Successful Use of the Hybrid Assistive Limb for Care Support to Reduce Lumbar Load in a Simulated Patient Transfer

Abstract

To determine whether the hybrid assistive limb (HAL) for Care Support can reduce lumbar load during a patient transfer. Overview of Literature: The prevalence of work-related low back pain (LBP) among nurses is high. In particular, transferring patients poses a high risk for LBP due to the large lumbar load. Attempts to reduce the lumbar load are crucial to avoid the risk of LBP. Therefore, we investigated the effects of the HAL for Care Support. Methods: Nineteen volunteers (16 men, three women) lifted a 60-kg doll from a seated position to a standing position. The first transfer was performed without the HAL for Care Support, and the second was performed with the HAL for Care Support assistive robot. We evaluated transfer performance, the visual analog scale (VAS) score for lumbar fatigue, and electromyogram analyses of the trunk and hip. Results: Four participants (two men, two women) succeeded with the HAL for Care Support even though they were unable to perform the task without it. The mean lumbar fatigue VAS score for all participants without the HAL for Care Support was 62 mm, while that with it was 43 mm. With lumbar assistance from the HAL for Care Support, subjective lumbar fatigue during the transfer decreased significantly. A power analysis indicated adequate statistical power to detect a difference in the VAS score for lumbar fatigue (0.99). The activity of the left gluteus maximus alone increased significantly during transfers with the HAL for Care Support. No adverse events occurred during use of the HAL for Care Support for transfers. Conclusions: The HAL for Care Support was able to reduce lumbar load in a simulated patient transfer.

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

“…In the past several years, the deployment of the lumbar-type HAL for care support has been reported to significantly reduce subjective lumbar fatigue during simulated patient transfer. 17 The lumbar-type HAL also facilitates the stand-up exercise. 18 The sit-to-stand exercise is one of the usual cardiac rehabilitation exercises performed by cardiac patients affected by sarcopenia.…”

Human Gait During Level Walking With an Occupational Whole-Body Powered Exoskeleton: Not Yet a Walk in the Park

“…Existing work on powered, occupational exoskeletons has had more emphasis on prototyping, structural design, and control algorithms while targeting a specific body part such as the low back [14], [15], the lower extremity [16], [17], or the upper extremity [18], [19]. There are a few reports on the effectiveness of a commercially-available powered exoskeleton for the low back [Hybrid Assistive Limb (HAL TM ) for Care Support, Cyberdyne, Ibaraki, Japan] during snow shoveling [20], repetitive lifting [21], and patient handling [22]. These and related studies suggest that a powered exoskeleton is likely heavier and more complex in design than a passive one, but that it can be more versatile and functional with active control.…”

Early Postoperative Rehabilitation Using the Hybrid Assistive Limb (HAL) Lumbar Type in Patients With Hip Fracture: A Pilot Study

“…The HAL lumbar type can detect BES of the lumbar erector spinae muscle and support the wearer's hip extension movement at optimal timing [15]. It was initially developed as a device to reduce the lumbar load during heavy work and has been reported to reduce the lumbar load during lifting [16], snow-shoveling [17], and simulated patient transfer movements [18]. More recently, it has been considered that support for hip extension movements by the HAL lumbar type may also be effective in supporting the standing movement.…”