Robot-assisted training using hybrid assistive limb ameliorates gait ability in patients with amyotrophic lateral sclerosis
Robot-assisted training using hybrid assistive limb ameliorates gait ability in patients with amyotrophic lateral sclerosis
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DOI：
10.1016/j.jocn.2022.02.032
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发表时间：
2022-03-10
影响因子：
2
通讯作者：
Kano, Osamu
中科院分区：
文献类型：
--
作者：
Morioka, Harumi;Hirayama, Takehisa;Kano, Osamu
目的：混合辅助肢体（HAL; CYBERDYNE，Inc.，日本）是一种可穿戴机器人设备，通过检测皮肤表面神经肌肉活动的微弱生物电信号，根据自愿意图提供有效的步态辅助。我们将HAL用于肌萎缩侧索硬化症（ALS）患者，以确定HAL训练是否对他们的步态能力有影响。方法：我们进行了一项单中心、单臂、观察性研究。ALS患者每天接受一次HAL训练（每次20 - 40分钟），持续9 - 10天，持续至少4周。分别于训练前后进行2 min步行试验、10 m步行试验、Barthel指数和功能独立性量表评定步态能力。结果：在观察期内没有脱落或不良事件。HAL训练后步态功能改善。2分钟步行试验显示，基线时的平均步态距离为73.87 m（36.65），HAL训练后为89.9 m（36.70）（p = 0.004）。10米步行试验显示步频显著改善，尽管步态速度、10米步行步长或ADL测量值没有显著变化。结论：虽然HAL不是ALS的治愈性治疗，但我们的数据表明HAL可能有效改善和保留ALS患者的步态能力。
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.