title: A newly developed robot suit hybrid assistive limb facilitated walking rehabilitation after spinal surgery for thoracic ossification of the posterior longitudinal ligament: a case report.
abstract: Most patients with thoracic ossification of the posterior longitudinal ligament (OPLL) exhibit delayed recovery of gait dysfunction after spinal injury. The hybrid assistive limb (HAL) is a new robot suit controlling knee and hip joint motion by detecting very weak bioelectric signals on the surface of the skin. This study is to report the feasibility and benefits of patient-assistive HAL walking rehabilitation for facilitating locomotor function after spinal surgery. The patient was a 60-year-old woman with thoracic OPLL, and her motor and sensory paralyses did not improve after spinal surgery, indicating severe impairment in the paretic legs. The subject underwent 6 HAL sessions per week for 8 weeks, consisting of a standing and sitting exercise and walking on the ground with HAL. Clinical outcomes were evaluated before and after HAL training and 1 year after surgery. The subject improved considerably as a result of HAL training. Subsequently, her walking ability recovered rapidly, and she was able to walk unaided six months after surgery. This case study suggests that HAL training is a feasible and effective option to facilitating locomotor function and the early HAL training with physiotherapy may enhance motor recovery of patients with residual paralysis after surgery.
authors.affiliation: Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Sakakima
authors.affiliation: Department of Orthopedic Surgery, Faculty of Medicine, Kagoshima University, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Ijiri
authors.affiliation: Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Matsuda
authors.affiliation: Department of Orthopedic Surgery, Faculty of Medicine, Kagoshima University, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tominaga
authors.affiliation: Fujiyoshi Orthopedic Hospital, Kagoshima, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Biwa
authors.affiliation: Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yone
authors.affiliation: Faculty of Systems and Information Engineering, Center for Cybernics Research, University of Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Sankai