Abstract
BackgroundThe Hybrid Assistive Limb (HAL®) is an exoskeleton wearable robot suit that assists in voluntary control of knee and hip joint motion. There have been several studies on HAL intervention effects in stroke, spinal cord injury, and cerebral palsy. However, no study has investigated HAL intervention for patients with cerebral palsy after surgery.Case presentationWe report a case of using HAL in a postoperative patient with cerebral palsy. A 15-year-old boy was diagnosed with spastic diplegia cerebral palsy Gross Motor Function Classification System level IV, with knee flection contracture, equinus foot, and paralysis of the right upper extremity with adduction contracture. He underwent tendon lengthening of the bilateral hamstrings and Achilles tendons. Although the flexion contractures of the bilateral knees and equinus foot improved, muscle strength decreased after the soft tissue surgery. HAL intervention was performed twice during postoperative months 10 and 11. Walking speed, stride, and cadence were increased after HAL intervention. Post HAL intervention, extension angles of the knee in stance phase and hip in the pre-swing phase were improved. In the gait cycle, the proportion of terminal stance in the stance and swing phase was increased.ConclusionsHybrid Assistive Limb intervention for postoperative patients with cerebral palsy whose muscle strength decreases can enhance improvement in walking ability. Further studies are needed to examine the safety and potential application of HAL in this setting.
Highlights
The Hybrid Assistive Limb (HAL®) is a wearable robot suit that assists in voluntary control of knee and hip joint motion [1]
We report a case of HAL intervention in a patient with cerebral palsy after tendon lengthening surgery of the bilateral hamstrings and Achilles tendons
After the first HAL intervention, speed, length of stride for walking, and cadence increased on the 10 m-walk test in the pre-second HAL intervention
Summary
The Hybrid Assistive Limb (HAL®) is an exoskeleton wearable robot suit that assists in voluntary control of knee and hip joint motion. Conclusions: Hybrid Assistive Limb intervention for postoperative patients with cerebral palsy whose muscle strength decreases can enhance improvement in walking ability. HAL intervention with a CVC system can potentially improve walking ability due to enhanced range of movement, muscle strength, and feedback within the neurological system throughout the gait cycle. Patients with cerebral palsy and abnormal gait may be able to learn a more normal walking pattern with HAL intervention.
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