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Clinical application of the Hybrid Assistive Limb (HAL) for gait training-a systematic review.

Wall A, Borg J, Palmcrantz S - Front Syst Neurosci (2015)

Bottom Line: Beneficial effects on gait function variables and independence in walking were observed.Beneficial effects on gait function and independence in walking were observed but data do not allow conclusions.Further controlled studies are recommended.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Danderyd University Hospital Stockholm, Sweden ; Department of Clinical Sciences, Karolinska Institute Stockholm, Sweden.

ABSTRACT

Objective: The aim of this study was to review the literature on clinical applications of the Hybrid Assistive Limb system for gait training.

Methods: A systematic literature search was conducted using Web of Science, PubMed, CINAHL and clinicaltrials.gov and additional search was made using reference lists in identified reports. Abstracts were screened, relevant articles were reviewed and subject to quality assessment.

Results: Out of 37 studies, 7 studies fulfilled inclusion criteria. Six studies were single group studies and 1 was an explorative randomized controlled trial. In total, these studies involved 140 participants of whom 118 completed the interventions and 107 used HAL for gait training. Five studies concerned gait training after stroke, 1 after spinal cord injury (SCI) and 1 study after stroke, SCI or other diseases affecting walking ability. Minor and transient side effects occurred but no serious adverse events were reported in the studies. Beneficial effects on gait function variables and independence in walking were observed.

Conclusions: The accumulated findings demonstrate that the HAL system is feasible when used for gait training of patients with lower extremity paresis in a professional setting. Beneficial effects on gait function and independence in walking were observed but data do not allow conclusions. Further controlled studies are recommended.

No MeSH data available.


Related in: MedlinePlus

Presentation of the results of the systematic search of the literature.
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Figure 1: Presentation of the results of the systematic search of the literature.

Mentions: A systematic search of the literature was conducted using the databases Web of Science, PubMed, and CINAHL. Both MeSH (Medical Subject Headings for Medline) terms and free text relevant for the subject were used and detected synonyms were added to the search. Search terms were (MeSH terms in bold): ((((robot OR robots OR robotic OR robotics OR robot-assisted OR exoskeleton OR machine-assisted OR electro-mechanic OR DGO OR “driven gait orthosis”))) AND (gait OR gaits OR walking OR walk OR walks OR locomotion OR “motor activity”)) AND (HAL OR “hybrid assistive limb” OR “wearable robot”). Search limitations were “Humans” and “English,” while publication date was unlimited. Using the same search terms, a search was also performed at clinicaltrials.gov, in order to identify ongoing studies and/or unpublished papers (Clinicaltrials, online). Abstracts identified were screened and studies were considered relevant if they addressed any clinical application of the HAL system regardless of study design. If needed the full text article was retrieved and assessed. Relevant studies were exported to EndNote where duplicates were identified and removed. Reference lists of these studies were manually searched for further articles. Studies were included if they were primary research articles, concerned gait training with the Hybrid Assistive Limb. Studies only reporting technology data, including only healthy subjects, single subjects or reviews were excluded. Thirty-seven articles were identified, 20 were retrieved in full text for assessment of eligibility and 13 of these did not fulfill inclusion criteria (see Figure 1). Overall 7 studies met the inclusion criteria and were subject to data extraction and analyses (Maeshima et al., 2011; Kawamoto et al., 2013; Kubota et al., 2013; Ueba et al., 2013; Aach et al., 2014; Nilsson et al., 2014; Watanabe et al., 2014). Included studies were subject to critical review by two independent reviewers.


Clinical application of the Hybrid Assistive Limb (HAL) for gait training-a systematic review.

Wall A, Borg J, Palmcrantz S - Front Syst Neurosci (2015)

Presentation of the results of the systematic search of the literature.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4373251&req=5

Figure 1: Presentation of the results of the systematic search of the literature.
Mentions: A systematic search of the literature was conducted using the databases Web of Science, PubMed, and CINAHL. Both MeSH (Medical Subject Headings for Medline) terms and free text relevant for the subject were used and detected synonyms were added to the search. Search terms were (MeSH terms in bold): ((((robot OR robots OR robotic OR robotics OR robot-assisted OR exoskeleton OR machine-assisted OR electro-mechanic OR DGO OR “driven gait orthosis”))) AND (gait OR gaits OR walking OR walk OR walks OR locomotion OR “motor activity”)) AND (HAL OR “hybrid assistive limb” OR “wearable robot”). Search limitations were “Humans” and “English,” while publication date was unlimited. Using the same search terms, a search was also performed at clinicaltrials.gov, in order to identify ongoing studies and/or unpublished papers (Clinicaltrials, online). Abstracts identified were screened and studies were considered relevant if they addressed any clinical application of the HAL system regardless of study design. If needed the full text article was retrieved and assessed. Relevant studies were exported to EndNote where duplicates were identified and removed. Reference lists of these studies were manually searched for further articles. Studies were included if they were primary research articles, concerned gait training with the Hybrid Assistive Limb. Studies only reporting technology data, including only healthy subjects, single subjects or reviews were excluded. Thirty-seven articles were identified, 20 were retrieved in full text for assessment of eligibility and 13 of these did not fulfill inclusion criteria (see Figure 1). Overall 7 studies met the inclusion criteria and were subject to data extraction and analyses (Maeshima et al., 2011; Kawamoto et al., 2013; Kubota et al., 2013; Ueba et al., 2013; Aach et al., 2014; Nilsson et al., 2014; Watanabe et al., 2014). Included studies were subject to critical review by two independent reviewers.

Bottom Line: Beneficial effects on gait function variables and independence in walking were observed.Beneficial effects on gait function and independence in walking were observed but data do not allow conclusions.Further controlled studies are recommended.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Danderyd University Hospital Stockholm, Sweden ; Department of Clinical Sciences, Karolinska Institute Stockholm, Sweden.

ABSTRACT

Objective: The aim of this study was to review the literature on clinical applications of the Hybrid Assistive Limb system for gait training.

Methods: A systematic literature search was conducted using Web of Science, PubMed, CINAHL and clinicaltrials.gov and additional search was made using reference lists in identified reports. Abstracts were screened, relevant articles were reviewed and subject to quality assessment.

Results: Out of 37 studies, 7 studies fulfilled inclusion criteria. Six studies were single group studies and 1 was an explorative randomized controlled trial. In total, these studies involved 140 participants of whom 118 completed the interventions and 107 used HAL for gait training. Five studies concerned gait training after stroke, 1 after spinal cord injury (SCI) and 1 study after stroke, SCI or other diseases affecting walking ability. Minor and transient side effects occurred but no serious adverse events were reported in the studies. Beneficial effects on gait function variables and independence in walking were observed.

Conclusions: The accumulated findings demonstrate that the HAL system is feasible when used for gait training of patients with lower extremity paresis in a professional setting. Beneficial effects on gait function and independence in walking were observed but data do not allow conclusions. Further controlled studies are recommended.

No MeSH data available.


Related in: MedlinePlus