Sakakima Harutoshi, Ijiri Kosei, Matsuda Fumiyo, Tominaga Hiroyuki, Biwa Takanori, Yone Kazunori, Sankai Yoshiyuki
Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.
Department of Orthopedic Surgery, Faculty of Medicine, Kagoshima University, Japan.
Case Rep Orthop. 2013;2013:621405. doi: 10.1155/2013/621405. Epub 2013 Nov 28.
Most patients with thoracic ossification of the posterior longitudinal ligament (OPLL) exhibit delayed recovery of gait dysfunction after spinal injury. The hybrid assistive limb (HAL) is a new robot suit controlling knee and hip joint motion by detecting very weak bioelectric signals on the surface of the skin. This study is to report the feasibility and benefits of patient-assistive HAL walking rehabilitation for facilitating locomotor function after spinal surgery. The patient was a 60-year-old woman with thoracic OPLL, and her motor and sensory paralyses did not improve after spinal surgery, indicating severe impairment in the paretic legs. The subject underwent 6 HAL sessions per week for 8 weeks, consisting of a standing and sitting exercise and walking on the ground with HAL. Clinical outcomes were evaluated before and after HAL training and 1 year after surgery. The subject improved considerably as a result of HAL training. Subsequently, her walking ability recovered rapidly, and she was able to walk unaided six months after surgery. This case study suggests that HAL training is a feasible and effective option to facilitating locomotor function and the early HAL training with physiotherapy may enhance motor recovery of patients with residual paralysis after surgery.
大多数胸椎后纵韧带骨化(OPLL)患者在脊髓损伤后步态功能恢复延迟。混合辅助肢体(HAL)是一种新型机器人套装,通过检测皮肤表面非常微弱的生物电信号来控制膝关节和髋关节运动。本研究旨在报告患者辅助HAL步行康复对促进脊柱手术后运动功能恢复的可行性和益处。该患者为一名60岁的胸椎OPLL女性,脊柱手术后其运动和感觉麻痹未改善,表明患侧下肢严重受损。该受试者每周接受6次HAL训练,共8周,包括站立和坐下练习以及穿着HAL在地面行走。在HAL训练前后以及手术后1年对临床结果进行评估。由于HAL训练,该受试者有了显著改善。随后,她的步行能力迅速恢复,术后6个月能够独立行走。本案例研究表明,HAL训练是促进运动功能恢复的一种可行且有效的选择,早期结合物理治疗的HAL训练可能会增强手术后仍有残留麻痹患者的运动恢复。
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