Hirose Fumi, Nishino Tomofumi, Shimizu Yukiyo, Soma Yuichiro, Haginoya Ayumu, Yasunaga Shota, Shimasaki Koshiro, Watanabe Ryunosuke, Yoshizawa Tomohiro, Mishima Hajime
Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan.
Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan.
J Clin Med. 2025 Jan 12;14(2):454. doi: 10.3390/jcm14020454.
Preoperative muscle atrophy leads to persistent gait abnormalities in patients undergoing total hip arthroplasty (THA). Efficient motor learning of the gluteus medius is crucial for their recovery. In this study, a single-joint hybrid assistive limb (HAL) was developed to assist hip abduction. We aimed to evaluate the muscle activity and safety of this device during hip abduction in healthy adults. Ten healthy adults (five males and five females; mean age, 40.7 years) with no hip disorders performed one set of 30 repetitions of side-lying hip abduction under three conditions: without HAL (pre-HAL), with HAL, and without HAL (post-HAL). Muscle activities of the gluteus medius, gluteus maximus, tensor fasciae latae, rectus femoris, and biceps femoris (expressed as percentage of maximum voluntary contraction [%MVC]); vital signs; hip visual analog scale (VAS); and hip abduction and flexion angles were assessed. The mean values were compared among the conditions. The %MVC of the gluteus medius significantly increased from 52% (pre-HAL) to 75.4% (HAL) and then decreased slightly to 61.6% (post-HAL). No other muscle groups showed significant changes. Vital signs and hip VAS scores showed no significant variation. Although no significant differences were found in the hip abduction and flexion angles, a reduction in the hip flexion angle was observed in the HAL and post-HAL conditions. The hip abduction HAL effectively and safely enhanced gluteus medius activity. Reduction in the hip flexion angle during HAL and post-HAL suggests the possibility of appropriate abduction movements and motor learning effects.
术前肌肉萎缩会导致全髋关节置换术(THA)患者出现持续的步态异常。臀中肌有效的运动学习对其恢复至关重要。在本研究中,我们开发了一种单关节混合辅助肢体(HAL)来辅助髋关节外展。我们旨在评估该装置在健康成年人髋关节外展过程中的肌肉活动及安全性。10名无髋关节疾病的健康成年人(5名男性和5名女性;平均年龄40.7岁)在三种情况下进行一组30次侧卧位髋关节外展:无HAL(HAL前)、有HAL、无HAL(HAL后)。评估了臀中肌、臀大肌、阔筋膜张肌、股直肌和股二头肌的肌肉活动(以最大自主收缩百分比[%MVC]表示)、生命体征、髋关节视觉模拟量表(VAS)以及髋关节外展和屈曲角度。对各情况间的平均值进行了比较。臀中肌的%MVC从52%(HAL前)显著增加至75.4%(HAL时),然后略有下降至61.6%(HAL后)。其他肌肉群未显示出显著变化。生命体征和髋关节VAS评分无显著差异。虽然髋关节外展和屈曲角度未发现显著差异,但在HAL和HAL后情况下观察到髋关节屈曲角度减小。髋关节外展HAL有效且安全地增强了臀中肌的活动。HAL和HAL后髋关节屈曲角度的减小表明可能存在适当的外展运动和运动学习效果。