Robot assisted rehabilitation ameliorates gait ability in amyotrophic lateral sclerosis patients

Research Objectives: To investigate the effects of Hybrid Assistive Limb (HAL) in amyotrophic lateral sclerosis (ALS) patients. Rehabilitation plays an important role in ALS patients helping them enjoy a fulfilling life despite the shortened lifespan (1). HAL is a cyborg-type robot that supports gait training. Although its effect has been reported (2) (3) (4), the effect among ALS patients is not sufficiently investigated (5).

Design: A single center, baseline controlled observational study.

Setting: Toho University Faculty of Medicine, Japan.

Participants: Eleven ALS patients with an unsteady gait with the ability to walk more than 10 m with assistance from a caregiver and/or a walker.

Interventions: HAL therapy was done once per day for 9-10 days for at least 4weeks. The period between courses were at least two months, and patients underwent conventional rehabilitation during this period.

Main Outcome Measures: The 2-minute walk test (2MWT), and the10-meter walk test (10MWT) without the use of HAL. ALS Functional Rating Score Revised (ALSFRS-R) and %Forced vital capacity (%FVC) were also evaluated.

Results: Eleven underwent 1 course, and three underwent 3 courses of therapy. Paired t-test was used for the results of 1 course, and a multiple regression analysis was performed for the results of 3 courses. After 1 course of therapy, the 2MWT mean gait distance improved from 73.87m (36.65) at baseline to 89.9m(36.69) (p=0.004). The 10MWT also showed improvement in cadence (steps/sec) from 1.71 (0.50) at baseline to 1.81 (0.50) after 1 course. Following the 3 courses, the 2MWT distance showed a tendency of being maintained. Cadence improved by 1.30 (95% confidence interval, 0.17-2.42; p=0.02). ALSFRS-R and %FVC tended to be maintained throughout the courses.

Conclusions: HAL therapy was suggested to be effective in ameliorating and preserving gait ability in ALS patients.

Author(s) Disclosures: The author has no conflict of interest.