The voluntary driven exoskeleton Hybrid Assistive Limb (HAL) for postoperative training of thoracic ossification of the posterior longitudinal ligament: a case report
The voluntary driven exoskeleton Hybrid Assistive Limb (HAL) for postoperative training of thoracic ossification of the posterior longitudinal ligament: a case report
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DOI：
10.1080/10790268.2016.1142056
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发表时间：
2017-01-01
影响因子：
1.7
通讯作者：
Yamazaki, Masashi
中科院分区：
文献类型：
--
作者：
Fujii, Kengo;Abe, Tetsuya;Yamazaki, Masashi
内容：混合辅助肢体（HAL）是一种可穿戴机器人套装，通过高灵敏度检测皮肤表面的生物电信号来辅助膝关节和髋关节运动的自主控制。据报道，HAL对运动障碍的功能恢复有效。然而，很少有报告显示HAL对接受胸椎后纵韧带骨化症（胸椎OPLL）手术的患者的效用。在此，我们提出了一个术后胸椎OPLL患者谁表现出显着的功能恢复训练后HAL.Findings：一个63岁的女人，谁不能走，由于肌肉无力手术前，进行了后路减压和融合。术后首次起身后，瘫痪再次加重。我们诊断瘫痪是由于前路病变的残余压迫和后路固定后的微不稳定，并规定卧床休息3周。不完全性瘫痪逐渐恢复，除了标准的物理治疗外，术后第44天开始使用HAL进行步行训练。患者接受了10次HAL训练，直至术后第73天出院。每次治疗后，评估10米步行试验的结果，患者的速度和节奏明显改善。出院时，患者可使用2支拐杖行走，无需辅助。结论：HAL训练对胸椎OPLL患者术后步行能力的改善有促进作用，即使术前存在严重的上肢功能障碍和肌无力。
Context: The hybrid assistive limb (HAL) is a wearable robot suit that assists in voluntary control of knee and hip joint motion by detecting bioelectric signals on the surface of the skin with high sensitivity. HAL has been reported to be effective for functional recovery in motor impairments. However, few reports have revealed the utility of HAL for patients who have undergone surgery for thoracic ossification of the posterior longitudinal ligament (thoracic OPLL). Herein, we present a postoperative thoracic OPLL patient who showed remarkable functional recovery after training with HAL.Findings: A 63-year-old woman, who could not walk due to muscle weakness before surgery, underwent posterior decompression and fusion. Paralysis was re-aggravated after the initial postoperative rising. We diagnosed that paralysis was due to residual compression from the anterior lesion and microinstability after posterior fixation, and prescribed bed rest for a further 3 weeks. The incomplete paralysis gradually recovered, and walking training with HAL was started on postoperative day 44 in addition to standard physical therapy. The patient underwent 10 sessions of HAL training until discharge on postoperative day 73. Results of a 10-m walk test were assessed after every session, and the patient's speed and cadence markedly improved. At discharge, the patient could walk with 2 crutches and no assistance. Furthermore, no adverse events associated with HAL training occurred.Conclusion: HAL training for postoperative thoracic OPLL patients may enhance improvement in walking ability, even if severe impairment of ambulation and muscle weakness exist preoperatively.