Gait training with Hybrid Assistive Limb enhances the gait functions in subacute stroke patients: A pilot study.
BACKGROUND
The robotic Hybrid Assistive Limb (HAL) provides motion according to the wearer's voluntary activity. HAL training effects on walking speed and capacity have not been clarified in subacute stroke.


OBJECTIVE
To determine improvement in walking ability by HAL and the most effective improvement measure for use in future large-scale trials.


METHODS
Sixteen first-ever hemiplegic stroke patients completed at least 20 sessions over 5 weeks. Per session, the experimental group received no more than 20 min of gait training with HAL (HT) and 40 min of conventional physiotherapy, whereas the control group received at least 60 min of conventional physiotherapy. Primary outcome was maximum walking speed (MWS).


RESULTS
The change in MWS from baseline at week 5 was 11.6±10.6 m/min (HAL group) and 2.2±4.1 m/min (control group) (adjusted mean difference = 9.24 m/min, 95% confidence interval 0.48-18.01, P = 0.040). In HAL subjects there were significant increases in Self-selected walking speed (SWS; a secondary outcome) and in step length (a secondary outcome) at MWS and SWS compared with controls.


CONCLUSIONS
HT improved walking speed in hemiplegic sub-acute stroke patients. In future, randomized controlled trials are needed to confirm the utility of HT.
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami Ibaraki, Japan.
Kenichi
K
Yoshikawa
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami Ibaraki, Japan.
Masafumi
M
Mizukami
Faculty of Systems and Information Engineering, University of Tsukuba, Tsukuba Ibaraki, Japan.
Hiroaki
H
Kawamoto
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami Ibaraki, Japan.
Ayumu
A
Sano
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami Ibaraki, Japan.
Kazunori
K
Koseki
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami Ibaraki, Japan.
Kumiko
K
Sano
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami Ibaraki, Japan.
Yasutsugu
Y
Asakawa
Department of Neurology, Ibaraki Prefectural University of Health Sciences Hospital, Ami Ibaraki, Japan.
Yutaka
Y
Kohno
Department of Neurology, Ibaraki Prefectural University of Health Sciences Hospital, Ami Ibaraki, Japan.|Faculty of Medicine, University of Tsukuba, Tsukuba Ibaraki, Japan.
Kei
K
Nakai
Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba Ibaraki, Japan.
Masahiko
M
Gosho
Faculty of Medicine, University of Tsukuba, Tsukuba Ibaraki, Japan.
Hideo
H
Tsurushima
D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D012371:Robotics / Q000379:methods*; D020521:Stroke / Q000150:complications / Q000628:therapy*; D000071939:Stroke Rehabilitation / Q000379:methods*
Hybrid Assistive Limb; robot-assisted gait training; stroke