Hybrid assistive limb (HAL) treatment for patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) in the postoperative acute/subacute phase: A clinical trial
Hybrid assistive limb (HAL) treatment for patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) in the postoperative acute/subacute phase: A clinical trial
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DOI：
10.1080/10790268.2018.1525975
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发表时间：
2019-01-01
影响因子：
1.7
通讯作者：
Yamazaki, Masashi
中科院分区：
文献类型：
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作者：
Kubota, Shigeki;Abe, Tetsuya;Yamazaki, Masashi
背景/目标：混合辅助肢体（HAL）是一种可穿戴外骨骼机器人，通过实时驱动器控制来辅助行走和下肢运动。我们的目的是为了阐明使用HAL机器人服对由于后纵韧带骨化（T-OPLL）导致的严重胸椎脊髓病患者进行康复治疗的安全性和可行性。设计：非对照病例系列;干预前后测量。设置：住院患者康复单位。干预：HAL训练时间为60分钟，每周2-3次，共10次。术后平均27.5天开始HAL训练。患者：8例严重脊髓病患者（4男4女;平均年龄60.9 ± 10.2岁），均接受后路减压和内固定融合术。结果测量：步态速度，步长和节奏沿着10米走道进行测量。还在基线和10次治疗后评估了美国脊髓损伤协会（ASIA）运动评分（下肢）和脊髓损伤行走指数（WISCI）II。日本骨科协会（乔亚）评分计算随着时间的推移后surgical.Results：所有参与者完成了10个培训课程，没有严重的不良反应。随着时间的推移，步态速度，步长和节奏得到改善。10次治疗后，WISCI-II和ASIA运动（下肢）评分均较基线改善。结论：乔亚训练可在术后早期进行，对T-OPLL相关的严重步态障碍患者无严重不良反应。
Context/Objective: The hybrid assistive limb (HAL) is a wearable exoskeleton robot that assists walking and lower limb movements via real-time actuator control. Our aim was to clarify the safety and feasibility of using the HAL robotic suit for rehabilitation in patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (T-OPLL).Design: Uncontrolled case series; pre- and post-intervention measurement.Setting: In-patient rehabilitation unit.Intervention: HAL training was provided in 60-minuts session, 2-3 sessions per week, for a total of 10 sessions. HAL training was initiated on average 27.5 days post-surgery.Patients: Eight patients (four males and four females; mean age, 60.9 +/- 10.2 years) with severe myelopathy, who had undergone posterior decompression with instrumented fusion, were enrolled.Outcome Measures: Gait speed, step length and cadence were measured along a 10-m walkway every session. The American Spinal Injury Association (ASIA) motor score (lower extremities) and Walking Index for Spinal Cord Injury (WISCI) II were also evaluated at baseline and after 10 sessions. The Japanese Orthopaedic Association (JOA) score was calculated over time after surgery.Results: All participants completed the 10 training sessions, with no serious adverse effect noted. Gait speed, step length and cadence improved over time. Both the WISCI-II and ASIA motor (lower extremities) scores improved from baseline after 10 sessions. The JOA score improved over time post-surgery.Conclusion: HAL training can be feasibly initiated in the early postoperative period, without severe adverse events in patients, with T-OPLL-related severe gait disturbance.