International Medical Case Reports Journal (Jun 2021)

Hybrid Assistive Limb Functional Treatment for a Patient with Chronic Incomplete Cervical Spinal Cord Injury

  • Soma Y,
  • Kubota S,
  • Kadone H,
  • Shimizu Y,
  • Takahashi H,
  • Hada Y,
  • Koda M,
  • Sankai Y,
  • Yamazaki M

Journal volume & issue
Vol. Volume 14
pp. 413 – 420

Abstract

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Yuichiro Soma,1 Shigeki Kubota,2 Hideki Kadone,3 Yukiyo Shimizu,1 Hiroshi Takahashi,2 Yasushi Hada,1 Masao Koda,2 Yoshiyuki Sankai,4 Masashi Yamazaki2 1Department of Rehabilitation Medicine, University of Tsukuba Hospital, Ibaraki, Japan; 2Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; 3Center for Innovating Medicine and Engineering (CIME), University of Tsukuba Hospital, Ibaraki, Japan; 4Faculty of Systems and Information Engineering, University of Tsukuba, Ibaraki, JapanCorrespondence: Shigeki KubotaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, JapanTel +81-29-853-3219Fax +81-29-853-3162Email [email protected]: The hybrid assistive limb (HAL) is a wearable exoskeleton cyborg that assists walking and lower limb movements via real-time actuator control by detecting the wearer’s bioelectric signals on the surface of their skin.Purpose: The purpose of this study was to report the improvement in walking ability following HAL gait training in a patient with tetraplegia after incomplete cervical spinal cord injury (SCI).Patient and Methods: A 47-year-old man with traumatic cervical SCI for six months after fall had incomplete tetraplegic SCI grade C as classified according to the American Spinal Cord Injury Association impairment scale and was unable to walk in conventional rehabilitation.Results: The HAL gait training was received 2 or 3 times per week for 13 sessions. Improvement was observed in gait speed (baseline: 0.12; after training: 0.45 m/sec), step length (baseline: 0.30; after training: 0.45 m), and cadence (baseline: 23.1; after training: 59.6 steps/min) based on a 10-meter walking test; International Standards for Neurological and functional Classification of Spinal Cord Injury (ISNCSCI) motor score (baseline: 59; after training: 76); and walking index for spinal cord injury (WISCI) II score (baseline: 1; after training: 6).Conclusion: We report the recovery of walking ability in a patient with chronic severe incomplete tetraplegic SCI following the HAL training.Keywords: hybrid assistive limb, robotic rehabilitation, incomplete spinal cord injury, robotic gait training

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