Hybrid Assistive Limb Intervention in a Patient with Late Neurological Deterioration after Thoracic Myelopathy Surgery due to Ossification of the Ligamentum Flavum

Case Reports in Orthopedics, 2018 · DOI: https://doi.org/10.1155/2018/6171760 · Published: February 8, 2018

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This case report evaluates the use of the Hybrid Assistive Limb (HAL®) exoskeleton robot to improve gait in a patient experiencing late-onset neurological decline after spinal surgery. The patient, a 70-year-old man, underwent ten 20-minute sessions of HAL intervention over five weeks, with evaluations including gait speed, lower limb movement, and muscle activity. The study found that the HAL intervention improved gait speed and step length, increased hip flexion during the swing phase, and reduced gastrocnemius muscle activation.

Study Duration

5 weeks

Participants

A 70-year-old man

Evidence Level

Case Report

Key Findings

1
HAL intervention improved gait speed from 0.83 m/s to 0.97 m/s.
2
The intervention increased maximum hip flexion angle during the swing phase.
3
Muscle activation ratio of the gastrocnemius decreased from 30 ± 10% to 14 ± 5%.

Research Summary

This case report describes the improvement in gait function of a 70-year-old patient with a chronic spinal disorder following a gait intervention using the HAL exoskeleton robot. The HAL intervention improved specific components of gait, such as speed and step length, and also improved ISNCSCI subscores of lower limb motor function, from 34 to 49. Gait training using the HAL exoskeleton robot can be used to provide a safe and feasible intervention to improve functional gait in patients with chronic spinal cord disorders.

Practical Implications

Improved Gait Function

HAL intervention can effectively improve gait speed, step length, and overall functional ambulation in patients with chronic spinal disorders.

Reduced Spasticity

The HAL intervention may be effective in reducing plantar flexor spasticity, leading to improved muscle control and strengthening of lower limb muscles.

Enhanced Motor Learning

The HAL's unique use of innate neuromuscular control enhances motor learning, making it a valuable tool for rehabilitation.

Study Limitations

1
Single case report limits generalizability.
2
Need for clinical trials to evaluate effectiveness in different conditions.
3
Case-control studies needed to compare HAL intervention with conventional physical therapy.

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