Kubota Shigeki, Abe Tetsuya, Kadone Hideki, Shimizu Yukiyo, Funayama Toru, Watanabe Hiroki, Marushima Aiki, Koda Masao, Hada Yasushi, Sankai Yoshiyuki, Yamazaki Masashi
a Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine , University of Tsukuba , Tsukuba , Japan.
b Department of Orthopaedic Surgery, Faculty of Medicine , University of Tsukuba , Tsukuba , Japan.
J Spinal Cord Med. 2019 Jul;42(4):517-525. doi: 10.1080/10790268.2018.1525975. Epub 2018 Oct 18.
The hybrid assistive limb (HAL) is a wearable exoskeleton robot that assists walking and lower limb movements via real-time actuator control. Our aim was to clarify the safety and feasibility of using the HAL robotic suit for rehabilitation in patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (T-OPLL). Uncontrolled case series; pre- and post-intervention measurement. In-patient rehabilitation unit. HAL training was provided in 60-minuts session, 2-3 sessions per week, for a total of 10 sessions. HAL training was initiated on average 27.5 days post-surgery. Eight patients (four males and four females; mean age, 60.9 ± 10.2 years) with severe myelopathy, who had undergone posterior decompression with instrumented fusion, were enrolled. Gait speed, step length and cadence were measured along a 10-m walkway every session. The American Spinal Injury Association (ASIA) motor score (lower extremities) and Walking Index for Spinal Cord Injury (WISCI) II were also evaluated at baseline and after 10 sessions. The Japanese Orthopaedic Association (JOA) score was calculated over time after surgery. All participants completed the 10 training sessions, with no serious adverse effect noted. Gait speed, step length and cadence improved over time. Both the WISCI-II and ASIA motor (lower extremities) scores improved from baseline after 10 sessions. The JOA score improved over time post-surgery. HAL training can be feasibly initiated in the early postoperative period, without severe adverse events in patients, with T-OPLL-related severe gait disturbance.
混合辅助肢体(HAL)是一种可穿戴外骨骼机器人,通过实时致动器控制来辅助行走和下肢运动。我们的目的是阐明使用HAL机器人套装对因后纵韧带骨化(T-OPLL)导致的严重胸段脊髓病患者进行康复治疗的安全性和可行性。非对照病例系列;干预前后测量。住院康复单元。HAL训练以60分钟为一个疗程,每周2 - 3个疗程,共10个疗程。HAL训练平均在术后27.5天开始。纳入了8例(4例男性和4例女性;平均年龄60.9±10.2岁)患有严重脊髓病且已接受后路减压并器械融合手术的患者。每次训练时沿10米长的通道测量步态速度、步长和步频。还在基线时以及10个疗程后评估美国脊髓损伤协会(ASIA)运动评分(下肢)和脊髓损伤步行指数(WISCI)II。术后随时间计算日本骨科协会(JOA)评分。所有参与者均完成了10个训练疗程,未观察到严重不良反应。步态速度、步长和步频随时间有所改善。WISCI-II和ASIA运动(下肢)评分在10个疗程后均较基线有所提高。术后JOA评分随时间改善。对于患有T-OPLL相关严重步态障碍的患者,HAL训练可在术后早期切实可行地开展,且无严重不良事件发生。
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