The Hybrid Assistive Limb® intervention for a postoperative patient with spinal dural arteriovenous fistula and chronic spinal cord injury: A case study

This case study explores the use of the Hybrid Assistive Limb® (HAL®) in a patient with chronic spinal cord injury whose condition worsened due to a spinal dural arteriovenous fistula (SDAVF). The HAL® is a wearable robot suit designed to aid in walking by detecting bioelectric signals and assisting joint movement. The patient, a 48-year-old man, underwent HAL® intervention twice per week for a total of 10 sessions after his condition plateaued post-surgery. The intervention aimed to improve his walking ability, which was assessed through various tests, including the 10-meter walk test (10MWT) and electromyography. The study found that the HAL® intervention improved the patient's gait speed, cadence, and muscle activation in the legs. The patient's motor scores also improved, suggesting that HAL® can be an effective tool for improving functional ambulation in patients with chronic spinal cord injury.

• 1
  The HAL® intervention improved gait speed and cadence during the 10MWT. This suggests the device can enhance walking performance in patients with chronic spinal cord injury.
• 2
  Before the intervention, the patient's gluteus maximus (Gmax) and left quadriceps femoris (Quad) muscles were not activated. After the intervention, the right Gmax and both Quad muscles were activated rhythmically during the stance phase of gait.
• 3
  The patient's International Standards for Neurological and Functional Classification of Spinal Cord Injury (ISNCSCI) motor score improved from 14 to 16, and the Walking Index for Spinal Cord Injury II (WISCI II) score improved from 7 to 12, indicating enhanced motor function.