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Efficacy of a hybrid assistive limb in post-stroke hemiplegic patients: a preliminary report.

Maeshima S, Osawa A, Nishio D, Hirano Y, Takeda K, Kigawa H, Sankai Y - BMC Neurol (2011)

Bottom Line: Robotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work.Four patients required assistance, and 12 needed supervision while walking.Further investigation would clarify its indication for the possibility of gait training.

View Article: PubMed Central - HTML - PubMed

Affiliation: Rehabilitation Medicine, Saitama Medical University International Medical Center, Hidaka, Japan. maeshima@saitama-med.ac.jp

ABSTRACT

Background: Robotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work. We evaluated the effects of a hybrid assistive limb robot suit on the gait of stroke patients undergoing rehabilitation.

Methods: The study group comprised 16 stroke patients with severe hemiplegia. All patients underwent gait training. Four patients required assistance, and 12 needed supervision while walking. The stride length, walking speed and physiological cost index on wearing the hybrid assistive limb suit and a knee-ankle-foot orthosis were compared.

Results: The hybrid assistive limb suit increased the stride length and walking speed in 4 of 16 patients. The patients whose walking speed decreased on wearing the hybrid assistive limb suit either had not received sufficient gait training or had an established gait pattern with a knee-ankle-foot orthosis using a quad cane. The physiological cost index increased after wearing the hybrid assistive limb suit in 12 patients, but removal of the suit led to a decrease in the physiological cost index values to equivalent levels prior to the use of the suit.

Conclusions: Although the hybrid assistive limb suit is not useful for all hemiplegic patients, it may increase the walking speed and affect the walking ability. Further investigation would clarify its indication for the possibility of gait training.

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Related in: MedlinePlus

A stroke patient using the hybrid assistive limb (HAL) suit. The left image shows a patient using the HAL suit and walking with a cane, and a physiotherapist pays attention to the patient while noting his fall. In the right image, the patient is being trained to climb down stairs by a physiotherapist.
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Figure 1: A stroke patient using the hybrid assistive limb (HAL) suit. The left image shows a patient using the HAL suit and walking with a cane, and a physiotherapist pays attention to the patient while noting his fall. In the right image, the patient is being trained to climb down stairs by a physiotherapist.

Mentions: The issue of nursing care in an ageing society is a major social concern and will continue to be so in future. Therefore, robotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work [1-3]. The hybrid assistive limb (HAL) suit does not merely use the concept of power assist; it is a hybrid system composed of a 'cybernics voluntary control system' that provides complete control of the HAL suit using bioelectric signals and a 'cybernics robotic autonomous control system' that autonomously generates motor patterns reflecting characteristics of human motion (Figure 1). It is the world's first cyborg-type robot that takes advantage of cybernics that integrate human, mechanical and information technologies [4]. The leg structure of the HAL exoskeleton powers the flexion/extension joints at the hip and knee through a DC motor with a harmonic drive placed directly on the joints. The ankle flexion/extension degree of freedom is passive. Lower limb components interface with the wearer through a number of connections that include a special shoe with ground reaction force sensors, harnesses on the calf and thigh and a wide waist belt. The HAL system utilises several sensing modalities for control: skin-surface electromyographic (EMG) electrodes placed below the hip and above the knee on the anterior (front) and posterior (back) sides of the wearer's body, potentiometers and a gyroscope and accelerometer mounted on the backpack for torso posture estimation. These sensing modalities are in-built and operate the suit, which consists of EMG-based and walking pattern-based systems. The HAL suit was designed to increase and assist the voluntary motor fuction of the body and is used to provide walking support for people who require nursing care, including the elderly with muscle weakness and people with impaired motor function [4,5].


Efficacy of a hybrid assistive limb in post-stroke hemiplegic patients: a preliminary report.

Maeshima S, Osawa A, Nishio D, Hirano Y, Takeda K, Kigawa H, Sankai Y - BMC Neurol (2011)

A stroke patient using the hybrid assistive limb (HAL) suit. The left image shows a patient using the HAL suit and walking with a cane, and a physiotherapist pays attention to the patient while noting his fall. In the right image, the patient is being trained to climb down stairs by a physiotherapist.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198922&req=5

Figure 1: A stroke patient using the hybrid assistive limb (HAL) suit. The left image shows a patient using the HAL suit and walking with a cane, and a physiotherapist pays attention to the patient while noting his fall. In the right image, the patient is being trained to climb down stairs by a physiotherapist.
Mentions: The issue of nursing care in an ageing society is a major social concern and will continue to be so in future. Therefore, robotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work [1-3]. The hybrid assistive limb (HAL) suit does not merely use the concept of power assist; it is a hybrid system composed of a 'cybernics voluntary control system' that provides complete control of the HAL suit using bioelectric signals and a 'cybernics robotic autonomous control system' that autonomously generates motor patterns reflecting characteristics of human motion (Figure 1). It is the world's first cyborg-type robot that takes advantage of cybernics that integrate human, mechanical and information technologies [4]. The leg structure of the HAL exoskeleton powers the flexion/extension joints at the hip and knee through a DC motor with a harmonic drive placed directly on the joints. The ankle flexion/extension degree of freedom is passive. Lower limb components interface with the wearer through a number of connections that include a special shoe with ground reaction force sensors, harnesses on the calf and thigh and a wide waist belt. The HAL system utilises several sensing modalities for control: skin-surface electromyographic (EMG) electrodes placed below the hip and above the knee on the anterior (front) and posterior (back) sides of the wearer's body, potentiometers and a gyroscope and accelerometer mounted on the backpack for torso posture estimation. These sensing modalities are in-built and operate the suit, which consists of EMG-based and walking pattern-based systems. The HAL suit was designed to increase and assist the voluntary motor fuction of the body and is used to provide walking support for people who require nursing care, including the elderly with muscle weakness and people with impaired motor function [4,5].

Bottom Line: Robotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work.Four patients required assistance, and 12 needed supervision while walking.Further investigation would clarify its indication for the possibility of gait training.

View Article: PubMed Central - HTML - PubMed

Affiliation: Rehabilitation Medicine, Saitama Medical University International Medical Center, Hidaka, Japan. maeshima@saitama-med.ac.jp

ABSTRACT

Background: Robotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work. We evaluated the effects of a hybrid assistive limb robot suit on the gait of stroke patients undergoing rehabilitation.

Methods: The study group comprised 16 stroke patients with severe hemiplegia. All patients underwent gait training. Four patients required assistance, and 12 needed supervision while walking. The stride length, walking speed and physiological cost index on wearing the hybrid assistive limb suit and a knee-ankle-foot orthosis were compared.

Results: The hybrid assistive limb suit increased the stride length and walking speed in 4 of 16 patients. The patients whose walking speed decreased on wearing the hybrid assistive limb suit either had not received sufficient gait training or had an established gait pattern with a knee-ankle-foot orthosis using a quad cane. The physiological cost index increased after wearing the hybrid assistive limb suit in 12 patients, but removal of the suit led to a decrease in the physiological cost index values to equivalent levels prior to the use of the suit.

Conclusions: Although the hybrid assistive limb suit is not useful for all hemiplegic patients, it may increase the walking speed and affect the walking ability. Further investigation would clarify its indication for the possibility of gait training.

Show MeSH
Related in: MedlinePlus