Pilot study of locomotion improvement using hybrid assistive limb in chronic stroke patients
Identifieur interne : 002994 ( Ncbi/Checkpoint ); précédent : 002993; suivant : 002995Pilot study of locomotion improvement using hybrid assistive limb in chronic stroke patients
Auteurs : Hiroaki Kawamoto [Japon] ; Kiyotaka Kamibayashi [Japon] ; Yoshio Nakata [Japon] ; Kanako Yamawaki [Japon] ; Ryohei Ariyasu [Japon] ; Yoshiyuki Sankai [Japon] ; Masataka Sakane [Japon] ; Kiyoshi Eguchi [Japon] ; Naoyuki Ochiai [Japon]Source :
- BMC Neurology [ 1471-2377 ] ; 2013.
Abstract
Locomotor training using robots is increasingly being used for rehabilitation to reduce manpower and the heavy burden on therapists, and the effectiveness of such techniques has been investigated. The robot suit Hybrid Assistive Limb (HAL) has been developed to rehabilitate or support motor function in people with disabilities. The HAL provides motion support that is tailored to the wearer’s voluntary drive. We performed a pilot clinical trial to investigate the feasibility of locomotor training using the HAL in chronic stroke patients, and to examine differences between two functional ambulation subgroups.
Sixteen stroke patients in the chronic stage participated in this study. All patients were trained with the HAL over 16 sessions (20–30 min/day within 2 days/week). Primary outcomes were walking speed, cadence, and number of steps recorded during a 10-meter walk test (10MWT). Berg balance scale (BBS) and timed up and go (TUG) were also measured. All outcome measures were evaluated without wearing HAL assistance before and after the intervention in all patients as well as in the dependent ambulatory and independent ambulatory subgroups.
All participants completed the intervention with no adverse events. Gait speed, cadence, number of steps during the 10MWT, and BBS increased significantly from 0.41 m/s to 0.45 m/s (P = 0.031), from 68.6 steps/min to 72.0 steps/min (P = 0.020), from 37.5 steps to 33.1 steps (P = 0.017), and from 40.6 to 45.4 (P = 0.004) respectively. The TUG test score improved, although this difference was not statistically significant. The findings in the dependent ambulatory subgroup primarily contributed to the significant differences observed in the group as a whole.
This pilot study showed that locomotor training using the HAL is feasible for chronic stroke patients. Randomized controlled trials are now required to demonstrate the effectiveness of HAL-based rehabilitation over conventional therapies.
Url:
DOI: 10.1186/1471-2377-13-141
PubMed: 24099524
PubMed Central: 3851710
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Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Faculty of Medicine, University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author><author><name sortKey="Ochiai, Naoyuki" sort="Ochiai, Naoyuki" uniqKey="Ochiai N" first="Naoyuki" last="Ochiai">Naoyuki Ochiai</name><affiliation wicri:level="1"><nlm:aff id="I2">Faculty of Medicine, University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Faculty of Medicine, University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Tsukuba Critical Path Research and Education Integrated Leading Center (CREIL), University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Tsukuba Critical Path Research and Education Integrated Leading Center (CREIL), University of Tsukuba, 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first="Hiroaki" last="Kawamoto">Hiroaki Kawamoto</name><affiliation wicri:level="1"><nlm:aff id="I1">Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author><author><name sortKey="Kamibayashi, Kiyotaka" sort="Kamibayashi, Kiyotaka" uniqKey="Kamibayashi K" first="Kiyotaka" last="Kamibayashi">Kiyotaka Kamibayashi</name><affiliation wicri:level="1"><nlm:aff id="I1">Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author><author><name sortKey="Nakata, Yoshio" sort="Nakata, Yoshio" uniqKey="Nakata Y" first="Yoshio" last="Nakata">Yoshio Nakata</name><affiliation wicri:level="1"><nlm:aff id="I2">Faculty of Medicine, University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Faculty of Medicine, University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Tsukuba Critical Path Research and Education Integrated Leading Center (CREIL), University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Tsukuba Critical Path Research and Education Integrated Leading Center (CREIL), University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author><author><name sortKey="Yamawaki, Kanako" sort="Yamawaki, Kanako" uniqKey="Yamawaki K" first="Kanako" last="Yamawaki">Kanako Yamawaki</name><affiliation wicri:level="1"><nlm:aff id="I4">Center for Cybernics Research (CCR), University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Center for Cybernics Research (CCR), University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author><author><name sortKey="Ariyasu, Ryohei" sort="Ariyasu, Ryohei" uniqKey="Ariyasu R" first="Ryohei" last="Ariyasu">Ryohei Ariyasu</name><affiliation wicri:level="1"><nlm:aff id="I4">Center for Cybernics Research (CCR), University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Center for Cybernics Research (CCR), University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author><author><name sortKey="Sankai, Yoshiyuki" sort="Sankai, Yoshiyuki" uniqKey="Sankai Y" first="Yoshiyuki" last="Sankai">Yoshiyuki Sankai</name><affiliation wicri:level="1"><nlm:aff id="I1">Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Center for Cybernics Research (CCR), University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Center for Cybernics Research (CCR), University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author><author><name sortKey="Sakane, Masataka" sort="Sakane, Masataka" uniqKey="Sakane M" first="Masataka" last="Sakane">Masataka Sakane</name><affiliation wicri:level="1"><nlm:aff id="I2">Faculty of Medicine, University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Faculty of Medicine, University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Tsukuba Critical Path Research and Education Integrated Leading Center (CREIL), University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Tsukuba Critical Path Research and Education Integrated Leading Center (CREIL), University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author><author><name sortKey="Eguchi, Kiyoshi" sort="Eguchi, Kiyoshi" uniqKey="Eguchi K" first="Kiyoshi" last="Eguchi">Kiyoshi Eguchi</name><affiliation wicri:level="1"><nlm:aff id="I2">Faculty of Medicine, University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Faculty of Medicine, University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author><author><name sortKey="Ochiai, Naoyuki" sort="Ochiai, Naoyuki" uniqKey="Ochiai N" first="Naoyuki" last="Ochiai">Naoyuki Ochiai</name><affiliation wicri:level="1"><nlm:aff id="I2">Faculty of Medicine, University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Faculty of Medicine, University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Tsukuba Critical Path Research and Education Integrated Leading Center (CREIL), University of Tsukuba, Ibaraki, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Tsukuba Critical Path Research and Education Integrated Leading Center (CREIL), University of Tsukuba, Ibaraki</wicri:regionArea><wicri:noRegion>Ibaraki</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Neurology</title><idno type="eISSN">1471-2377</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Locomotor training using robots is increasingly being used for rehabilitation to reduce manpower and the heavy burden on therapists, and the effectiveness of such techniques has been investigated. The robot suit Hybrid Assistive Limb (HAL) has been developed to rehabilitate or support motor function in people with disabilities. The HAL provides motion support that is tailored to the wearer’s voluntary drive. We performed a pilot clinical trial to investigate the feasibility of locomotor training using the HAL in chronic stroke patients, and to examine differences between two functional ambulation subgroups.</p></sec><sec><title>Methods</title><p>Sixteen stroke patients in the chronic stage participated in this study. All patients were trained with the HAL over 16 sessions (20–30 min/day within 2 days/week). Primary outcomes were walking speed, cadence, and number of steps recorded during a 10-meter walk test (10MWT). Berg balance scale (BBS) and timed up and go (TUG) were also measured. All outcome measures were evaluated without wearing HAL assistance before and after the intervention in all patients as well as in the dependent ambulatory and independent ambulatory subgroups.</p></sec><sec><title>Results</title><p>All participants completed the intervention with no adverse events. Gait speed, cadence, number of steps during the 10MWT, and BBS increased significantly from 0.41 m/s to 0.45 m/s (P = 0.031), from 68.6 steps/min to 72.0 steps/min (P = 0.020), from 37.5 steps to 33.1 steps (P = 0.017), and from 40.6 to 45.4 (P = 0.004) respectively. The TUG test score improved, although this difference was not statistically significant. The findings in the dependent ambulatory subgroup primarily contributed to the significant differences observed in the group as a whole.</p></sec><sec><title>Conclusions</title><p>This pilot study showed that locomotor training using the HAL is feasible for chronic stroke patients. Randomized controlled trials are now required to demonstrate the effectiveness of HAL-based rehabilitation over conventional therapies.</p></sec><sec><title>Trial registration</title><p><ext-link ext-link-type="uri" xlink:href="https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000003582&language=E">UMIN000002969</ext-link></p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Duncan, Pw" uniqKey="Duncan P">PW Duncan</name></author><author><name sortKey="Zorowitz, R" uniqKey="Zorowitz R">R Zorowitz</name></author><author><name sortKey="Bates, B" uniqKey="Bates B">B Bates</name></author><author><name sortKey="Choi, Jy" uniqKey="Choi J">JY Choi</name></author><author><name sortKey="Glasberg, Jj" uniqKey="Glasberg J">JJ Glasberg</name></author><author><name sortKey="Graham, Gd" uniqKey="Graham G">GD Graham</name></author><author><name sortKey="Katz, Rc" 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Horno, S" uniqKey="Mena Del Horno S">S Mena-del Horno</name></author><author><name sortKey="Bermejo Bosch, I" uniqKey="Bermejo Bosch I">I Bermejo-Bosch</name></author><author><name sortKey="Moreno, Jc" uniqKey="Moreno J">JC Moreno</name></author><author><name sortKey="Pons, Jl" uniqKey="Pons J">JL Pons</name></author><author><name sortKey="Farina, D" uniqKey="Farina D">D Farina</name></author><author><name sortKey="Iosa, M" uniqKey="Iosa M">M Iosa</name></author><author><name sortKey="Molinari, M" uniqKey="Molinari M">M Molinari</name></author><author><name sortKey="Tamburella, F" uniqKey="Tamburella F">F Tamburella</name></author><author><name sortKey="Ramos, A" uniqKey="Ramos A">A Ramos</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Krakauer, Jw" uniqKey="Krakauer J">JW Krakauer</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Kawamoto, Hiroaki" sort="Kawamoto, Hiroaki" uniqKey="Kawamoto H" first="Hiroaki" last="Kawamoto">Hiroaki Kawamoto</name></noRegion><name sortKey="Ariyasu, Ryohei" sort="Ariyasu, Ryohei" uniqKey="Ariyasu R" first="Ryohei" last="Ariyasu">Ryohei Ariyasu</name><name sortKey="Eguchi, Kiyoshi" sort="Eguchi, Kiyoshi" uniqKey="Eguchi K" first="Kiyoshi" last="Eguchi">Kiyoshi Eguchi</name><name sortKey="Kamibayashi, Kiyotaka" sort="Kamibayashi, Kiyotaka" uniqKey="Kamibayashi K" first="Kiyotaka" last="Kamibayashi">Kiyotaka Kamibayashi</name><name sortKey="Nakata, Yoshio" sort="Nakata, Yoshio" uniqKey="Nakata Y" first="Yoshio" last="Nakata">Yoshio Nakata</name><name sortKey="Nakata, Yoshio" sort="Nakata, Yoshio" uniqKey="Nakata Y" first="Yoshio" last="Nakata">Yoshio Nakata</name><name sortKey="Ochiai, Naoyuki" sort="Ochiai, Naoyuki" uniqKey="Ochiai N" first="Naoyuki" last="Ochiai">Naoyuki Ochiai</name><name sortKey="Ochiai, Naoyuki" sort="Ochiai, Naoyuki" uniqKey="Ochiai N" first="Naoyuki" last="Ochiai">Naoyuki Ochiai</name><name sortKey="Sakane, Masataka" sort="Sakane, Masataka" uniqKey="Sakane M" first="Masataka" last="Sakane">Masataka Sakane</name><name sortKey="Sakane, Masataka" sort="Sakane, Masataka" uniqKey="Sakane M" first="Masataka" last="Sakane">Masataka Sakane</name><name sortKey="Sankai, Yoshiyuki" sort="Sankai, Yoshiyuki" uniqKey="Sankai Y" first="Yoshiyuki" last="Sankai">Yoshiyuki Sankai</name><name sortKey="Sankai, Yoshiyuki" sort="Sankai, Yoshiyuki" uniqKey="Sankai Y" first="Yoshiyuki" last="Sankai">Yoshiyuki Sankai</name><name sortKey="Yamawaki, Kanako" sort="Yamawaki, Kanako" uniqKey="Yamawaki K" first="Kanako" last="Yamawaki">Kanako Yamawaki</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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