Robot-assisted training using hybrid assistive limb ameliorates gait ability in patients with amyotrophic lateral sclerosis

Morioka, Harumi; Hirayama, Takehisa; Sugisawa, Tatsuki; Murata, Kiyoko; Shibukawa, Mari; Ebina, Junya; Sawada, Masahiro; Hanashiro, Sayori; Nagasawa, Junpei; Yanagihashi, Masaru; Uchi, Masayuki; Kawabe, Kiyokazu; Washizawa, Naohiro; Ebihara, Satoru; Nakajima, Takashi; Kano, Osamu

doi:10.1016/j.jocn.2022.02.032

Cited by 13 publications

(6 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, an inert proton-based long-range ultrafast signaled proprioceptive skeletal system is emerging that is suggested to be gradually lost in ALS due to the theorized progressive irreversible Piezo2 channelopathy. This may explain how soft and exoskeletal robotic-assisted therapeutic exercises show preventive or even positive results in ALS [ 106 , 107 , 108 , 109 ]. Correspondingly, the author proposes that the dying mechanism in ALS is backwards if it is looked at from a somatosensory angle.…”

Section: Discussionmentioning

confidence: 99%

Progressive Irreversible Proprioceptive Piezo2 Channelopathy-Induced Lost Forced Peripheral Oscillatory Synchronization to the Hippocampal Oscillator May Explain the Onset of Amyotrophic Lateral Sclerosis Pathomechanism

Sonkodi

2024

Cells

View full text Add to dashboard Cite

Amyotrophic lateral sclerosis (ALS) is a mysterious lethal multisystem neurodegenerative disease that gradually leads to the progressive loss of motor neurons. A recent non-contact dying-back injury mechanism theory for ALS proposed that the primary damage is an acquired irreversible intrafusal proprioceptive terminal Piezo2 channelopathy with underlying genetic and environmental risk factors. Underpinning this is the theory that excessively prolonged proprioceptive mechanotransduction under allostasis may induce dysfunctionality in mitochondria, leading to Piezo2 channelopathy. This microinjury is suggested to provide one gateway from physiology to pathophysiology. The chronic, but not irreversible, form of this Piezo2 channelopathy is implicated in many diseases with unknown etiology. Dry eye disease is one of them where replenishing synthetic proteoglycans promote nerve regeneration. Syndecans, especially syndecan-3, are proposed as the first critical link in this hierarchical ordered depletory pathomechanism as proton-collecting/distributing antennas; hence, they may play a role in ALS pathomechanism onset. Even more importantly, the shedding or charge-altering variants of Syndecan-3 may contribute to the Piezo2 channelopathy-induced disruption of the Piezo2-initiated proton-based ultrafast long-range signaling through VGLUT1 and VGLUT2. Thus, these alterations may not only cause disruption to ultrafast signaling to the hippocampus in conscious proprioception, but could disrupt the ultrafast proprioceptive signaling feedback to the motoneurons. Correspondingly, an inert Piezo2-initiated proton-based ultrafast signaled proprioceptive skeletal system is coming to light that is suggested to be progressively lost in ALS. In addition, the lost functional link of the MyoD family of inhibitor proteins, as auxiliary subunits of Piezo2, may not only contribute to the theorized acquired Piezo2 channelopathy, but may explain how these microinjured ion channels evolve to be principal transcription activators.

show abstract

Section: Discussionmentioning

confidence: 99%

Progressive Irreversible Proprioceptive Piezo2 Channelopathy-Induced Lost Forced Peripheral Oscillatory Synchronization to the Hippocampal Oscillator May Explain the Onset of Amyotrophic Lateral Sclerosis Pathomechanism

Sonkodi

2024

Cells

View full text Add to dashboard Cite

show abstract

“…Additionally, repetition enhances the transmission efficiency of synapses based on the Hebbian rule 20 . Previous studies of HAL have shown that cybernic treatments based on iBF effectively improve the gait function of patients with several intractable neurological and neuromuscular disorders 14 , 21 – 23 . For these reasons, HAL (which provides lateral and cyclic forces based on conventional findings regarding physical therapy) generates somatosensory and motor cues and has the potential to enhance iBF because HAL amplifies the lateral sway of patients, allowing them to achieve near-normal voluntary movement.…”

Section: Introductionmentioning

confidence: 99%

Gait improvement with wearable cyborg HAL trunk unit for parkinsonian patients: five case reports

Uehara¹,

Kawamoto²,

Imai³

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Cybernic treatment involves the generation of an interactive bio-feedback loop between an individual’s nervous system and the worn cyborg Hybrid Assistive Limb (HAL); this treatment has been applied for several intractable neuromuscular disorders. Thus, it is of interest to determine its potential for parkinsonian patients. This study confirmed the feasibility of using a HAL trunk unit to improve parkinsonian gait disturbance. HAL establishes functional and physical synchronization with the wearer by providing lateral cyclic forces to the chest in the form of somatosensory and motor cues. To confirm the feasibility of its use for improving parkinsonian gait disturbances, we conducted experiments with three Parkinson’s disease patients and two patients with progressive supranuclear palsy. During the experiments, the immediate effect of the intervention was assessed; all participants exhibited improvements in gait disturbance while wearing the HAL unit, and this improvement effect persisted without the HAL unit in two participants. Afterward, based on the assessment, we conducted a continuous intervention for one participant. In this intervention, the number of steps in the final experiment was significantly decreased compared with the initial state. These findings suggest that the proposed method is an option for treating parkinsonian patients to generate somatosensory and motor cues.

show abstract

“…In this venue, the use of robotic devices, especially for gait impairment, is of potential benefit also in ALS individuals [41]. Promising are also coming from studies on upper-limb robotic devices, as functional improvement has also been demonstrated [42]. Nonetheless, most of the robotic devices used to potentiate both upper-and lower-limb functions are exoskeletons, which exert high forces and friction on the joints with a higher risk of fractures, especially in patients with osteopenia/osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Bone Health Status in Individuals with Amyotrophic Lateral Sclerosis: A Cross-Sectional Study on the Role of the Trabecular Bone Score and Its Implications in Neurorehabilitation

Morini

Portaro

Leonetti

et al. 2023

IJERPH

View full text Add to dashboard Cite

Background and Objectives: Osteoporosis is a metabolic skeletal disease resulting in low bone mass with increased bone fragility and susceptibility to fractures. May lead to rapid loss of bone mineral density (BMD) due to physical inactivity and reduced muscle contractions. Generally, the diagnosis of osteoporosis is made using dual X-ray absorptiometry (DXA), by measuring BMD and the trabecular bone score (TBS), which can be useful for detecting bone fragility and susceptibility to fractures. Therefore, the aim of this study was to investigate, using BMD and TBS, the bone health status in a sample of amyotrophic lateral sclerosis (ALS) inpatients attending neurorehabilitation. Materials and Methods: Thirty-nine patients were included in the study and underwent electrocardiogram and blood tests, including calcium and parathyroid hormone, as well as vitamin D dosage, and DXA. Results: We found that the TBS of patients with osteoporosis was lower than that of those ALS patients with osteopenia or normal bone status, both in the lumbar spine and femoral neck, although no statistical significance was reached. In addition, Spearman’s correlation coefficient indicated a moderate correlation between TBS and lumbar spine BMD (r = −0.34) and a mild correlation between TBS and femoral neck BMD (r = −0.28). Conclusions: This study confirmed the hypothesis that ALS patients may exhibit deteriorated bone health with lower bone density and focused on the possible role of the TBS in the multidisciplinary approach to ALS.

show abstract

Robot-assisted training using hybrid assistive limb ameliorates gait ability in patients with amyotrophic lateral sclerosis

Cited by 13 publications

References 39 publications

Progressive Irreversible Proprioceptive Piezo2 Channelopathy-Induced Lost Forced Peripheral Oscillatory Synchronization to the Hippocampal Oscillator May Explain the Onset of Amyotrophic Lateral Sclerosis Pathomechanism

Progressive Irreversible Proprioceptive Piezo2 Channelopathy-Induced Lost Forced Peripheral Oscillatory Synchronization to the Hippocampal Oscillator May Explain the Onset of Amyotrophic Lateral Sclerosis Pathomechanism

Gait improvement with wearable cyborg HAL trunk unit for parkinsonian patients: five case reports

Bone Health Status in Individuals with Amyotrophic Lateral Sclerosis: A Cross-Sectional Study on the Role of the Trabecular Bone Score and Its Implications in Neurorehabilitation

Contact Info

Product

Resources

About