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Karunakaran KK, Pamula SD, Bach CP, Legelen E, Saleh S, Nolan KJ. Lower extremity robotic exoskeleton devices for overground ambulation recovery in acquired brain injury-A review. Front Neurorobot 2023; 17:1014616. [PMID: 37304666 PMCID: PMC10249611 DOI: 10.3389/fnbot.2023.1014616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/27/2023] [Indexed: 06/13/2023] Open
Abstract
Acquired brain injury (ABI) is a leading cause of ambulation deficits in the United States every year. ABI (stroke, traumatic brain injury and cerebral palsy) results in ambulation deficits with residual gait and balance deviations persisting even after 1 year. Current research is focused on evaluating the effect of robotic exoskeleton devices (RD) for overground gait and balance training. In order to understand the device effectiveness on neuroplasticity, it is important to understand RD effectiveness in the context of both downstream (functional, biomechanical and physiological) and upstream (cortical) metrics. The review identifies gaps in research areas and suggests recommendations for future research. We carefully delineate between the preliminary studies and randomized clinical trials in the interpretation of existing evidence. We present a comprehensive review of the clinical and pre-clinical research that evaluated therapeutic effects of RDs using various domains, diagnosis and stage of recovery.
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Affiliation(s)
- Kiran K. Karunakaran
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers—New Jersey Medical School, Newark, NJ, United States
- Research Staff Children's Specialized Hospital New Brunswick, New Brunswick, NJ, United States
| | - Sai D. Pamula
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Caitlyn P. Bach
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Eliana Legelen
- Department of Psychology, Montclair State University, Montclair, NJ, United States
| | - Soha Saleh
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers—New Jersey Medical School, Newark, NJ, United States
| | - Karen J. Nolan
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers—New Jersey Medical School, Newark, NJ, United States
- Research Staff Children's Specialized Hospital New Brunswick, New Brunswick, NJ, United States
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Uehara A, Kawamoto H, Imai H, Shirai M, Sone M, Noda S, Sato S, Hattori N, Sankai Y. Gait improvement with wearable cyborg HAL trunk unit for parkinsonian patients: five case reports. Sci Rep 2023; 13:6962. [PMID: 37117241 PMCID: PMC10147720 DOI: 10.1038/s41598-023-33847-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/19/2023] [Indexed: 04/30/2023] Open
Abstract
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.
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Affiliation(s)
- Akira Uehara
- Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki, 305-8573, Japan.
- Center for Cybernics Research, University of Tsukuba, Ibaraki, 305-8573, Japan.
| | - Hiroaki Kawamoto
- Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki, 305-8573, Japan
- Center for Cybernics Research, University of Tsukuba, Ibaraki, 305-8573, Japan
| | - Hisamasa Imai
- Department of Neurology, Tokyo Rinkai Hospital, Tokyo, 134-0086, Japan
| | - Makoto Shirai
- Department of Rehabilitation, Limited Company Jin, Saitama, 341-0003, Japan
| | | | - Sachiko Noda
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, 113-8431, Japan
| | - Shigeto Sato
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, 113-8431, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, 113-8431, Japan
| | - Yoshiyuki Sankai
- Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki, 305-8573, Japan
- Center for Cybernics Research, University of Tsukuba, Ibaraki, 305-8573, Japan
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Lorusso M, Tramontano M, Casciello M, Pece A, Smania N, Morone G, Tamburella F. Efficacy of Overground Robotic Gait Training on Balance in Stroke Survivors: A Systematic Review and Meta-Analysis. Brain Sci 2022; 12:brainsci12060713. [PMID: 35741599 PMCID: PMC9221355 DOI: 10.3390/brainsci12060713] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 12/29/2022] Open
Abstract
Strokes often lead to a deficit in motor control that contributes to a reduced balance function. Impairments in the balance function severely limit the activities of daily living (ADL) in stroke survivors. The present systematic review and meta-analysis primarily aims to explore the efficacy of overground robot-assisted gait training (o-RAGT) on balance recovery in individuals with stroke. In addition, the efficacy on ADL is also investigated. This systematic review identified nine articles investigating the effects of o-RAGT on balance, four of which also assessed ADL. The results of the meta-analysis suggest that o-RAGT does not increase balance and ADL outcomes more than conventional therapy in individuals after stroke. The data should not be overestimated due to the low number of studies included in the meta-analysis and the wide confidence intervals. Subgroup analyses to investigate the influence of participant’s characteristics and training dosage were not performed due to lack of data availability. Further well-designed randomized controlled trials are needed to investigate the efficacy of o-RAGT on balance in individuals with stroke.
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Affiliation(s)
- Matteo Lorusso
- Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (M.L.); (M.C.); (F.T.)
| | - Marco Tramontano
- Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (M.L.); (M.C.); (F.T.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00185 Rome, Italy
- Correspondence:
| | - Matteo Casciello
- Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (M.L.); (M.C.); (F.T.)
| | - Andrea Pece
- Ospedale Israelitico di Roma, Via Fulda 14, 00148 Rome, Italy;
| | - Nicola Smania
- Neurorehabilitation Unit, University Hospital of Verona, 37124 Verona, Italy;
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Federica Tamburella
- Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (M.L.); (M.C.); (F.T.)
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Morioka H, Hirayama T, Sugisawa T, Murata K, Shibukawa M, Ebina J, Sawada M, Hanashiro S, Nagasawa J, Yanagihashi M, Uchi M, Kawabe K, Washizawa N, Ebihara S, Nakajima T, Kano O. Robot-assisted training using hybrid assistive limb ameliorates gait ability in patients with amyotrophic lateral sclerosis. J Clin Neurosci 2022; 99:158-163. [PMID: 35279589 DOI: 10.1016/j.jocn.2022.02.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The Hybrid Assistive Limb (HAL; CYBERDYNE, Inc., Japan) is a wearable robot device that provides effective gait assistance according to voluntary intention by detecting weak bioelectrical signals of neuromuscular activity on the surface of the skin. We used HAL for patients with amyotrophic lateral sclerosis (ALS) to determine whether HAL training had an effect on their gait ability. METHODS We conducted a single-center, single-arm, observational study. Patients with ALS underwent HAL training once per day (20-40 min per session) for 9-10 days for at least 4 weeks. Gait ability was evaluated using the 2-minute walk test, the 10-meter walk test without the assistance of HAL, and activities of daily living (ADL) using the Barthel Index and Functional Independence Measures before and after a full course of HAL training. RESULTS There were no dropouts or adverse events during the observation period. Gait function improved after HAL training. The 2-minute walk test revealed a mean gait distance of 73.87 m (36.65) at baseline and 89.9m (36.70) after HAL training (p = 0.004). The 10-meter walk test showed significantly improved cadence, although gait speed, step length on the 10-m walk, or ADL measurements did not change significantly. CONCLUSIONS Although HAL is not a curative treatment for ALS, our data suggest that HAL may be effective in ameliorating and preserving gait ability in patients with ALS.
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Affiliation(s)
- Harumi Morioka
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Takehisa Hirayama
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Tatsuki Sugisawa
- Department of Rehabilitation Medicine, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Kiyoko Murata
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Mari Shibukawa
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Junya Ebina
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Masahiro Sawada
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Sayori Hanashiro
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Junpei Nagasawa
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Masaru Yanagihashi
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Masayuki Uchi
- Department of Rehabilitation Medicine, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Kiyokazu Kawabe
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Naohiro Washizawa
- Nutrition Therapy Center, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Satoru Ebihara
- Department of Rehabilitation Medicine, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Takashi Nakajima
- Niigata National Hospital, National Hospital Organization, 3-52 Akasaka Kashiwazaki City, Niigata 945-8585, Japan
| | - Osamu Kano
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan.
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Pinto-Fernandez D, Torricelli D, Sanchez-Villamanan MDC, Aller F, Mombaur K, Conti R, Vitiello N, Moreno JC, Pons JL. Performance Evaluation of Lower Limb Exoskeletons: A Systematic Review. IEEE Trans Neural Syst Rehabil Eng 2021; 28:1573-1583. [PMID: 32634096 DOI: 10.1109/tnsre.2020.2989481] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Benchmarks have long been used to verify and compare the readiness level of different technologies in many application domains. In the field of wearable robots, the lack of a recognized benchmarking methodology is one important impediment that may hamper the efficient translation of research prototypes into actual products. At the same time, an exponentially growing number of research studies are addressing the problem of quantifying the performance of robotic exoskeletons, resulting in a rich and highly heterogeneous picture of methods, variables and protocols. This review aims to organize this information, and identify the most promising performance indicators that can be converted into practical benchmarks. We focus our analysis on lower limb functions, including a wide spectrum of motor skills and performance indicators. We found that, in general, the evaluation of lower limb exoskeletons is still largely focused on straight walking, with poor coverage of most of the basic motor skills that make up the activities of daily life. Our analysis also reveals a clear bias towards generic kinematics and kinetic indicators, in spite of the metrics of human-robot interaction. Based on these results, we identify and discuss a number of promising research directions that may help the community to attain a comprehensive benchmarking methodology for robot-assisted locomotion more efficiently.
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Watanabe H, Tsurushima H, Yanagi H. Effect of hybrid assistive limb treatment on maximal walking speed and six-minute walking distance during stroke rehabilitation: a pilot study. J Phys Ther Sci 2021; 33:168-174. [PMID: 33642694 PMCID: PMC7897533 DOI: 10.1589/jpts.33.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/25/2020] [Indexed: 12/04/2022] Open
Abstract
[Purpose] In stroke rehabilitation, gait assessment measures the maximal walking speed and six-minute walking distance, both of which have not been thoroughly investigated as determinants of walking ability. Here, we assessed the methods for evaluating these gait parameters using clinical data on hybrid assistive limb treatment compared with conventional training. [Participants and Methods] In total, 20 stroke patients (hybrid assistive limb group, n=9; conventional group, n=11) participated in this randomized controlled trial. For 12 sessions (three times per week in 4 weeks), the hybrid assistive limb and conventional groups performed gait treatment with hybrid assistive limb and conventional gait training, respectively. Short physical performance battery and walking ability (maximal walking speed and six-minute walking distance) were evaluated pre- and post-intervention. Subsequently, the patients were divided further into two groups: low- and high-balance score groups. [Results] Maximum walking speed and six-minute walking distance were significantly associated, with a positive relationship observed post-intervention. The high-balance score group showed a significant improvement in the six-minute walking distance compared to the low-balance score group. However, no significant improvement in maximum walking speed was observed between both groups. [Conclusion] Due to its sensitivity in detecting differences in balance, six-minute walking distance may be a useful assessment parameter for stroke rehabilitation, particularly in the recovery of physiological walking ability.
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Affiliation(s)
- Hiroki Watanabe
- Department of Neurosurgery, Faculty of Medicine, University
of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Hideo Tsurushima
- Department of Neurosurgery, Faculty of Medicine, University
of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Hisako Yanagi
- Department of Medical Science and Welfare, Faculty of
Medicine, University of Tsukuba, Japan
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A Consecutive 25-Week Program of Gait Training, Using the Alternating Hybrid Assistive Limb (HAL ®) Robot and Conventional Training, and Its Effects on the Walking Ability of a Patient with Chronic Thoracic Spinal Cord Injury: A Single Case Reversal Design. ACTA ACUST UNITED AC 2019; 55:medicina55110746. [PMID: 31752225 PMCID: PMC6915663 DOI: 10.3390/medicina55110746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 11/29/2022]
Abstract
Background and Objectives: In this study, we examined the effect of a consecutive 25-week gait training program, consisting of 5-week alternating phases of Hybrid Assistive Limb (HAL)-assisted robot gait training and conventional gait training, on the walking ability of a 50-year-old man with a chronic thoracic spinal cord injury (SCI). Materials and Methods: Clinical features of this patient’s paraplegia were as follows: neurological level, T7; American Spinal Cord Injury Association Impairment Scale Score, C; Lower Extremity Motor Score, 20 points; Berg Balance Scale score, 15 points; and Walking Index for Spinal Cord Injury, 6 points. The patient completed a 100 m walk, under close supervision, using a walker and bilateral ankle-foot orthoses. The intervention included two phases: phase A, conventional walking practice and physical therapy for 5 weeks, and phase B, walking using the HAL robot (3 d/week, 30 min/session), combined with conventional physical therapy, for 5 weeks. A consecutive A-B-A-B-A sequence was used, with a 5-week duration for each phase. Results: The gait training intervention increased the maximum walking speed, cadence, and 2-min walking distance, as well as the Berg Balance and Walking Index for Spinal Cord Injury from 15 to 17 and 6 to 7, respectively. Walking speed, stride length, and cadence improved after phase A (but not B). Improved standing balance was associated with measured improvements in measured gait parameters. Conclusion: The walking ability of patients with a chronic SCI may be improved, over a short period by combining gait training, using HAL-assisted and conventional gait training and physical therapy.
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Sczesny-Kaiser M, Trost R, Aach M, Schildhauer TA, Schwenkreis P, Tegenthoff M. A Randomized and Controlled Crossover Study Investigating the Improvement of Walking and Posture Functions in Chronic Stroke Patients Using HAL Exoskeleton - The HALESTRO Study (HAL-Exoskeleton STROke Study). Front Neurosci 2019; 13:259. [PMID: 30983953 PMCID: PMC6450263 DOI: 10.3389/fnins.2019.00259] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/05/2019] [Indexed: 01/26/2023] Open
Abstract
Background: The exoskeleton HAL (hybrid assistive limb) has proven to improve walking functions in spinal cord injury and chronic stroke patients when using it for body-weight supported treadmill training (BWSTT). Compared with other robotic devices, it offers the possibility to initiate movements actively. Previous studies on stroke patients did not compare HAL-BWSTT with conventional physiotherapy (CPT). Therefore, we performed a crossover clinical trial comparing CPT and HAL-BWSTT in chronic stroke patients with hemiparesis, the HALESTRO study. Our hypothesis was that HAL-training would have greater effects on walking and posture functions compared to a mixed-approach CPT. Methods: A total of 18 chronic stroke patients participated in this study. Treatment consisted of 30 CPT sessions and of 30 sessions of BWSTT with a double leg type HAL exoskeleton successively in a randomized, crossover study design. Primary outcome parameters were walking time and speed in 10-meter walk test (10MWT), time in timed-up-and-go test (TUG) and distance in 6-min walk test (6MWT). Secondary outcome parameters were the functional ambulatory categories (FAC) and the Berg-Balance Scale (BBS). Data were assessed at baseline, at crossover and at the end of the study, all without using and wearing HAL. Results: Our study demonstrate neither a significant difference in walking parameters nor in functional and balance parameters. When HAL-BWSTT was applied to naïve patients, it led to an improvement in walking parameters and in balance abilities. Pooling all data, we could show a significant effect in 10MWT, 6MWT, FAC and BBS, both therapies sequentially applied over 12 weeks. Thereby, FAC improve from dependent to independent category (3 to 4). One patient dropped out of the study due to intensive fatigue after each training session. Conclusion: HAL-BWSTT and mixed-approach CPT were effective therapies in chronic stroke patients. However, compared with CPT, HAL training with 30 sessions over 6 weeks was not more effective. The combination of both therapies led to an improvement of walking and balance functions. Robotic rehabilitation of walking disorders alone still lacks the proof of superiority in chronic stroke. Robotic treatment therapies and classical CPT rehabilitation concepts should be applied in an individualized therapy program.
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Affiliation(s)
| | - Rebecca Trost
- Department of Neurology, BG University Hospital Bergmannsheil Bochum, Bochum, Germany
| | - Mirko Aach
- Department of Spinal Cord Injury, BG University Hospital Bergmannsheil Bochum, Bochum, Germany
| | - Thomas A Schildhauer
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil Bochum, Bochum, Germany
| | - Peter Schwenkreis
- Department of Neurology, BG University Hospital Bergmannsheil Bochum, Bochum, Germany
| | - Martin Tegenthoff
- Department of Neurology, BG University Hospital Bergmannsheil Bochum, Bochum, Germany
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Sczesny-Kaiser M, Kowalewski R, Schildhauer TA, Aach M, Jansen O, Grasmücke D, Güttsches AK, Vorgerd M, Tegenthoff M. Treadmill Training with HAL Exoskeleton-A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy-Preliminary Study. Front Neurosci 2017; 11:449. [PMID: 28848377 PMCID: PMC5550721 DOI: 10.3389/fnins.2017.00449] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/24/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies.
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Affiliation(s)
- Matthias Sczesny-Kaiser
- Department of Neurology, BG-University Hospital Bergmannsheil Bochum, Ruhr University BochumBochum, Germany
| | - Rebecca Kowalewski
- Department of Neurology, BG-University Hospital Bergmannsheil Bochum, Ruhr University BochumBochum, Germany
| | - Thomas A Schildhauer
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr University BochumBochum, Germany
| | - Mirko Aach
- Department of Spinal Cord Injury, BG-University Hospital Bergmannsheil Bochum, Ruhr University BochumBochum, Germany
| | - Oliver Jansen
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr University BochumBochum, Germany
| | - Dennis Grasmücke
- Department of Spinal Cord Injury, BG-University Hospital Bergmannsheil Bochum, Ruhr University BochumBochum, Germany
| | - Anne-Katrin Güttsches
- Department of Neurology, BG-University Hospital Bergmannsheil Bochum, Ruhr University BochumBochum, Germany
| | - Matthias Vorgerd
- Department of Neurology, BG-University Hospital Bergmannsheil Bochum, Ruhr University BochumBochum, Germany
| | - Martin Tegenthoff
- Department of Neurology, BG-University Hospital Bergmannsheil Bochum, Ruhr University BochumBochum, Germany
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