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A Consecutive 25-Week Program of Gait Training, Using the Alternating Hybrid Assistive Limb (HAL®) Robot and Conventional Training, and its Effects on the Walking Ability of a Patient with Chronic Thoracic Spinal Cord Injury: A Single Case Reversal Design

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Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital 4733 Ami-machi Ami, Inashiki-gun, Ibaraki 300-0331, Japan
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Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital 4733 Ami-machi Ami, Inashiki-gun, Ibaraki 300-0331, Japan
3
Centre for Medical Sciences, Ibaraki Prefectural University of Health Sciences 4669-2 Ami-machi Ami, Inashiki-gun, Ibaraki 300-0394, Japan
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(11), 746; https://doi.org/10.3390/medicina55110746
Received: 11 September 2019 / Revised: 14 November 2019 / Accepted: 15 November 2019 / Published: 18 November 2019
Background and Objectives: In this study, we examined the effect of a consecutive 25-week gait training program, consisting of 5-week alternating phases of Hybrid Assistive Limb (HAL)-assisted robot gait training and conventional gait training, on the walking ability of a 50-year-old man with a chronic thoracic spinal cord injury (SCI). Materials and Methods: Clinical features of this patient’s paraplegia were as follows: neurological level, T7; American Spinal Cord Injury Association Impairment Scale Score, C; Lower Extremity Motor Score, 20 points; Berg Balance Scale score, 15 points; and Walking Index for Spinal Cord Injury, 6 points. The patient completed a 100 m walk, under close supervision, using a walker and bilateral ankle-foot orthoses. The intervention included two phases: phase A, conventional walking practice and physical therapy for 5 weeks, and phase B, walking using the HAL robot (3 d/week, 30 min/session), combined with conventional physical therapy, for 5 weeks. A consecutive A-B-A-B-A sequence was used, with a 5-week duration for each phase. Results: The gait training intervention increased the maximum walking speed, cadence, and 2-min walking distance, as well as the Berg Balance and Walking Index for Spinal Cord Injury from 15 to 17 and 6 to 7, respectively. Walking speed, stride length, and cadence improved after phase A (but not B). Improved standing balance was associated with measured improvements in measured gait parameters. Conclusion: The walking ability of patients with a chronic SCI may be improved, over a short period by combining gait training, using HAL-assisted and conventional gait training and physical therapy. View Full-Text
Keywords: Hybrid Assistive Limb; long-term walking exercises; chronic thoracic cord injury; gait; walking ability Hybrid Assistive Limb; long-term walking exercises; chronic thoracic cord injury; gait; walking ability
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MDPI and ACS Style

Kanazawa, A.; Yoshikawa, K.; Koseki, K.; Takeuchi, R.; Mutsuzaki, H. A Consecutive 25-Week Program of Gait Training, Using the Alternating Hybrid Assistive Limb (HAL®) Robot and Conventional Training, and its Effects on the Walking Ability of a Patient with Chronic Thoracic Spinal Cord Injury: A Single Case Reversal Design. Medicina 2019, 55, 746.

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