Voluntary ambulation using voluntary upper limb muscle activity and Hybrid Assistive Limb® (HAL®) in a patient with complete paraplegia due to chronic spinal cord injury: A case report

This case report describes the use of the Hybrid Assistive Limb® (HAL®) to help a patient with complete paraplegia walk. The HAL® uses sensors to detect weak bioelectric signals from the skin and assists with voluntary movement of the knee and hip joints. The patient used remaining muscle activity, including hip flexor and upper limb activity, to trigger the HAL® and improve active knee extension and voluntary ambulation.

• 1
  The patient's manual muscle hip flexor scores improved after using the HAL®.
• 2
  Knee extensor MMT scores also improved following the HAL® intervention.
• 3
  Walking distance increased significantly during the course of the HAL® sessions.