Effect of gait training using Hybrid Assistive Limb on gait ability and the risk for overwork weakness in the lower limb muscles in patients with neuromuscular disease: a proof-of-concept study

Abstract

BACKGROUND: Few previous studies have reported the efficacy of robot rehabilitation for improving gait ability or its adverse events in patients with neuromuscular diseases. AIM: The aim of the present study was to elucidate the effects of gait training with a hybrid assistive limb (HAL) on gait ability and to investigate serum enzyme levels associated with skeletal muscle damage. DESIGN: Proof-of-concept study. SETTING: Department of rehabilitation medicine in university hospital. POPULATION: Twenty-one patients with neuromuscular disease (NMD, 13 males and 8 females, mean age of 60.6 years). METHODS: All patients underwent 1 to 5 series of gait rehabilitation which consisted of 9 sessions of HAL training. Gait ability was assessed with the 10-meter walk test and the 2-min walk test before and after HAL training, while serum creatine phosphokinase, aspartate aminotransferase, and lactic acid dehydrogenase values were measured before, midway through, and after HAL training. RESULTS: Gait velocity and step length for 10-meter walk test, and 2-min walk distance were significantly improved after HAL gait training. There was no significant change in serum level of all 3 measured enzymes between the three time points. CONCLUSIONS: HAL gait training with the practical setting as this study improved gait ability in patients with progressive NMD and did not damage skeletal muscle, as indicated by no significant change in serum level of muscle enzymes. CLINICAL REHABILITATION IMPACT: Robot assisted gait training could be safely applied to the patients with NMD, as one of the effective rehabilitation programs to improve gait ability.