Gait training using a hybrid assistive limb (HAL) attenuates head drop: A case report
Gait training using a hybrid assistive limb (HAL) attenuates head drop: A case report
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使用混合辅助肢 (HAL) 进行步态训练可减轻头部下垂：病例报告
DOI：
10.1016/j.jocn.2018.03.010
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发表时间：
2018
影响因子：
2
通讯作者：
M. Yamazaki
中科院分区：
文献类型：
--
作者：
Kousei Miura;M. Koda;H. Kadone;S. Kubota;Yukiyo Shimizu;H. Kumagai;Katsuya Nagashima;Kentaro Mataki;Kengo Fujii;H. Noguchi;T. Funayama;T. Abe;Y. Sankai;M. Yamazaki
头部下垂综合征(DHS)以胸下巴畸形为特征，严重干扰视力，影响日常生活活动。DHS的标准化治疗策略尚未建立。据我们所知，这是第一个描述使用混合辅助肢体(HAL)进行DHS步态训练效果的病例报告。一名75岁的男性在站立姿势时明显头部下垂，导致被动可复位的胸部下巴畸形。X线影像显示明显的颈椎后凸。头部重心(CGH)-C7SVA为 +115 mm，CL为−40°，T1为39°。患者接受HAL治疗方案，其中主要进行步态训练，每天60 分钟，每周5 天，共2 周(10次)。经过2-3次治疗后，下降的头部开始减弱。在10个疗程结束时，患者能够以正常姿势行走，X线片图像显示由于HAL训练，颈椎后凸显著减少。CGH-C7SVA为42 mm，CL为−1.7°，T1为30°。门诊随访3个月，颈椎排列略有恶化。然而，患者能够保持比HAL训练前更好的颈椎排列，并保持向前视力行走。在任何一次HAL治疗中均未出现并发症。总之，除了先前报道的颈部伸肌训练外，使用HAL的步态训练是治疗DHS的一种选择。
Dropped head syndrome (DHS) is characterized by a chin-on-chest deformity, which can severely interfere with forward vision and impair activities of daily living. A standardized treatment strategy for DHS has not been established. To our knowledge, this is the first case report describing the efficacy of gait training using a hybrid assistive limb (HAL) for DHS. A 75-year-old man showed apparent head drop in a standing position, resulting in passively reducible chin-on-chest deformity. A radiograph image showed apparent cervical kyphosis. Center of gravity of the head (CGH)–C7 SVA was +115 mm, CL was −40°, and T1S 39°. The patient underwent a treatment program using HAL, in which gait training was mainly performed, 60 min a day, 5 days a week for 2 weeks (10 sessions). After 2–3 sessions, dropped head started to attenuate. At the end of 10 sessions, the patient was able to walk with normal posture and radiograph images showed cervical kyphosis dramatically decreased because of HAL training. CGH–C7 SVA was 42 mm, CL was −1.7°, and T1S was 30°. Three months’ outpatient follow-up revealed a slight deterioration of cervical alignment. However, the patient was able to maintain a better cervical alignment than before HAL training and keep walking with forward vision. There were no complications in any HAL treatment session. In conclusion, gait training using HAL is an option for treatment of DHS in addition to previously reported neck extensor muscle training.