybrid assistive limb suit increased the stride length and walking speed in 4 of 16 patients. The patients whose walking speed decreased on wearing the hybrid assistive limb suit either had not received sufficient gait training or had an established gait pattern with a knee-ankle-foot orthosis using a quad cane. The physiological cost index increased after wearing the hybrid assistive limb suit in 12 patients, but removal of the suit led to a decrease in the physiological cost index values to equivalent levels prior to the use of the suit.ConclusionsAlthough the hybrid assistive limb suit is not useful for all hemiplegic patients, it may increase the walking speed and affect the walking ability. Further investigation would clarify its indication for the possibility of gait training.

Effectiveness of robot-assisted therapy on ankle rehabilitation – a systematic review

“…Both [59] and [60] which focused on a novel approach to walking therapy were excluded. Another two studies [61,62] concerning the whole lower limb recovery but no ankle were excluded. Eventually, 29 papers that still met the inclusion criteria were selected for this systematic review [58,63-90].…”

Feasibility and Safety of Acute Phase Rehabilitation After Stroke Using the Hybrid Assistive Limb Robot Suit

“…The HAL suit consists of a`cybernics voluntary control system,' which provides complete control using bioelectric signals, and a`cybernics robotic autonomous control system,' which generates the characteristic motor patterns of human motion. 12,16) The HAL system functions by utilizing several sensing modalities: skin-surface electromyographic electrodes placed on the rectus femoris, vastus lateralis, gluteus maximus, and biceps femoris muscles, potentiometers, and a gyroscope and accelerometer mounted in a backpack for torso posture estimation. The objective of the HAL suit is to increase and assist the voluntary motor functions of stroke patients.…”

“…3,5,6,8,9,[13][14][15]17) The hybrid assistive limb (HAL) suit is one of a number of advanced technologies that have been developed for the assistance of stroke patients. 12,16) This robotic device was originally designed to support elderly patients with muscle weakness, and to assist with independent mobility in people with impaired motor function. However, whether the HAL suit can be used for the rehabilitation of patients with acute stroke without adverse complications remains unclear.…”

The use of robots in stroke rehabilitation: A narrative review

“…The hybrid system supports autonomous control, driven by weight shift, or voluntary control, driven by activation of specific muscles, as determined by surface EMG. Initial studies of the HAL suit have been mixed in the stroke population, with some patients experiencing marked difficulty adjusting to the technology (Maeshima et al, 2011) and others suggesting initial feasibility for patients with severe gait impairment when paired with a bodyweight support system (Nilsson et al, 2014).…”