HAL Training in Spinal Cord Injured Patients: A Narrative Review of 10 Years Experience

Abstract

To provide a summary and overview of the use of Hybrid Assistive Limb in spinal cord injured patients over the past 10 years. A review of the literature was performed via Web of Science and PubMed using the search terms “Hybrid assistive limb” or “HAL“ or “wearable robot“ or “exoskeleton” and “SCI” or “spinal cord injury” by two of the authors. Relevant articles were then studied in full text. Our review of the literature found 21 articles that met the inclusion criteria of this narrative review including 344 participants. Articles were sorted into two general categories: (1) clinical trials, and (2) single-case or two-case reports. The vast majority of patients improved functionally, showing increased walking distances, walking speeds, and endurance. In addition, a variety of other advances were described, such as temporary decrease in spasticity, improvement in bladder and bowel management, pain reduction, and change in muscle activity. Even though there is no uniform application of HAL training in people living with SCI the current study situation suggests that many patients could benefit from this innovative training within their means.

Keywords

• spinal cord injury
• exoskeleton
• Hybrid Assistive Limb
• rehabilitation
• review