Hybrid Assistive Limb enhances the gait functions in sub-acute stroke stage: A multi single-case study

Article type: Research Article

Authors: Yoshikawa, Kenichi^{a; *} | Mizukami, Masafumi^b | Kawamoto, Hiroaki^c | Sano, Ayumu^a | Koseki, Kazunori^a | Hashizume, Yuko^a | Asakawa, Yasutsugu^b | Iwamoto, Koji^b | Kohno, Yutaka^d | Nagata, Hiroshi^e | Nakai, Kei^{d; f} | Tsurushima, Hideo^f

Affiliations: [a] Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami Ibaraki, Japan | [b] Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami Ibaraki, Japan | [c] Faculty of Systems and Information Engineering, University of Tsukuba, Tsukuba Ibaraki, Japan | [d] Department of Neurology, Ibaraki Prefectural University of Health Sciences Hospital, Ami Ibaraki, Japan | [e] Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami Ibaraki, Japan | [f] Faculty of Medicine, University of Tsukuba, Tsukuba Ibaraki, Japan

Correspondence: [*] Corresponding author: Kenichi Yoshikawa, 4733 Ami, Ami-Machi, Inashiki-County, Ibaraki 300-0394, Japan. Tel.: +81 29 888 9216; Fax: +81 29 888 9279; E-mail: [email protected].

Abstract: BACKGROUND: Hybrid Assistive Limb (HAL) is a new robotics walking training device consisting of a wearable robot that interactively provides motion according to the wearer’s voluntary drive. The ability of HAL to enhance walking speed has not been clarified in sub-acute people with stroke, and few studies have focused on changes in walking pattern. OBJECTIVES: To assess clinical availability of HAL in sub-acute stroke stage, we conduct a multi single-case study. METHOD: An A-B-A single case study design was used in 4 patients. The intervention was conventional training in period A1 for 5 weeks and period A2 for 4 or 5 weeks and training with HAL and conventional training in period B for 5 weeks. The primary outcomes were maximum walking speed (MWS), cadence, and mean step length assessed each week. The secondary outcomes were Functional Ambulation Category, Berg Balance Scale, Fugl-Meyer Motor Assessment, and asymmetry rate in single-limb support time, as assessed before and after period B. RESULTS: The significant increases in MWS was found in three patients through period B. The cadence, mean step length, FAC and AR were also increased in one, three, two and two patients, respectively. CONCLUSIONS: It was found that HAL training of people with sub-acute stroke is an effective walking training to enhance the walking speed with the change of walking pattern in our clinical setting. Further studies are needed including control trials to analyze satirical difference.

Keywords: Hybrid Assistive Limb, robotics walking training, stroke

DOI: 10.3233/PPR-160074

Journal: Physiotherapy Practice and Research, vol. 37, no. 2, pp. 91-100, 2016