Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors

Medicina, 2022 · DOI: 10.3390/medicina58121825 · Published: December 12, 2022

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This case report explores using a Hybrid Assistive Limb (HAL) robot for gait training in a 70-year-old woman who had walking difficulties due to spinal cord compression from tumors. The patient underwent surgery and then received gait training with HAL, which is a wearable exoskeleton that helps with walking by providing support to the hip and knee joints. The study tracked improvements in her walking ability, joint movements, and muscle activity to see if HAL training could be a beneficial rehabilitation method for people with similar conditions.

Study Duration

1 month

Participants

One 70-year-old woman

Evidence Level

Case Report

Key Findings

1
After 10 HAL training sessions, the patient's walking speed increased from 0.16 m/s to 0.3 m/s, and her step length improved from 0.19 m to 0.37 m.
2
The variability in knee and ankle joint movements significantly decreased, indicating more consistent and controlled movements.
3
Lower limb muscle activation during the gait cycle increased after HAL gait training, suggesting improved muscle engagement.

Research Summary

This case report presents the results of using HAL gait training on a 70-year-old woman with gait ataxia due to spinal cord compression from tumors. The HAL training involved 10 sessions over one month, during which the patient's walking ability, joint angles, and muscle activity were assessed. The study found significant improvements in walking speed, step length, and joint control, suggesting that HAL training may be a beneficial rehabilitation approach for patients with sensory ataxia.

Practical Implications

Rehabilitation Strategy

HAL gait training may be a feasible and effective rehabilitation option for patients with non-traumatic spinal cord dysfunction and sensory ataxia.

Improved Motor Control

HAL training can improve motor coordination and balance impairment in patients with lower-extremity ataxia.

Potential for Neuroplasticity

HAL training might improve neuronal plasticity, leading to coordinated normal movements and contributing to motor learning.

Study Limitations

1
The study only analyzed one patient, limiting the generalizability of the findings.
2
Improvements could be due to natural recovery or conventional rehabilitation, rather than solely the HAL training.
3
Muscle network and synergy analysis of EMG may serve as a useful tool to evaluate muscle activity which was not performed.

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