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  4. Feasibility, safety, and functional outcomes using the neurological controlled Hybrid Assistive Limb exoskeleton (HAL®) following acute incomplete and complete spinal cord injury – Results of 50 patients

Feasibility, safety, and functional outcomes using the neurological controlled Hybrid Assistive Limb exoskeleton (HAL®) following acute incomplete and complete spinal cord injury – Results of 50 patients

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2023.2200362 · Published: January 1, 2023

Spinal Cord InjuryAssistive TechnologyRehabilitation

Simple Explanation

This study investigates the use of a robotic exoskeleton (HAL®) in the rehabilitation of patients with acute spinal cord injuries. The goal was to determine if HAL®-assisted training is safe, feasible, and effective in improving functional mobility in these patients during their initial rehabilitation phase. The study found that HAL® locomotion training is feasible and safe for acute SCI patients and leads to improvements in functional and ambulatory mobility.

Study Duration
12 weeks
Participants
50 acute SCI patients (14 women, 36 men)
Evidence Level
Single center, prospective study

Key Findings

  • 1
    Patients showed significant improvements in overground walking speed, endurance, and the time required for the Timed-Up-And-Go test after HAL® training.
  • 2
    The Walking Index for Spinal Cord Injury (WISCI II) scores significantly increased, with many patients becoming less dependent on walking aids.
  • 3
    The Lower Extremity Motor Score (LEMS) also increased significantly in almost all patients, indicating improved muscle strength.

Research Summary

The study aimed to assess the safety, feasibility, and effectiveness of HAL® locomotion training in acute SCI patients. Significant improvements were observed in both HAL®-associated parameters (walking time, distance, and speed) and functional outcomes (10 MWT, 6 MWT, and TUG-test). The results suggest that HAL® training is a feasible and safe method for improving functional mobility in acute SCI patients, but further controlled trials are needed to confirm these findings.

Practical Implications

Early Rehabilitation

HAL® can be integrated into early rehabilitation programs for acute SCI patients to improve functional mobility.

Assistive Technology

HAL® can serve as an assistive technology to enhance overground walking and reduce dependence on walking aids.

Muscle Strength

HAL® training may contribute to increased muscle strength in the lower extremities of SCI patients.

Study Limitations

  • 1
    Lack of a control group
  • 2
    Heterogeneity of the patient cohort
  • 3
    Relatively small number of patients (n = 50)

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