Effects of Cardiac Rehabilitation With Lumbar-Type Hybrid Assistive Limb on Muscle Strength in Patients With Chronic Heart Failure　― A Randomized Controlled Trial ―

Abstract

indispensable to alleviate sarcopenia and improve the prognosis of frail patients who participate in cardiac rehabilitation programs. The standard rehabilitation programs in patients with chronic HF include walking and bicycle exercise. These exercises are unavailable to many patients, especially those with severe HF in whom skeletal muscle functions are too severely compromised to endure an exercise-based regimen. 7 As the world's first wearable cyborg, the hybrid assistive limb (HAL) supports, improves, and expands a wearer's H eart failure (HF) is a growing public health issue with an estimated prevalence of around 37.7 million individuals globally. 1 Cardiac rehabilitation is a comprehensive therapeutic program consisting of exercise therapy, diet, daily life guidance, etc. 2 Of the components of cardiac rehabilitation, exercise therapy is essential. 2,3 Cardiac rehabilitation is recommended throughout the world as a means of preventing the recurrence and worsening of HF. 4 Sarcopenia, a condition characterized by qualitative and quantitative impairment of skeletal muscle, commonly afflicts HF patients and contributes to a poor prognosis. 5 A significant association between sarcopenia and frailty has been reported. 6 Therefore, an effective approach is Editorial p ????

Effects of cardiac rehabilitation with motion assistance from a wearable cyborg hybrid assistive limb on patients with chronic heart failure: a randomized controlled trial with a one-year follow-up

“…Our study included 28 patients who were admitted to the University of Tsukuba Hospital with chronic HF, satisfied all inclusion criteria, and did not meet any of the exclusion criteria. The inclusion and exclusion criteria have been described in our previous study 13,24) . The enrolled patients were randomly assigned to the HAL or conventional exercise therapy (control) groups at a 1:1 allocation ratio through the minimization method using the Electronic Data Capture clinical research support system.…”

“…All patients who participated in this study 13) were investigated one year after discharge. The Tsukuba University Clinical Research Review Board approved this study (TCRB18-023).…”

“…The physical therapist checked the patient's heart rate, systolic and diastolic blood pressures, and subjective ratings of exercise intensity on the Borg scale every minute during the exercise therapy. The intervention method in both groups has been described in detail in our previous study 13,24) . Patients in both groups implemented physical therapy, except for this intervention, as mentioned in the "Rehabilitation Guidelines for Cardiovascular Disease Patients" published by the Japanese Circulation Society in 2012 28) .…”

“…Lumbar-type HAL can assist body-trunk and lower limb training 22,23) . Our recent study suggested that patients with chronic HF had significant improvement in isometric knee extensor muscle strength after sit-to-stand exercise using lumbar-type HAL 13) . However, there have been no reports on the long-term effects of the lumbartype HAL during sit-to-stand exercises in patients with HF.…”

“…In general, walking and bicycle exercises as aerobic exercises are standard cardiac rehabilitation programs in chronic HF patients [10][11][12] . These exercise therapies are unavailable to many patients, especially those with severe HF in whom skeletal muscle functions are too severely compromised to endure an exercise-based regimen 13) . It is, therefore, necessary to establish safer and more effective exercise therapies for the elderly and HF patients with frailty.…”