Yuki Mataki1, Hirotaka Mutsuzaki1,2, Hiroshi Kamada3, Ryoko Takeuchi1, Shogo Nakagawa1,3, Kenichi Yoshikawa4, Kazushi Takahashi4, Mayumi Kuroda5, Nobuaki Iwasaki2,6, Masashi Yamazaki3. 1. Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan. 2. Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan. 3. Department of Orthopaedic Surgery, University of Tsukuba, Tsukuba 305-8575, Japan. 4. Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan. 5. Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan. 6. Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan.
Abstract
Background and objectives: Cerebral palsy (CP) is the most frequent childhood motor disability. Achieving ambulation or standing in children with CP has been a major goal of physical therapy. Recently, robot-assisted gait training using the Hybrid Assistive Limb® (HAL) has been effective in improving walking ability in patients with CP. However, previous studies have not examined in detail the changes in gait pattern after HAL training for patients with spastic CP, including gait symmetry. This study aimed to evaluate the immediate effect of HAL training on the walking ability and the changes in gait pattern and gait symmetry in patients with spastic CP. Materials and Methods: We recruited 19 patients with spastic CP (13 male and six female; mean age, 15.7 years). Functional ambulation was assessed using the 10-Meter Walk Test and gait analysis in the sagittal plane before and after a single 20-min HAL intervention session. Results: The walking speed and stride length significantly increased after HAL intervention compared to the pre-intervention values. Two-dimensional gait analysis showed improvement in equinus gait, increase in the flexion angle of the swing phase in the knee and hip joints, and improvement in gait symmetry. Immediate improvements in the walking ability and gait pattern were noted after HAL training in patients with spastic CP. Conclusions: The symmetry of the joint angle of the lower limb, including the trunk, accounts for the improvement in walking ability after HAL therapy.
Background and objectives: Cerebral palsy (CP) is the most frequent childhood motor disability. Achieving ambulation or standing in children with CP has been a major goal of physical therapy. Recently, robot-assisted gait training using the Hybrid Assistive Limb® (HAL) has been effective in improving walking ability in patients with CP. However, previous studies have not examined in detail the changes in gait pattern after HAL training for patients with spastic CP, including gait symmetry. This study aimed to evaluate the immediate effect of HAL training on the walking ability and the changes in gait pattern and gait symmetry in patients with spastic CP. Materials and Methods: We recruited 19 patients with spastic CP (13 male and six female; mean age, 15.7 years). Functional ambulation was assessed using the 10-Meter Walk Test and gait analysis in the sagittal plane before and after a single 20-min HAL intervention session. Results: The walking speed and stride length significantly increased after HAL intervention compared to the pre-intervention values. Two-dimensional gait analysis showed improvement in equinus gait, increase in the flexion angle of the swing phase in the knee and hip joints, and improvement in gait symmetry. Immediate improvements in the walking ability and gait pattern were noted after HAL training in patients with spastic CP. Conclusions: The symmetry of the joint angle of the lower limb, including the trunk, accounts for the improvement in walking ability after HAL therapy.
Authors: Andreas Sebastian Schroeder; Rüdiger Von Kries; Christina Riedel; Maria Homburg; Helene Auffermann; Astrid Blaschek; Klaus Jahn; Florian Heinen; Ingo Borggraefe; Steffen Berweck Journal: Dev Med Child Neurol Date: 2014-08-25 Impact factor: 5.449
Authors: I Borggraefe; L Kiwull; J S Schaefer; I Koerte; A Blaschek; A Meyer-Heim; F Heinen Journal: Eur J Phys Rehabil Med Date: 2010-02-18 Impact factor: 2.874
Authors: Mariusz Drużbicki; Wojciech Rusek; Slawomir Snela; Joanna Dudek; Magdalena Szczepanik; Ewelina Zak; Jacek Durmala; Anna Czernuszenko; Marcin Bonikowski; Grzegorz Sobota Journal: J Rehabil Med Date: 2013-04 Impact factor: 2.912