Context/Objective: The hybrid assistive limb (HAL) is a wearable exoskeleton robot that assists walking and lower limb movements via real-time actuator control. Our aim was to clarify the safety and feasibility of using the HAL robotic suit for rehabilitation in patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (T-OPLL). Design: Uncontrolled case series; pre-and post-intervention measurement. Setting: In-patient rehabilitation unit. Intervention: HAL training was provided in 60-minuts session, 2-3 sessions per week, for a total of 10 sessions. HAL training was initiated on average 27.5 days post-surgery. Patients: Eight patients (four males and four females; mean age, 60.9 ± 10.2 years) with severe myelopathy, who had undergone posterior decompression with instrumented fusion, were enrolled. Outcome Measures: Gait speed, step length and cadence were measured along a 10-m walkway every session. The American Spinal Injury Association (ASIA) motor score (lower extremities) and Walking Index for Spinal Cord Injury (WISCI) II were also evaluated at baseline and after 10 sessions. The Japanese Orthopaedic Association (JOA) score was calculated over time after surgery. Results: All participants completed the 10 training sessions, with no serious adverse effect noted. Gait speed, step length and cadence improved over time. Both the WISCI-II and ASIA motor (lower extremities) scores improved from baseline after 10 sessions. The JOA score improved over time post-surgery. Conclusion: HAL training can be feasibly initiated in the early postoperative period, without severe adverse events in patients, with T-OPLL-related severe gait disturbance.
[Purpose] The efficacy of a stabilometer-based index of postural stability (IPS) as an
indicator of dynamic balance ability was investigated. [Subjects and Methods] Using a
stabilometer, we calculated the IPS in 583 healthy subjects (178 males, 405 females) under
two conditions (open eyes/hard surface, OE/HS; closed eyes/soft surface, CE/SS). [Results]
Results revealed a negative relation between IPS and age. IPS (OE/HS) began to decrease at
middle-age (40–60 years old), and then decreased more rapidly during elderly ages
(>60 years old). On the other hand, IPS (CE/SS) decreased linearly with increasing age.
There was no gender difference between the two IPSs. [Conclusion] These results suggest
that IPS can evaluate balance ability quantitatively and without a ceiling effect. It was
concluded that IPS (OE/HS) indicates comprehensive balance ability, while IPS (CE/SS)
reveals balance ability without compensation by visual acuity and plantar superficial
sense.
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