Hiroki Watanabe1,2, Aiki Marushima3, Hiroaki Kawamoto2,4, Hideki Kadone2,5, Tomoyuki Ueno6, Yukiyo Shimizu6, Ayumu Endo6, Yasushi Hada7, Kousaku Saotome2, Tetsuya Abe8, Masashi Yamazaki8, Yoshiyuki Sankai2,4, Eiichi Ishikawa3, Akira Matsumura3. 1. a Department of Neurosurgery , Graduate school of Comprehensive human sciences, University of Tsukuba , Tsukuba, Ibaraki , Japan. 2. b Center for Cybernics Research , University of Tsukuba , Tsukuba, Ibaraki , Japan. 3. c Department of Neurosurgery, Faculty of Medicine , University of Tsukuba , Tsukuba, Ibaraki , Japan. 4. d Faculty of Systems and Information Engineering , University of Tsukuba , Tsukuba, Ibaraki , Japan. 5. e Center for Innovating Medicine and Engineering , University of Tsukuba Hospital , Tsukuba, Ibaraki , Japan. 6. f Department of Rehabilitation Medicine , University of Tsukuba Hospital , Tsukuba, Ibaraki , Japan. 7. g Department of Rehabilitation Medicine, Faculty of Medicine , University of Tsukuba , Tsukuba, Ibaraki , Japan. 8. h Department of Orthopaedic Surgery, Faculty of Medicine , University of Tsukuba , Tsukuba, Ibaraki , Japan.
Abstract
CONTEXT: Spinal cord infarction (SCI) causes gait disturbance because of paresis, spasticity, and sensory disturbance of the lower limbs. There is no effective medical treatment for SCI, and conventional rehabilitation alone is the main approach to helping individuals work toward independent walking. The aim of this study was to evaluate the effect of gait treatment using the Hybrid Assistive Limb (HAL) on acute SCI. FINDINGS: A 61-year-old female and a 62-year-old male with incomplete paraplegia participated in this study. Our study participants received gait treatment with HAL 3-4 times per week, with a total of 7-8 sessions (20 min), in addition to conventional physical therapy. The American Spinal Injury Association Impairment Scale, Lower Extremity Motor Score (LEMS), Modified Ashworth Scale (MAS), the Walking Index for Spinal Cord Injury (WISCI II), comfortable gait speed (CGS), stride, cadence, Barthel Index (BI), Functional Independence Measure (FIM), modified Rankin Scale (mRS), joint angles, and adverse effects were assessed prior to HAL treatment and post-HAL treatment. HAL facilitated intensive gait treatment in people during the acute phase after SCI. Improvements in LEMS, WISCI II, CGS, stride, cadence, BI, FIM, mRS, and joint angles were observed in both study participants. Furthermore, decreased spasticity in the gastrocnemius muscle was found in one participant as assessed by MAS. CONCLUSION: Gait treatment using HAL may be beneficial for paraplegic, non-ambulatory individuals with acute SCI. HAL may be useful for intensive gait treatment without increasing spasticity.
CONTEXT: Spinal cord infarction (SCI) causes gait disturbance because of paresis, spasticity, and sensory disturbance of the lower limbs. There is no effective medical treatment for SCI, and conventional rehabilitation alone is the main approach to helping individuals work toward independent walking. The aim of this study was to evaluate the effect of gait treatment using the Hybrid Assistive Limb (HAL) on acute SCI. FINDINGS: A 61-year-old female and a 62-year-old male with incomplete paraplegia participated in this study. Our study participants received gait treatment with HAL 3-4 times per week, with a total of 7-8 sessions (20 min), in addition to conventional physical therapy. The American Spinal Injury Association Impairment Scale, Lower Extremity Motor Score (LEMS), Modified Ashworth Scale (MAS), the Walking Index for Spinal Cord Injury (WISCI II), comfortable gait speed (CGS), stride, cadence, Barthel Index (BI), Functional Independence Measure (FIM), modified Rankin Scale (mRS), joint angles, and adverse effects were assessed prior to HAL treatment and post-HAL treatment. HAL facilitated intensive gait treatment in people during the acute phase after SCI. Improvements in LEMS, WISCI II, CGS, stride, cadence, BI, FIM, mRS, and joint angles were observed in both study participants. Furthermore, decreased spasticity in the gastrocnemius muscle was found in one participant as assessed by MAS. CONCLUSION: Gait treatment using HAL may be beneficial for paraplegic, non-ambulatory individuals with acute SCI. HAL may be useful for intensive gait treatment without increasing spasticity.
Authors: Raffaele Nardone; Slaven Pikija; J Sebastian Mutzenbach; Martin Seidl; Stefan Leis; Eugen Trinka; Johann Sellner Journal: Drug Discov Today Date: 2016-06-17 Impact factor: 7.851
Authors: Krassen Nedeltchev; Thomas J Loher; Frank Stepper; Marcel Arnold; Gerhard Schroth; Heinrich P Mattle; Matthias Sturzenegger Journal: Stroke Date: 2004-01-15 Impact factor: 7.914
Authors: Mirko Aach; Oliver Cruciger; Matthias Sczesny-Kaiser; Oliver Höffken; Renate Ch Meindl; Martin Tegenthoff; Peter Schwenkreis; Yoshiyuki Sankai; Thomas A Schildhauer Journal: Spine J Date: 2014-04-04 Impact factor: 4.166