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混合型辅助肢体(HAL)对术后急性/亚急性期后纵韧带骨化症(OPLL)所致严重胸段脊髓病患者的治疗:一项临床试验。

Hybrid assistive limb (HAL) treatment for patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) in the postoperative acute/subacute phase: A clinical trial.

作者信息

Kubota Shigeki, Abe Tetsuya, Kadone Hideki, Shimizu Yukiyo, Funayama Toru, Watanabe Hiroki, Marushima Aiki, Koda Masao, Hada Yasushi, Sankai Yoshiyuki, Yamazaki Masashi

机构信息

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.

出版信息

J Spinal Cord Med. 2019 Jul;42(4):517-525. doi: 10.1080/10790268.2018.1525975. Epub 2018 Oct 18.


DOI:10.1080/10790268.2018.1525975
PMID:30335588
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6718179/
Abstract

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.

摘要

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。

相似文献

[1]
Hybrid assistive limb (HAL) treatment for patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) in the postoperative acute/subacute phase: A clinical trial.

J Spinal Cord Med. 2019-7

[2]
The voluntary driven exoskeleton Hybrid Assistive Limb (HAL) for postoperative training of thoracic ossification of the posterior longitudinal ligament: a case report.

J Spinal Cord Med. 2017-5

[3]
Walking ability following hybrid assistive limb treatment for a patient with chronic myelopathy after surgery for cervical ossification of the posterior longitudinal ligament.

J Spinal Cord Med. 2019-1

[4]
Management of thoracic myelopathy caused by ossification of the posterior longitudinal ligament combined with ossification of the ligamentum flavum-a retrospective study.

Spine J. 2012-12-6

[5]
Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report.

Front Neurol. 2020-3-31

[6]
Analysis of Gait Motion Changes by Intervention Using Robot Suit Hybrid Assistive Limb (HAL) in Myelopathy Patients After Decompression Surgery for Ossification of Posterior Longitudinal Ligament.

Front Neurorobot. 2021-3-31

[7]
Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors.

Medicina (Kaunas). 2022-12-12

[8]
Surgical results and complications of anterior decompression and fusion as a revision surgery after initial posterior surgery for cervical myelopathy due to ossification of the posterior longitudinal ligament.

J Neurosurg Spine. 2017-4

[9]
Against the odds: what to expect in rehabilitation of chronic spinal cord injury with a neurologically controlled Hybrid Assistive Limb exoskeleton. A subgroup analysis of 55 patients according to age and lesion level.

Neurosurg Focus. 2017-5

[10]
Risk Factors for Ineffectiveness of Posterior Decompression and Dekyphotic Corrective Fusion with Instrumentation for Beak-Type Thoracic Ossification of the Posterior Longitudinal Ligament: A Single Institute Study.

Neurosurgery. 2017-5-1

引用本文的文献

[1]
Wearable Robots for Rehabilitation and Assistance of Gait: A Narrative Review.

Ann Rehabil Med. 2025-8

[2]
Muscle Strength and Efficiency of Muscle Activities Recovery Using Single-Joint Type Hybrid Assistive Limb in Knee Rehabilitation after Anterior Cruciate Ligament Reconstruction.

J Clin Med. 2023-9-22

[3]
New Neuromuscular Training for Peripheral Nerve Disorders Using an Ankle Joint Hybrid Assistive Limb: A Case Series.

Medicina (Kaunas). 2023-7-5

[4]
Robotic rehabilitation therapy using Hybrid Assistive Limb (HAL) for patients with spinal cord lesions: a narrative review.

N Am Spine Soc J. 2023-3-11

[5]
Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors.

Medicina (Kaunas). 2022-12-12

[6]
Alteration of muscle activity during voluntary rehabilitation training with single-joint Hybrid Assistive Limb (HAL) in patients with shoulder elevation dysfunction from cervical origin.

Front Neurosci. 2022-11-9

[7]
Ankle dorsiflexion training with a newly developed Hybrid Assistive Limb for a patient with foot drop caused by common peroneal nerve palsy: a case report.

J Phys Ther Sci. 2022-5

[8]
Early Postoperative Rehabilitation Using the Hybrid Assistive Limb (HAL) Lumbar Type in Patients With Hip Fracture: A Pilot Study.

Cureus. 2022-2-22

[9]
Development of a New Ankle Joint Hybrid Assistive Limb.

Medicina (Kaunas). 2022-3-7

[10]
Overground robotic training effects on walking and secondary health conditions in individuals with spinal cord injury: systematic review.

J Neuroeng Rehabil. 2022-3-15

本文引用的文献

[1]
Robotic device-assisted knee extension training during the early postoperative period after opening wedge high tibial osteotomy: a case report.

J Med Case Rep. 2017-8-5

[2]
Improvement of walking ability during postoperative rehabilitation with the hybrid assistive limb after total knee arthroplasty: A randomized controlled study.

SAGE Open Med. 2017-6-8

[3]
The Hybrid Assistive Limb® intervention for a postoperative patient with spinal dural arteriovenous fistula and chronic spinal cord injury: A case study.

J Spinal Cord Med. 2018-11

[4]
Walking ability following hybrid assistive limb treatment for a patient with chronic myelopathy after surgery for cervical ossification of the posterior longitudinal ligament.

J Spinal Cord Med. 2019-1

[5]
Active elbow flexion is possible in C4 quadriplegia using hybrid assistive limb (HAL®) technology: A case study.

J Spinal Cord Med. 2017-7

[6]
Gait training with Hybrid Assistive Limb enhances the gait functions in subacute stroke patients: A pilot study.

NeuroRehabilitation. 2017

[7]
Knee-Extension Training with a Single-Joint Hybrid Assistive Limb during the Early Postoperative Period after Total Knee Arthroplasty in a Patient with Osteoarthritis.

Case Rep Orthop. 2016

[8]
Decrease of spasticity after hybrid assistive limb training for a patient with C4 quadriplegia due to chronic SCI.

J Spinal Cord Med. 2017-9

[9]
Feasibility of rehabilitation using the single-joint hybrid assistive limb to facilitate early recovery following total knee arthroplasty: A pilot study.

Assist Technol. 2017

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Repeat Exposure to Leg Swing Perturbations During Treadmill Training Induces Long-Term Retention of Increased Step Length in Human SCI: A Pilot Randomized Controlled Study.

Am J Phys Med Rehabil. 2016-12

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