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

BackgroundRobotic 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.MethodsThe 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.ResultsThe 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.ConclusionsAlthough 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.

[1]  J. MacGREGOR,et al.  The objective measurement of physical performance with long term ambulatory physiological surveillance equipment , 1979 .

[2]  Munehito Yoshida,et al.  Mobility and Muscle Strength Contralateral to Hemiplegia from Stroke: Benefit from Self-Training with Family Support , 2003, American Journal of Physical Medicine & Rehabilitation.

[3]  Yoshiyuki Sankai,et al.  Virtual impedance adjustment in unconstrained motion for an exoskeletal robot assisting the lower limb , 2005, Adv. Robotics.

[4]  N. Hogan,et al.  A novel approach to stroke rehabilitation , 2000, Neurology.

[5]  N. Hogan,et al.  Robot-aided neurorehabilitation. , 1998, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[6]  F. Finley,et al.  Locomotive characteristics of urban pedestrians. , 1970, Archives of physical medicine and rehabilitation.

[7]  T. Demott,et al.  Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke: A Randomized Controlled Study , 2008, Stroke.

[8]  J. Hidler,et al.  Advances in the Understanding and Treatment of Stroke Impairment Using Robotic Devices , 2005, Topics in stroke rehabilitation.

[9]  T. Kawarai,et al.  Re-evaluation of clinical features and risk factors of acute ischemic stroke in Japanese longevity society. , 2010, The Kobe journal of medical sciences.

[10]  N. Hogan,et al.  Response to upper-limb robotics and functional neuromuscular stimulation following stroke. , 2005, Journal of rehabilitation research and development.

[11]  Kenji Hachisuka [Robot-aided training in rehabilitation]. , 2010, Brain and nerve = Shinkei kenkyu no shinpo.

[12]  Yoshiyuki Sankai,et al.  Power assist method based on Phase Sequence and muscle force condition for HAL , 2005, Adv. Robotics.

[13]  Yoshiyuki Sankai,et al.  Development of single leg version of HAL for hemiplegia , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[14]  K. Yamagishi,et al.  Caregiver Burden for Impaired Elderly Japanese with Prevalent Stroke and Dementia under Long-Term Care Insurance System , 2008, Cerebrovascular Diseases.