Immediate effects of a single session of robot-assisted gait training using Hybrid Assistive Limb (HAL) for cerebral palsy

Matsuda, Mayumi; Mataki, Yuki; Mutsuzaki, Hirotaka; Yoshikawa, Kenichi; Takahashi, Katsumi; Enomoto, Keiko; Sano, Kumiko; Mizukami, Masafumi; Tomita, Kazuhide; Ohguro, Haruka; Iwasaki, Naoko

doi:10.1589/jpts.30.207

Cited by 35 publications

(52 citation statements)

References 44 publications

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“…With regard to the immediate effect, gait training using HAL significantly increased the gait speed and mean step length. Matsuda et al compared gait function before and after a HAL intervention for CP patients and found a significantly increased hip extension angle and knee extension angle in the stance phase and knee flexion angle in the swing phase 16 ) . Therefore, we considered that the step length improved.…”

Section: Discussionmentioning

confidence: 99%

“…However, few studies have reported the effect of gait training using HAL among CP patients. Matsuda et al reported that 12 CP patients who participated in a single gait training session using HAL showed an instantaneous improvement in single-leg support per gait cycle and hip and knee joint angle during walking 16 ) . However, there has been no other report on the immediate effect on walking ability of HAL training in CP patients.…”

Section: Introductionmentioning

confidence: 99%

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Safety and immediate effect of gait training using a Hybrid Assistive Limb in patients with cerebral palsy

et al. 2018

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[Purpose] This study aimed to determine the safety and immediate effect of a single training session with the Hybrid Assistive Limb (CYBERDYNE) on walking ability in patients with cerebral palsy. [Participants and Methods] This study included 20 patients with cerebral palsy (15 males, 5 females, mean age 15.0 ± 6.3 years; 19 with spastic cerebral palsy, 1 with athetoid cerebral palsy; Gross Motor Function Classification System level I: 4, II: 3, III: 9, and IV: 4). Participants completed a single 20-minute gait training session using the Hybrid Assistive Limb. The safety and immediate effect were evaluated. The immediate outcomes were gait speed and mean step length, and cadence before and after training. [Results] Two participants were excluded because they were not tall enough to use the Hybrid Assistive Limb. Eighteen participants performed the training. There were no serious adverse events during the training. Since 14 participants were able to walk on their own, walking evaluations were performed before and after training. Statistically significant improvements were observed in gait speed and mean step length. [Conclusion] Gait training using the Hybrid Assistive Limb is safe for patients with cerebral palsy and can produce immediate effects on walking ability in ambulatory patients with cerebral palsy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and immediate effect of gait training using a Hybrid Assistive Limb in patients with cerebral palsy

et al. 2018

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“…The wearer operates HAL by adjusting his or her own muscle activity. Clinical trials of training using HAL have been already conducted for patients with stroke [ 18 , 19 ], spinal cord injury [ 20 ], cerebral palsy [ 21 ], and neuromuscular diseases [ 22 ], and its clinical safety has been confirmed.…”

Section: Introductionmentioning

confidence: 99%

Training with Hybrid Assistive Limb for walking function after total knee arthroplasty

et al. 2018

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BackgroundThe Hybrid Assistive Limb (HAL, CYBERDYNE) is a wearable robot that provides assistance to patients while walking, standing, and performing leg movements based on the intended movement of the wearer. We aimed to assess the effect of HAL training on the walking ability, range of motion (ROM), and muscle strength of patients after total knee arthroplasty (TKA) for osteoarthritis and rheumatoid arthritis, and to compare the functional status after HAL training to the conventional training methods after surgery.MethodsNine patients (10 knees) underwent HAL training (mean age 74.1 ± 5.7 years; height 150.4 ± 6.5 cm; weight 61.2 ± 8.9 kg), whereas 10 patients (11 knees) underwent conventional rehabilitation (mean age 78.4 ± 8.0 years; height 150.5 ± 10.0 cm; weight 59.1 ± 9.8 kg). Patients underwent HAL training during 10 to 12 (average 14.4 min a session) sessions over a 4-week period, 1 week after TKA. There was no significant difference in the total physical therapy time including HAL training between the HAL and control groups. Gait speed, step length, ROM, and muscle strength were evaluated.ResultsThe nine patients completed the HAL training sessions without adverse events. The walking speed and step length in the self-selected walking speed condition, and the walking speed in the maximum walking speed condition were greater in the HAL group than in the control group at 4 and 8 weeks (P < 0.05). The step length in the maximum walking speed condition was greater in the HAL group than in the control group at 2, 4, and 8 weeks (P < 0.05). The extension lag and knee pain were lower in the HAL group than in the control group at 2 weeks (P < 0.05). The muscle strength of knee extension in the HAL group was greater than that in the control group at 8 weeks (P < 0.05).ConclusionHAL training after TKA can improve the walking ability, ROM, and muscle strength compared to conventional physical therapy for up to 8 weeks after TKA. Since the recovery of walking ability was earlier in the HAL group than in the control group and adverse events were not observed in this pilot study, HAL training after TKA can be considered a safe and effective rehabilitation intervention.Trial registrationUMIN, UMIN000017623. Registered 19 May 2015

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“…It has electrically driven power units at the bilateral hip and knee joints, which are actuated, amplifying the neuro-muscular activation of the relevant lower-limb muscles. HAL is known to be effective for gait improvement after neurological motion impairments including stroke [11,12], myelopathy in acute and chronic phases after spine surgery [13], spinal cord injury [14][15][16][17], and cerebral palsy [18]. However, regardless of these recent reports, improvement of DHS using HAL is reported only for a case so far [10].…”

Section: Introductionmentioning

confidence: 99%

Dropped Head Syndrome Attenuation by Hybrid Assistive Limb: A Preliminary Study of Three Cases on Cervical Alignment during Walking

et al. 2020

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Background and Objectives: Dropped head syndrome (DHS) is characterized by apparent neck extensor muscle weakness and difficulty in extending the neck to raise the head against gravity. DHS affects forward vision and eating behavior, and hence impairs quality of life. However, standardized treatment of DHS has not yet been established. The purpose of this preliminary study is to seek for a possibility of effective non-surgical, conservative treatment for DHS, by applying a robotic treatment. Materials and Methods: A wearable exoskeleton type robot suit hybrid assistive limb (HAL) was applied to three patients with DHS. A course of HAL treatment included 10 sessions of gait training using HAL. One session lasted about an hour. Case 1 completed the course twice, the first time in two weeks (one session per day) and second time in 10 months (one session per month). Case 2 and Case 3 completed the course once in 10 weeks (one session per week) and in 6 months (one session per 2.5 weeks), respectively. Immediate and lasting effects of HAL on the reduction of cervical sagittal vertical alignment (SVA) during gait was evaluated using a motion capture system. Results: Case 1 showed improvement of cervical alignment during gait after the HAL courses of both different frequencies. Case 2 did not show improvement of cervical alignment during gait. Case 3 showed improvement of cervical kyphosis but not of cervical sagittal alignment during gait. Conclusions: The results of the preliminary study suggest that gait training using HAL may be an effective option of conservative treatment for a part of DHS patients. They also suggest that a lack of immediate effects on the cervical alignment and a lack of ability to perform compensatory trunk motion may indicate a non-responding patient. Generalization of the results requires further research with more cases.

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Immediate effects of a single session of robot-assisted gait training using Hybrid Assistive Limb (HAL) for cerebral palsy

Cited by 35 publications

References 44 publications

Safety and immediate effect of gait training using a Hybrid Assistive Limb in patients with cerebral palsy

Safety and immediate effect of gait training using a Hybrid Assistive Limb in patients with cerebral palsy

Training with Hybrid Assistive Limb for walking function after total knee arthroplasty

Dropped Head Syndrome Attenuation by Hybrid Assistive Limb: A Preliminary Study of Three Cases on Cervical Alignment during Walking

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