BACKGROUND: Gait training using the Hybrid Assistive Limb® (HAL®) may have beneficial effects on post-stroke gait function and independent walking. However, the long-term and medium-term efficacies of gait training using HAL® in stroke patients remain unclear.
OBJECTIVE: To compare the medium-term efficacy of gait training using a single-leg version of the Hybrid Assistive Limb® (HAL®) on the paretic side with conventional gait training (CGT) in recovery-phase stroke patients.
METHODS: Twenty-four post-stroke participants (HAL® group: n = 12, CGT group: n = 12) completed the trial. Over 4 weeks, all participants received twelve 20-min sessions of either HAL® (using the single-leg version of HAL® on the paretic side) or conventional (performed by skilled and experienced physical therapists) gait training. Outcome measures were evaluated prior to training, after 12 sessions, and at 8 and 12 weeks after intervention initiation. Functional Ambulation Category (FAC) was the primary outcome measure.
RESULTS: The HAL® group showed significant improvement in FAC after 12 sessions, and at 8 and 12 weeks compared to the conventional group (P = 0.02).
CONCLUSIONS: The results suggested that a gait training program based on HAL® may improve independent walking more efficiently than CGT at 1 and 2 months after intervention.
ChuaJ., CulpanJ., & MenonE. (2016). Efficacy of an Electromechanical Gait Trainer Poststroke in Singapore: A Randomized Controlled Trial. Arch Phys Med Rehabil, 97, 683–690.
2.
DobkinB. H. (2005). Clinical practice. Rehabilitation after stroke. N Engl J Med, 352, 1677–1684.
3.
GeroinC., MazzoleniS., SmaniaN., GandolfiM., BonaiutiD., GasperiniG., et al (2013). Systematic review of outcome measures of walking training using electromechanical and robotic devices in patients with stroke. J Rehabil Med, 45, 987–996.
4.
KawamotoH., & SankaiY. (2002). Power assist system HAL-3 for gait disorder person. Proceedings of the 8th International Conference on Computers Helping People with Special Needs (ICCHP 2002), 196–203.
5.
KawamotoH., HayashiT., SakuraiT., EguchiK., & SankaiY. (2009). Development of single leg version of HAL for hemiplegia. Annual International Conference of the IEEE Engineering in Medicine and Biology Society Conf Proc IEEE Eng Med Biol Soc5038–5043.
6.
KawamotoH., KamibayashiK., NakataY., YamawakiK., AriyasuR., SankaiY., et al (2013). Pilot study of locomotion improvement using hybrid assistive limb in chronic stroke patients. BMC Neurology, 13, 141.
7.
LeeS., & SankaiY. (2005). Virtual impedance adjustment in unconstrained motion for exoskeletal robot assisting lower limb. Adv Robot, 19, 773–795.
8.
MehrholzJ., ElsnerB., WernerC., KuglerJ., & PohlM. (2013). Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev, 7, CD006185.
9.
MizukamiM., YoshikawaK., KawamotoH., SanoA., KosekiK., AsakawaY., & etal. (2016). Gait training of subacute stroke patients using a hybrid assistive limb: A pilot study. Disabil Rehabil Assist Technol, 26, 1–8.
10.
MoroneG., IosaM., BragoniM., AngelisD. D., VenturieroV., CoiroP., et al (2012). Who may have durable benefit from robotic gait training?: A 2-year follow-up randomized controlled trial in patients with subacute stroke. Stroke, 43, 1140–1142.
11.
NilssonA., VreedeK. S., HäglundV., KawamotoH., SankaiY., & BorgJ. (2014). Gait training early after stroke with a new exoskeleton – the hybrid assistive limb: A study of safety and feasibility. J Neuroeng Rehabil, 11, 92–.
12.
SuzukiK., MitoG., KawamotoH., HasegawaY., & SankaiY. (2007). Intention-based walking support for paraplegia patients with Robot Suit HAL. Adv Robot, 21, 1441–1469.
13.
WallA., BorgJ., & PalmcrantzS. (2015). Clinical application of the Hybrid Assistive Limb (HAL) for gait training – a systematic review. Front Syst Neurosci, 9, 48–.
14.
WatanabeH., TanakaN., InutaT., SaitouH., & YanagiH. (2014). Locomotion improvement using a hybrid assistive limb in recovery phase stroke patients: A randomized controlled pilot study. Arch Phys Med Rehabil, 95, 2006–2012.
