Matsuda Mayumi, Iwasaki Nobuaki, Mataki Yuki, Mutsuzaki Hirotaka, Yoshikawa Kenichi, Takahashi Kazushi, Enomoto Keiko, Sano Kumiko, Kubota Aoi, Nakayama Tomohiro, Nakayama Junko, Ohguro Haruka, Mizukami Masafumi, Tomita Kazuhide
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Japan; Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Japan.
Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, Japan; Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Japan.
Brain Dev. 2018 Sep;40(8):642-648. doi: 10.1016/j.braindev.2018.04.004. Epub 2018 Jul 14.
The Hybrid Assistive Limb® (HAL®, CYBERDYNE) is a wearable robot that provides assistance to a patient while they are walking, standing, and performing leg movements based on the wearer's intended movement. The effect of robot-assisted training using HAL® for cerebral palsy (CP) is unknown. Therefore, we assessed the effect of robot-assisted training using HAL® on patients with CP, and compared walking and gross motor abilities between pre-intervention and post-intervention.
Six subjects with CP were included (mean age: 16.8 years; range: 13-24 years; Gross Motor Function Classification System levels II-IV: n = 1, 4, 1). Robot-assisted training using HAL® were performed 2-4 sessions per week, 20 min per session, within a 4 weeks period, 12 times in total. Outcome measures included gait speed, step length, cadence, single-leg support per gait cycle, hip and knee joint angle in stance, and swing phase per gait cycle, 6-minute walking distance (6 MD), physiological cost index (PCI), knee-extension strength, and Gross Motor Function Measure (GMFM).
There were significant increases in self-selected walking speed (SWS), cadence during SWS and maximum walking speed (MWS), single-leg support per gait cycle, hip joint angle in the swing phase, 6 MD, and GMFM. In contrast, gait speed during MWS, step length during SWS and MWS, hip and knee joint angle in the stance phase, knee joint angle in the swing phase, PCI, and knee-extension strength generally improved, but not significantly.
Robot-assisted training using HAL® may improve walking and gross motor abilities of patients with CP.
混合辅助肢体（HAL®，赛博迪恩公司）是一种可穿戴机器人，能根据穿戴者的预期动作，在其行走、站立和进行腿部运动时提供辅助。使用HAL®进行机器人辅助训练对脑瘫（CP）患者的效果尚不清楚。因此，我们评估了使用HAL®进行机器人辅助训练对CP患者的效果，并比较了干预前后的行走和粗大运动能力。
纳入6例CP患者（平均年龄：16.8岁；范围：13 - 24岁；粗大运动功能分类系统II - IV级：n = 1、4、1）。每周进行2 - 4次使用HAL®的机器人辅助训练，每次训练20分钟，为期4周，共12次。结果指标包括步态速度、步长、步频、每个步态周期的单腿支撑时间、站立时髋关节和膝关节角度、每个步态周期的摆动相、6分钟步行距离（6MD）、生理成本指数（PCI）、膝关节伸展力量和粗大运动功能测量（GMFM）。
自我选择步行速度（SWS）、SWS期间的步频和最大步行速度（MWS）、每个步态周期的单腿支撑时间、摆动相髋关节角度、6MD和GMFM均有显著增加。相比之下，MWS期间的步态速度、SWS和MWS期间的步长、站立相髋关节和膝关节角度、摆动相膝关节角度、PCI和膝关节伸展力量总体上有所改善，但不显著。
使用HAL®进行机器人辅助训练可能会改善CP患者的行走和粗大运动能力。
